Dataset Information

Disease associations of excessive daytime sleepiness in multiple sclerosis: A prospective study.

ABSTRACT:

Background

Excessive daytime sleepiness (EDS) in multiple sclerosis (MS) can be a significant source of disability. Despite this, its prevalence as a patient-reported outcome in this condition has not been well established, and its causes are not well understood.

Methods

We prospectively assessed EDS as part of an observational study for patients referred for diagnostic neuro-ophthalmological testing. EDS was evaluated by the Epworth Sleepiness Scale (ESS), and visual data were also collected as part of a research protocol. Analysis with patient data was performed following the exclusion of patients with known primary sleep disorders.

Results

A total of 69 patients with MS were included in the analysis. The mean ESS was 6.5 with a SD of 4.3. ESS ≥ 10 was present in 23% of the cohort even in the presence of minimal mean neurological disability (Patient Determined Disease Steps (PDDS) = 1.5). The ESS score was not associated with age, sex, disease-related disability, retinal nerve fiber layer (RNFL), or optic neuritis (ON), but displayed an association with visual dysfunction.

Conclusions

There is an increased prevalence of EDS in MS. The increased values of the ESS are not explained by other sleep disorders, suggesting separate mechanisms. Further study of the underlying mechanisms is warranted.

SUBMITTER: Sguigna PV

PROVIDER: S-EPMC10017949 | biostudies-literature | 2023 Jan-Mar

REPOSITORIES: biostudies-literature

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Publications

Disease associations of excessive daytime sleepiness in multiple sclerosis: A prospective study.

Sguigna Peter V PV Toranian Sabeen S Tardo Lauren M LM Blackburn Kyle M KM Horton Lindsay A LA Conger Darrel D Meltzer Ethan E Hogan R Nick RN McCreary Morgan C MC Zee Phyllis C PC Takahashi Joseph S JS Greenberg Benjamin M BM

Multiple sclerosis journal - experimental, translational and clinical 20230101 1

<h4>Background</h4>Excessive daytime sleepiness (EDS) in multiple sclerosis (MS) can be a significant source of disability. Despite this, its prevalence as a patient-reported outcome in this condition has not been well established, and its causes are not well understood.<h4>Methods</h4>We prospectively assessed EDS as part of an observational study for patients referred for diagnostic neuro-ophthalmological testing. EDS was evaluated by the Epworth Sleepiness Scale (ESS), and visual data were al ...[more]

PMID: 36936446

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Project description:Objectives: Excessive daytime sleepiness (EDS) in multiple system atrophy (MSA) has received scant attention in the literature, thus the present cross-sectional study aimed to investigate the prevalence of EDS and its potential risk factors among Chinese patients with MSA. Methods: A total of 66 patients with MSA (60.6% males) were consecutively recruited. Eighteen patients (27.3%, 13 men) with Epworth Sleepiness Scale score >10 were defined as having EDS. Demographic, motor [Unified Multiple-System Atrophy (UMSARS)] and non-motor symptoms [Non-Motor Symptoms Scale (NMSS)], and sleep parameters [polysomnography (PSG)] were compared between patients with MSA with and without EDS. A logistic regression analysis was used to calculate the risk factors of EDS in patients with MSA. Results: There were no significant differences in age, sex, MSA onset age, disease duration, MSA sub-type, and motor symptom severity between MSA patients with and without EDS. However, compared with the MSA patients without EDS, their counterparts with EDS had higher scores of NMSS (65.3 ± 23.1 vs. 43.4 ± 25.3, P = .0002), Hamilton Anxiety (HAMA) [15.3 (10.3-20.0) vs. 9.5 (3.0-15.0), P = 0.006], Hamilton Depression (HAMD) [13.7 (12.5-17.8) vs. 9.0 (4.0-13.0), P = 0.015], and Fatigue Severity Scale (FSS) [29.8 (17.3-47.8) vs. 18.7 (10.3-21.8), P = 0.040]. Conversely, the patients with EDS had lower score of Mini-Mental State Examination (MMSE) [23.3 (20.3-27.0) vs. 25.7 (22.0-29.0), P = 0.023]. Similarly, there was a significantly lower percentage of N3 sleep (%) [0.3 (0-0) vs. 2.0 (0-0), P = 0.007] and a higher apnea-hypopnea index (AHI/h) [30.5 (14.5-47.8) vs. 19.3 (5.0-28.7), P = 0.034] in patients with EDS. After adjusting for age, sex, disease duration, MSA sub-type, and UMSARS score, the odds ratio (OR) (95% CI) of EDS was higher while increasing scores in FSS [1.06 (1.02-1.11)], HAMA [1.16 (1.04-1.28)], HAMD [1.13 (1.02-1.25)], NMSS [1.04 (1.01-1.07)], and AHI [1.03 (1.00-1.10)]. The OR of EDS was lower while the MMSE score was increasing [0.85 (0.72-1.00)]. Conclusions: The presence and severity of EDS may be significantly associated with the non-motor dysfunction, including fatigue, anxiety, depression, cognitive dysfunction, and sleep-related breathing disorder, but not with the motor dysfunction in MSA.

Dataset Information

Disease associations of excessive daytime sleepiness in multiple sclerosis: A prospective study.

Background

Methods

Results

Conclusions

Publications

Disease associations of excessive daytime sleepiness in multiple sclerosis: A prospective study.

Similar Datasets

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