DA Trojan

McGill University Health Centre

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Marta Kamińska

McGill University Health Centre

R. John Kimoff

McGill University Health Centre

Ann Robinson

McGill University Health Centre

Andrea Benedetti

McGill University Health Centre

Yves Lapierre

McGill University Health Centre

Kevin Schwartzman

McGill University Health Centre

Amit Bar‐Or

University of Pennsylvania

D Weiss

University of Miami

M Cardoso

Universidade da Região de Joinville

Deborah Da Costa

McGill University

Cooperative Institutions

McGill University Health Centre

McGill University

Montreal Neurological Institute and Hospital

Centre for Health Evaluation and Outcome Sciences

Nunavik Regional Board of Health and Social Services

Johns Hopkins University

University College London

University of British Columbia

Simon Fraser University

Université Laval

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Impact of sleep disorder treatment on fatigue in multiple sclerosis

Multiple Sclerosis Journal (2012)

Isabelle Côté DA Trojan Marta Kamińska M Cardoso Andrea Benedetti

Background: We recently reported that sleep disorders are significantly associated with fatigue in multiple sclerosis (MS). Objective: The objective of this paper is to assess the effects of sleep disorder treatment on fatigue and related clinical outcomes in MS. Methods: This was a controlled, non-randomized clinical treatment study. Sixty-two MS patients completed standardized questionnaires including the Fatigue Severity Scale (FSS), Multidimensional Fatigue Inventory (MFI), Epworth Sleepiness scale (ESS) and Pittsburgh Sleep Quality Index (PSQI), and underwent polysomnography (PSG). Patients with sleep disorders were offered standard treatment. Fifty-six subjects repeated the questionnaires after ≥ three months, and were assigned to one of three groups: sleep disorders that were treated (SD-Tx, n=21), sleep disorders remaining untreated (SD-NonTx, n=18) and no sleep disorder (NoSD, n=17). Results: FSS and MFI general and mental fatigue scores improved significantly from baseline to follow-up in SD-Tx ( p <0.03), but not SD-NonTx or NoSD subjects. ESS and PSQI scores also improved significantly in SD-Tx subjects ( p <0.001). Adjusted multivariate analyses confirmed significant effects of sleep disorder treatment on FSS (-0.87, p = 0.005), MFI general fatigue score ( p = 0.034), ESS (p = 0.042) and PSQI (p = 0.023). Conclusion: Treatment of sleep disorders can improve fatigue and other clinical outcomes in MS.

Epworth Sleepiness Scale

Sleep

10.1177/1352458512455958

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Citations (82)

Sleep disorders and fatigue in multiple sclerosis: Evidence for association and interaction

Journal of the Neurological Sciences (2011)

Marta Kamińska R. John Kimoff Kevin Schwartzman DA Trojan

Sleep

10.1016/j.jns.2010.12.008

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Citations (94)

Reply: ‘Obstructive sleep apnea is associated with fatigue in multiple sclerosis’ by Kaminska et al.

Multiple Sclerosis Journal (2012)

Marta Kamińska R. John Kimoff DA Trojan

Sleep

10.1177/1352458512446038

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Citations (4)

Evaluating and Treating Symptomatic Postpolio Patients

Elsevier eBooks (2004)

DA Trojan

10.1016/b978-1-56053-606-2.50006-8

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Citations (2)

Obstructive sleep apnea is associated with fatigue in multiple sclerosis

Multiple Sclerosis Journal (2011)

Marta Kamińska R. John Kimoff Andrea Benedetti Ann Robinson Amit Bar‐Or

Background: Multiple sclerosis (MS) patients often suffer from fatigue. Objective: We evaluated the relationship of obstructive sleep apnea (OSA) to fatigue and sleepiness in MS patients. Methods: Ambulatory MS patients without known sleep disorders and healthy controls underwent diagnostic polysomnography and a multiple sleep latency test (objective sleepiness measure). Fatigue was measured with the Fatigue Severity Scale (FSS) and the Multidimensional Fatigue Inventory (MFI), and subjective sleepiness by Epworth Sleepiness Scale. Covariates included age, sex, body mass index, Expanded Disability Status Scale (EDSS), depression, pain, nocturia, restless legs syndrome, and medication. Results: OSA (apnea–hypopnea index ≥15) was found in 36 of 62 MS subjects and 15 of 32 controls. After adjusting for confounders, severe fatigue (FSS ≥5) and MFI-mental fatigue (>group median) were associated with OSA and respiratory-related arousals in MS, but not control subjects. Subjective and objective sleepiness were not related to OSA in either group. In a multivariate model, variables independently associated with severe fatigue in MS were severe OSA [OR 17.33, 95% CI 2.53–199.84], EDSS [OR 1.88, 95% CI 1.21–3.25], and immunomodulating treatment [OR 0.14, 95% CI 0.023–0.65]. Conclusions: OSA was frequent in MS and was associated with fatigue but not sleepiness, independent of MS-related disability and other covariates.

Epworth Sleepiness Scale

Depression

10.1177/1352458511432328

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Citations (136)

Sleep-Disordered Breathing (SDB) and Fatigue in Multiple Sclerosis (MS).

Marta Kamińska DA Trojan Deborah Da Costa Amit Bar‐Or Andrea Benedetti

Sleep-Disordered Breathing

Sleep

10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a2128

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Citations (0)