title: Factors associated with poor sleep quality in patients with multiple sclerosis differ by disease duration.
abstract: BACKGROUND
  Sleep disturbance is a common symptom of multiple sclerosis (MS) and knowledge about factors that contribute to poor sleep quality is scarce.
  
  
  OBJECTIVE
  The aim was to explore the differences in the prevalence and determinants of poor sleep quality in a sample of patients with MS with disease duration ≤ 5 years and >5 years.
  
  
  METHODS
  We collected data from 152 consecutive patients with MS; 66 patients (78% women, averaged 37.35 ± 10.1 years) were in the group with disease duration ≤ 5 years and 86 patients (73.3% women, averaged 42.10 ± 9.4 years) in the group with disease duration >5 years. Patients filled out the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, one item of the Incapacity Status Scale regarding bladder problems and one item of the Short Form-36 regarding pain. Multiple linear regression was used to analyze the relationship between the study variables.
  
  
  RESULTS
  The prevalence of poor sleep is significantly higher in patients with longer disease duration (34.8 vs. 51.2%). Anxiety, reduced motivation and mental fatigue (all p < 0.05) were associated with poor sleep quality in patients with disease duration ≤5 years, whereas pain (p < 0.01), depression and mental fatigue (both p < 0.05) were in patients with disease duration >5 years.
  
  
  CONCLUSIONS
  Sleep problems are present in patients with MS with both short and long disease duration, but these problems are associated with different factors. These should be recognized and managed in addition to the treatment of sleep disorders.
authors.affiliation: Department of Neurology, Faculty of Medicine, Safarik University, Kosice, Slovakia; Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia. Electronic address: marianna.vitkova@gmail.com.
authors.forename: Marianna
authors.initials: M
authors.lastname: Vitkova
authors.affiliation: Department of Neurology, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Gdovinova
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.affiliation: Department of Neurology, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Jarmila
authors.initials: J
authors.lastname: Szilasiova
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia.
authors.forename: Iveta
authors.initials: I
authors.lastname: Nagyová
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia.
authors.forename: Pavol
authors.initials: P
authors.lastname: Mikula
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; 1st Department of Psychiatry, Faculty of Medicine, Safarik University, Kosice, Slovakia.
authors.forename: Martina
authors.initials: M
authors.lastname: Krokavcova
authors.affiliation: Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, the Netherlands.
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.affiliation: Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovakia; Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, the Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications*; D003863:Depression / Q000150:complications*; D006233:Persons with Disabilities; D005221:Fatigue / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology; D010146:Pain / Q000150:complications*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D001743:Urinary Bladder; D055815:Young Adult
keywords: Anxiety; Disease duration; Multiple sclerosis; Pain; Quality of sleep