title: Sleep disturbances in multiple sclerosis.
abstract: OBJECTIVE
  The frequency of sleep disturbances in multiple sclerosis (MS), and their impact on the quality of life of MS patients, have traditionally been underestimated. Here we review the most common sleep disorders seen in this disease, their prevalence, pathophysiology, clinical manifestations and current treatments.
  
  
  METHODS
  We begin with a brief description of epidemiological data on sleep disturbances in MS, explain how these disturbances increase potential associated morbidities, and discuss the bidirectional relationship established between these two comorbid conditions (i.e. MS worsens sleep disturbances and vice versa). We then analyze the main dyssomnias and parasomnias described in MS: insomnia, circadian rhythm disorders, drug-induced sleep disturbances, restless legs syndrome (RLS) and periodic leg movements (PLM), respiratory disorders during sleep, narcolepsy-cataplexy syndrome and REM sleep behavior disorder (RBD). We also review the relationship between sleep disturbances and chronic fatigue syndrome, which is very frequent in MS patients.
  
  
  CONCLUSIONS
  Sleep disturbances are more common in MS patients than in the general population and limit these patients' quality of life. Therefore, we believe that these disturbances should be a focal point in any multidisciplinary treatment for MS.
authors.affiliation: Multiple Sclerosis Unit, Department of Neurology, Complejo Asistencial de Ávila, Spain. acaminero@saludcastillayleon.es
authors.forename: Ana
authors.initials: A
authors.lastname: Caminero
authors.forename: Manuel
authors.initials: M
authors.lastname: Bartolomé
mesh_terms: D006801:Humans; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D009290:Narcolepsy / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D017286:Polysomnography / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D020187:REM Sleep Behavior Disorder / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012148:Restless Legs Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology