title: Polysomnographic measures of disturbed sleep are associated with reduced quality of life in multiple sclerosis.
abstract: BACKGROUND
  The relationship of objective sleep parameters with health-related quality of life (HRQoL) in multiple sclerosis (MS) has not been studied.
  
  
  OBJECTIVE
  To evaluate the relationship between polysomnographic (PSG) parameters and HRQoL in MS.
  
  
  METHODS
  Ambulatory MS patients without a known sleep disorder completed the Short Form (36) Health Survey (SF-36), pain visual analog scale, and two consecutive overnight PSGs. HRQoL was assessed using SF-36 Physical and Mental Component Summary (PCS, MCS) scores. Standard objective PSG measures of sleep quality were determined. The relationship between objective sleep parameters and HRQoL was evaluated with multivariate linear regression, adjusting for age, sex, body mass index, disability, and pain.
  
  
  RESULTS
  62 MS patients were included. PSG measures of sleep disruption including stage changes, awakenings, time in N1 sleep, and apnea-hypopnea and total arousal indices were negatively associated (p<0.05) with MCS scores (lower scores indicating poorer HRQoL). PSG parameters reflective of better sleep quality including total sleep time, sleep efficiency, and time in REM sleep were positively associated with MCS scores. PSG parameters were not significantly associated with PCS scores.
  
  
  CONCLUSIONS
  PSG-documented sleep disruption negatively impacts, while better objective sleep quality positively impacts on the mental domain of HRQoL in MS.
authors.affiliation: Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University Health Centre, 3801 University St., Montreal, Quebec, Canada. daria.trojan@mcgill.ca
authors.forename: Daria A
authors.initials: DA
authors.lastname: Trojan
authors.forename: Marta
authors.initials: M
authors.lastname: Kaminska
authors.forename: Amit
authors.initials: A
authors.lastname: Bar-Or
authors.forename: Andrea
authors.initials: A
authors.lastname: Benedetti
authors.forename: Yves
authors.initials: Y
authors.lastname: Lapierre
authors.forename: Deborah
authors.initials: D
authors.lastname: Da Costa
authors.forename: Ann
authors.initials: A
authors.lastname: Robinson
authors.forename: Mauro
authors.initials: M
authors.lastname: Cardoso
authors.forename: Kevin
authors.initials: K
authors.lastname: Schwartzman
authors.forename: R John
authors.initials: RJ
authors.lastname: Kimoff
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D017286:Polysomnography / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D055815:Young Adult