Tired all the time: Could undiagnosed sleep problems be making MS patients' fatigue worse?

PUBLIC RELEASE DATE:

14-Feb-2014

Contact: Kara Gavin kegavin@umich.edu 734-764-2220 University of Michigan Health System

ANN ARBOR, Mich. People with multiple sclerosis (MS) might assume that the fatigue they often feel just comes with the territory of their chronic neurological condition.

But a new University of Michigan study suggests that a large proportion of MS patients may have an undiagnosed sleep disorder that is also known to cause fatigue. And that disorder obstructive sleep apnea is a treatable condition.

In the latest issue of the Journal of Clinical Sleep Medicine, researchers from the U-M Health System's Sleep Disorders Center report the results of a study involving 195 patients of the U-M Multiple Sclerosis Center.

In all, 56 percent of the MS patients were found to be at increased risk for obstructive sleep apnea, based on a method of screening for the condition known as the STOP-Bang questionnaire. But most had never received a formal diagnosis of sleep apnea, and less than half of those who had been told they had sleep apnea were using the standard treatment for it.

The authors also found that patients who were more fatigued were more likely to also be at elevated risk for sleep apnea even after taking into account other factors that might have contributed to feelings of fatigue, such as age, gender, body mass index (BMI), sleep duration, depression, and other nighttime symptoms.

The research is based on patients' answers from a sleep questionnaire designed by the authors, and four validated instruments designed to assess daytime sleepiness, fatigue severity, insomnia severity and obstructive sleep apnea risk. Medical records also were accessed with patients' permission, to examine clinical characteristics that may predict fatigue or obstructive sleep apnea risk.

"We were particularly surprised by the difference between the proportion of patients who carried an established diagnosis of obstructive sleep apnea 21 percent -- and the proportion at risk for obstructive sleep apnea based on their STOP-Bang scores, which was 56 percent," says the study's lead author, Tiffany Braley, M.D., M.S. "These findings suggest that OSA may be a highly prevalent and yet under-recognized contributor to fatigue in persons with MS."

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Tired all the time: Could undiagnosed sleep problems be making MS patients' fatigue worse?