title: Treatment of sleep disorders may improve fatigue in multiple sclerosis.
abstract: OBJECTIVE
  In a previous polysomnographic cross-sectional study we found a significant relationship between sleep disorders and multiple sclerosis (MS) related fatigue. The purpose of this open follow-up observation was to compare the impact of treatment of sleep disorders on MS related fatigue measured with the Modified Fatigue Impact Scale (MFIS).
  
  
  METHODS
  Non-randomized follow-up observation: treated versus untreated patients, subgroups according to compliance with sleep medical treatment recommendations (univariate, multivariate analysis, multiple logistic regression). 66 MS patients were followed after polysomnography, 49 patients with relevant sleep disorders and 17 without.
  
  
  RESULTS
  Mean MFIS scores decreased from 41.2 to 26.2 (p=0.025) in patients with good compliance (GC; n=18), from 42.4 to 32.1 (p=0.12) in patients with moderate compliance (MC; n=12), and from 41.6 to 35.5 (p=0.17) in non-compliant patients (NC; n=17). Mean MFIS values increased in patients without sleep disorders from 22.9 to 25.4 (NSD; n=12, p=0.56). In multiple logistic regression, treatment of sleep disorders predicted decrease of MFIS-values (GC versus NSD odds ratio 13.4; p=0.015; 95% confidence interval (CI) 1.7-107.2, MC versus NSD odds ratio 13.8; p=0.028; 95% CI 1.3-143.3).
  
  
  CONCLUSIONS
  Sleep medical treatment may improve MS related fatigue when patients adhere to treatment recommendations.
authors.affiliation: Hanse-Klinikum, Department of Neurology, Stralsund, Germany. cveauthier@web.de
authors.forename: Christian
authors.initials: C
authors.lastname: Veauthier
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gaede
authors.forename: Helena
authors.initials: H
authors.lastname: Radbruch
authors.forename: Sandra
authors.initials: S
authors.lastname: Gottschalk
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000209:etiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010349:Patient Compliance; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Fatigue; Modified Fatigue Impact Scale; Multiple sclerosis; Polysomnography; Sleep disorders