MS Patients with Social Support Slept Better During Pandemic: Study

Greater feelings of social support predicted better sleep quality in people with multiple sclerosis (MS) during the COVID-19 pandemic, a study shows.

Specifically, greater help with daily tasks and more leisure activities with others were the types of social support identified, after adjusting for potential influencing factors, as predicting better sleep in this patient population.

“I think this study shows that we really need to make more time and space for social interactions, because they have such an impact on our sleep quality,” Taylor Harris, a doctoral student at the University of Kansas and the study’s first author, said in a university press release.

“This is especially true for people with MS who may face additional hurdles for social interactions amid a global pandemic,” Harris added.

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The study, “Social support predicts sleep quality in people with multiple sclerosis during the COVID-19 pandemic,” was published in the journal Multiple Sclerosis and Related Disorders.

Poor sleep quality is a prominent symptom of MS, affecting up to 70% of patients. This can have a significant influence on other MS symptoms, cognitive function, mental health, and quality of life.

Social support, or the experience of being cared for emotionally and physically by another person, has been shown to improve mental health and sleep quality in the general population.

However, measures such as stay-at-home orders and social distancing aimed at preventing the spread of COVID-19 have markedly restricted social activities and in-person contact throughout the pandemic.

Connection between social support and better sleep

Now, Harris and colleagues at the University of Kansas and the University of Kansas Medical Center wondered whether such changes in social interaction influenced sleep quality in MS patients.

“People with MS have additional needs, and the pandemic affected social life for all of us,” Harris said, adding, “We were curious to assess if their social interactions had an impact on their sleep.”

The team surveyed 163 adults with MS from February to May 2021 about their sleep quality and social support during the pandemic. Most participants were female (70.6%) and had relapsing-remitting MS (79.8%), generally characterized by periods of relapses, followed by periods of remissions.

More than two-thirds (67%) were considered poor sleepers, scoring above a 5 in the Pittsburgh Sleep Quality Index (PSQI) questionnaire. On this assessment, scores range from 0 to 21, with higher values indicating worse sleep quality.

Social support was assessed with the patient-reported MS Social Support (MSSS) questionnaire. It covers four areas or domains: emotional/informational support, including emotional and conversational intimacy; affectionate support, covering physical touch and expression; tangible support, related to help with daily tasks; and positive social interaction support, which includes leisure activities with others.

Results showed that patient-reported social support was a significant predictor of the PSQI scores, “with higher feelings of being socially supported associated with better sleep quality,” the researchers wrote.

For the study, the team took into account potential influencing factors such as age, education level, disability status, and anxiety and depression. After adjusting for those factors, two types of social support — help with daily tasks, and leisure activities with others — remained significant predictors of better sleep quality.

No significant links were detected for emotional and conversational intimacy or physical touch and expression.

While anxiety and depression levels were found to be significant predictors of sleep quality, consistent with previous studies, the researchers here found that these factors do not weaken the link between social support and sleep quality.

Indeed, according to Harris, these findings demonstrate that “social support can really serve as that protective factor,” highlighting the “importance of what types of support we can form socially.” 

The researchers acknowledged that the COVID-19 pandemic was adding a new level of challenge for MS patients and caregivers in managing daily activities, including sleep, and disease symptoms. They encouraged patients to expand their MS toolbox.

“While engaging in these types of activities could be challenging amid an infection disease outbreak, current technologies allow us to safety interact with others virtually,” the team wrote.

“Coordinating online game nights or hosting group video streaming events are just a few of the many ways to promote positive social interactions while practicing social distancing,” they added.

Given that better sleep quality is linked to improved physical health and cognitive function, “preserving and promoting sleep in this population is crucial,” the researchers wrote.

The team noted that future studies should aim to examine the effects of social interaction on sleep over the long term, and accounting for other factors, like social class, economic status, and cultural identity — which may affect the link between social support and sleep.