title: Sleep disturbance and fatigue in mild relapsing remitting multiple sclerosis patients on chronic immunomodulant therapy: an actigraphic study.
abstract: BACKGROUND
  Poor sleep is common in MS and it contributes to fatigue. The beta interferons produce systemic effects which may not adapt and may induce fatigue.
  
  
  OBJECTIVE
  To verify whether subjective poor sleep and fatigue during chronic therapy correspond to reduced sleep efficiency obtained by actigraphy at home.
  
  
  METHODS
  42 ambulatory relapsing remitting MS patients with mild disability were monitored for at least 7 nights. Habitual sleep quality and fatigue were assessed with the MOS sleep measure and the Fatigue Severity Scale. Sleep logs provided daily sleep quality assessments during actigraphy at home. Patients were grouped according to their current treatment: no therapy, glatiramer acetate, IFNbeta 3 times a week, and IFNbeta once a week.
  
  
  CONCLUSIONS
  Sleep efficiency was reduced by an average of 5% in 2/3 of the nights following IFNbeta injections compared to the other nights, and daily sleep ratings correlated with actigraphy. Patients on glatiramer acetate also showed a lower sleep efficiency than patients without therapy. Actigraphy data were only modestly correlated with MOSsm scores, not with fatigue. Long term adaptation of sleep effects of immunomodulant agents is incomplete and needs to be considered in treatment planning and assessment of sleep in MS.
authors.affiliation: Multiple Sclerosis Rehabilitation Unit, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Mendozzi
authors.forename: Federica
authors.initials: F
authors.lastname: Tronci
authors.forename: Massimo
authors.initials: M
authors.lastname: Garegnani
authors.forename: Luigi
authors.initials: L
authors.lastname: Pugnetti
mesh_terms: D056044:Actigraphy; D000328:Adult; D004185:Disability Evaluation; D004334:Drug Administration Schedule; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects*; D016899:Interferon-beta / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012890:Sleep / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta