Sleep

[Petr75]

2020 May 18
Center of Affective, Stress and Sleep Disorders (ZASS), University of Basel, Psychiatric Clinic, Basel, Switzerland
Better Objective Sleep Was Associated With Better Subjective Sleep and Physical Activity; Results From an Exploratory Study Under Naturalistic Conditions Among Persons With Multiple Sclerosis
https://pubmed.ncbi.nlm.nih.gov/32443481/

Abstract

Persons with multiple sclerosis (PwMS) often complain about sleep problems. There is less known about objective sleep-electroencephalography (EEG) dimensions within naturalistic conditions (i.e., home and/or familiar setting). The present cross-sectional study examined the associations between objective and subjective sleep, depression, physical activity scores, and MS-related information among PwMS in their familiar setting. The sample consisted of 16 PwMS (mean age: 50.3 years; median Expanded Disability Status Scale (EDSS): 5.5) who completed questionnaires covering subjective sleep (symptoms of insomnia, restless legs syndrome (RLS) and sleep-disordered breathing), as well as daytime sleepiness, subjective physical activity, depression, and MS-related information (fatigue, EDSS; disease-modifying treatments). Objective sleep was assessed with a mobile sleep-EEG device under naturalist conditions within the home. Descriptively, better objective sleep patterns were associated with lower sleep complaints (rs = -0.51) and daytime sleepiness (rs = -0.43), and with lower symptoms of RLS (rs = -0.35), but not with sleep-disordered breathing (rs = -0.17). More deep sleep was associated with higher moderate physical activity levels (rs = 0.56). Objective sleep parameters were not associated with vigorous physical activity levels (rs < 0.25). Descriptively, moderate and vigorous physical activity scores were associated with lower symptoms of RLS (rs = -0.43 to -0.47). Results from this small study carried out under naturalistic conditions suggest that among PwMS, better objective sleep correlated with better subjective sleep and higher moderate physical activity levels.

[Petr75]

2020 Aug 1
School of Nursing, University at Buffalo
Improving Sleep among Adults with Multiple Sclerosis using Mindfulness plus Sleep Education
https://pubmed.ncbi.nlm.nih.gov/32744186/

Abstract

We explored the feasibility of a mindfulness plus sleep education intervention, SleepWell!, delivered via videoconference compared to onsite among adults with MS. A non-randomized wait-list control design was used. Participants wore actigraphy watches and kept sleep diaries for seven days pre- and post intervention. Questionnaires were completed pre-intervention, post-intervention, and three months post-intervention. One group was conducted onsite. Three groups participated via videoconference. Attrition among videoconference groups was 23% compared to 57% in the onsite group. Within group analysis showed moderate-to-large effect sizes on sleep efficiency (d=0.78) and total sleep time (d=0.54) in the videoconference groups. One-way repeated measures ANOVA post-hoc analysis suggested small-to-medium effect over three months on sleep quality (ηp2 =0.28), physical health quality of life (ηp2 =0.42), mental health quality of life (ηp2 =0.13), and mindfulness (ηp2 =0.29). Results indicate feasibility of providing our intervention via videoconferencing. Preliminary analysis suggests that SleepWell! improves sleep and mindfulness among adults with MS.

[Petr75]

2020 Nov 5
Department of Neurology, Beth Israel Deaconess Medical Center, Boston
Brainstem lesions are associated with sleep apnea in multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/33224518/

Abstract

Background: Studies linking MRI findings in MS patients with obstructive sleep apnea severity are limited.

Objective: We conducted a retrospective study to assess MRI abnormalities associated with obstructive sleep apnea (OSA) in patients with multiple sclerosis (MS).

Methods: We performed retrospective chart review of 65 patients with multiple sclerosis who had undergone polysomnography (PSG) for fatigue as well as brain MRI. We measured the number of lesions in the brainstem and calculated the standardized third ventricular width (sTVW) as a measure of brain atrophy, and subsequently performed correlation analyses of the apnea-hypopnea index (AHI) with brainstem lesion location, sTVW, and Expanded Disability Status Scale (EDSS).

Results: MS Patients with OSA were significantly older and had a higher body mass index (BMI) and higher AHI measures than patients without OSA. After adjustment for covariates, significant associations were found between AHI and lesion burden in the midbrain (p < 0.01) and pons (p = 0.05), but not medulla.

