The fatigue felt by so many people with multiple sclerosis was long thought to be a straight-forward consequence of the disease itself. Late-breaking research appearing in the Journal of Clinical Sleep Medicine seems to be changing the thinking on this topic. It now appears that, for at least some multiple sclerosis patients, fatigue points to undiagnosed sleep disorders.
There’s a lot of sleep trouble in those with multiple sclerosis. Of 2,375 surveys submitted by people with multiple sclerosis in this study, more than 60% reported an abnormal level of fatigue and 30% experienced excessive daytime sleepiness.
Based on survey questions, 38% of this group fit the diagnosis of having obstructive sleep apnea, 32% qualified as having moderate to severe insomnia, and 37% appeared to have restless legs syndrome. All told, more than seven in every ten patients fit the criteria for at least one sleep disorder. However, only a fraction of these people had been formally diagnosed with one of these conditions (4% with obstructive sleep apnea, 11% with insomnia, and 12% with restless legs syndrome). The men and women who reported abnormal fatigue levels and daytime sleepiness were more likely to also report symptoms matching obstructive sleep apnea, insomnia, and restless legs syndrome.
The seemingly huge percentage of people with multiple sclerosis who have an undiagnosed – and thus untreated – sleep disorder presents a serious and previously unrecognized problem. It may be possible that once the sleep disorders are properly treated, that quality of life can improve for many multiple sclerosis patients. Conversely, if allowed to continue untreated, sleep disorders could worsen the disease progression.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
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Brass SD, Li CS, Auerbach S. The underdiagnosis of sleep disorders in patients with multiple sclerosis. J Clin Sleep Med 2014;10(9):1025-31.