#CMSC16 – MS Care Should Include Fatigue, Sleep Quality and Inattentiveness Assessment, Study Shows

Margarida Azevedo, MSc avatar

by Margarida Azevedo, MSc |

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Mayis Al Dughmi, of the Physical Therapy and Rehabilitation Science at the University of Kansas Medical Center, recently presented her findings on the relationship between fatigue, measured using the Neurological Fatigue Index (NFI-MS), and sleep quality and attentiveness in patients with multiple sclerosis (MS).

The findings indicate that cognitive fatigue is associated with sleep problems and decreased sustained attention, which suggests that healthcare providers should take into account sleep quality and inattentiveness as part of the patients’ treatment plans.

The abstract, “Fatigue Measured Using the Neurological Fatigue Index Is Associated with Poor Sleep Quality and Inattentiveness in People with Multiple Sclerosis,” was recently presented at the 2016 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), in the Psychosocial: Cognition, Depression session.

Fatigue, one of the most common symptoms in MS, affects about 80% of patients according to the National Multiple Sclerosis Society. Cognitive fatigue can severely affect daily mental tasks, leading to serious disturbance in sustained attention. More than 50% of people living with MS report sleep disturbances. Both attention deficits and sleep disturbances greatly affect the patients’ quality of life.

The study aimed to determine the relationship between fatigue, measured using the Neurological Fatigue-MS (NFI-MS) index, and sleep quality and sustained attention. The NFI-MS assessment determine how sleep quality contributes to fatigue, and physical and cognitive components.

In total, 52 patients with relapsing-remitting or secondary progressive MS completed the NFI-MS to assess fatigue in the previous two weeks; the Pittsburgh Sleep Quality Index (PSQI) global score to evaluate sleep quality in the past month; and the Continuous Performance Test (CPT) to assess sustained attention.

Results indicated a significant association between the NFI-MS abnormal nocturnal sleep component and the PSQI global score, which translates into higher fatigue caused by abnormal sleep leading to poorer sleep quality. Higher cognitive fatigue was found to be associated with a slower reaction time, as there was a significant positive association between the NFI-MS cognitive component and the CPT measure of response speed.

The research team concluded in the abstract: “Cognitive fatigue is associated with decreased sustained attention. This is clinically important, as sustained attention is necessary for individuals to effectively perform continuous and repetitive activities, and being cognitively fatigued may affect the performance of these tasks. The finding that fatigue is associated with poor sleep quality emphasizes the need for healthcare providers to consider the assessment of sleep quality and possibly address sleep disturbances as part of the treatment plan.”

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