Conclusions: Midbrain and pontine lesions burden correlated with AHI, suggesting MS lesion location could contribute to development of OSA.

[Petr75]

2020 Oct
State Institution "Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine", Kharkiv; V. Karazin Kharkiv National University, Ukraine
ARCHITECTONICS OF THE NIGHT SLEEP BASED ON ITS POLYSOMNOGRAPHIC CHARACTERISTICS IN PATIENTS WITH MULTIPLE SCLEROSIS
https://pubmed.ncbi.nlm.nih.gov/33270592/


Abstract

Aim of our study is to establish polysomnographic characteristics of nocturnal sleep in various forms of multiple sclerosis. Fifty eight patients with different clinical course of multiple sclerosis (MS) were included into the study. Disturbances of sleep architectonics were identified: representation of deep stages of NREM sleep, as well as REM sleep were reduced. Maintenance and continuity of sleep and its architecture were affected, leading to reduced sleep efficacy. Destabilization of sleep phases can be explained by activation of desynchronizing brain systems, leading to poor organization of NREM and REM sleep. These disorders were especially pronounced in patients with progressive course of MS. Thus, abovementioned sleep disorders can have prognostic value for predicting clinical course severity in patients with MS. Management of sleep disorders can improve quality of live in people with MS.

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[Petr75]

2021 Feb 4
AP-HP, Pitié-Salpêtrière Hospital, Department of Neurology, Paris, France
Unexpected REM sleep excess associated with a pontine lesion in multiple sclerosis
https://pubmed.ncbi.nlm.nih.gov/33538688/

Abstract

Sleep disorders are prevalent in patients with multiple sclerosis. In contrast, a frank increase of REM sleep time is a rare phenomenon, mostly described in the context of REM sleep rebound (after sleep deprivation, abrupt withdrawal of antidepressants or neuroleptics, and during the first night of ventilation for severe sleep apnea), but not in link with specific brain lesions. We incidentally found an isolated, marked increase in REM sleep time (200 min, 40% of total sleep time, normative values: 18.2-20.3%) and in rapid eye movements density during REM sleep in a patient with a secondary progressive multiple sclerosis, associated with an anterior pontine demyelinating lesion on MRI. This result suggests that a network blocking REM sleep in the pons has been damaged.

[Petr75]

2021 Jul 16
Jordan University of Science and Technology, Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences, Irbid, Jordan
The Relationship between Sleep Quality, Sleep-Related Biomarkers and Motor Skill Acquisition in People with Multiple Sclerosis: A Pilot Study
https://pubmed.ncbi.nlm.nih.gov/34270772/

Abstract

Objective: Neurorehabilitation that involves learning new motor skills is one of the promising clinical methods for motor recovery in people with multiple sclerosis (PwMS); therefore, factors that influence the acquisition of motor skills in PwMS need to be investigated. Sleep disturbances are common in PwMS; however, no study has investigated the effect of sleep and sleep-related biomarkers on skill acquisition in PwMS. This study aimed to examine the effect of sleep and sleep-related biomarkers on motor acquisition in PwMS.

Methods: Forty participants with MS and 40 controls were recruited in this study. To assess motor acquisition, each participant was asked to perform a novel game through a virtual reality (VR) system 5 times (blocks). The main outcome measures for each block were the required time to complete the VR game and the recorded errors. The difference in scores between block 5 and block 1 for both outcomes was considered to represent motor skill acquisition. Sleep was assessed by self-report using the Pittsburgh Sleep Quality Index (PSQI) and objectively using sleep monitor technology. Serotonin level was assessed using means of enzyme-linked immunosorbent assay (ELISA) using plasma samples.

Results: There were significant positive correlations in both groups between motor skill acquisition and PSQI score. In PwMS, significant negative correlation between motor skill acquisition and sleep efficiency and significant positive correlation between motor skill acquisition and sleep latency were also observed. Interestingly, a significant negative correlation was observed between motor skill acquisition and the plasma serotonin level in both groups. Most of these correlations remained significant after controlling for disease severity, fatigue, baseline performance, and cognitive status.

Conclusions: Sleep quality may influence motor skill acquisition in PwMS. Circulatory serotonin level might explain this relationship.

Impact: Physical therapists are encouraged to be aware of sleep quality and sleep assessment. Sleep management strategies should be considered when treating PwMS.