title: Examining sleep, fatigue, and daytime sleepiness in pediatric multiple sclerosis patients.
abstract: BACKGROUND
  About 2-5% of patients with multiple sclerosis (MS) experience their first symptoms before age 18. Sleep disorders occur frequently in MS. The prevalence of sleep problems and their impact on fatigue and daytime sleepiness in pediatric MS is unknown.
  
  
  OBJECTIVE
  To determine whether pediatric MS patients have more sleep disturbances, fatigue, and daytime sleepiness compared with an age-, sex-, and race-matched control group.
  
  
  METHODS
  Patients and age-, sex-, and race-matched controls were surveyed to quantify daytime sleepiness via the modified Epworth Sleepiness Scale, sleep quality and hygiene through the Adolescent Sleep Wake and Hygiene Scale, respectively, and fatigue using the PediatricQL Multidimensional Fatigue Scale.
  
  
  RESULTS
  Pediatric MS patients (n = 30) and age-, sex-, and race-matched controls (n = 52) had similar levels of fatigue; however, when compared with previously published historical controls, both groups reported worse fatigue across all dimensions (p < 0.05). Pediatric MS patients also had similar sleep quality compared with the matched controls, but reported better sleep hygiene on the 'sleep stability' dimension (p < 0.05). In addition, pediatric MS patients had less daytime sleepiness than the matched controls (p < 0.05).
  
  
  CONCLUSIONS
  Although patients with MS reported similar levels of fatigue, they have better sleep hygiene, which could possibly account for the decreased amount of excessive daytime sleepiness. Also, when compared with historical controls, the MS and control samples reported more fatigue. Thus, caution must be taken when using published control data, especially when not properly matched.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA. abz8578@uab.edu
authors.forename: Abu-Bakar
authors.initials: AB
authors.lastname: Zafar
authors.forename: Jayne
authors.initials: J
authors.lastname: Ness
authors.forename: Sarah
authors.initials: S
authors.lastname: Dowdy
authors.forename: Kristin
authors.initials: K
authors.lastname: Avis
authors.forename: Khurram
authors.initials: K
authors.lastname: Bashir
mesh_terms: D000293:Adolescent; D002648:Child; D005221:Fatigue / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications*; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires