title: Is Poor Sleep Quality Associated With Greater Disability in Patients With Multiple Sclerosis?
abstract: Poor sleep is a serious burden for patients with multiple sclerosis (MS). The aim of this study is to assess whether the association between sleep quality and disability in MS patients is direct or mediated by depression, pain, and fatigue. We collected data from 152 patients with MS who filled out the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory and one item of the Short Form-36 regarding pain. The relationship between poor sleep and disability was found to be indirect, mediated by depression (p < 0.05), pain (p < 0.001) and physical fatigue (p < 0.01). Treatment of sleep disturbances may have beneficial effects beyond improving sleep. It may reduce depression, pain, and physical fatigue, which in turn may lessen disability.
authors.affiliation: a Department of Neurology, Faculty of Medicine , Safarik University , Kosice , Slovakia.|b Graduate School Kosice Institute for Society and Health, Safarik University , Kosice , Slovakia.
authors.forename: Marianna
authors.initials: M
authors.lastname: Vitkova
authors.affiliation: a Department of Neurology, Faculty of Medicine , Safarik University , Kosice , Slovakia.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Gdovinova
authors.affiliation: b Graduate School Kosice Institute for Society and Health, Safarik University , Kosice , Slovakia.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.affiliation: a Department of Neurology, Faculty of Medicine , Safarik University , Kosice , Slovakia.
authors.forename: Jarmila
authors.initials: J
authors.lastname: Szilasiova
authors.affiliation: b Graduate School Kosice Institute for Society and Health, Safarik University , Kosice , Slovakia.
authors.forename: Pavol
authors.initials: P
authors.lastname: Mikula
authors.affiliation: c Department of Community & Occupational Health , University Medical Center Groningen, University of Groningen , Groningen , the Netherlands.
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: c Department of Community & Occupational Health , University Medical Center Groningen, University of Groningen , Groningen , the Netherlands.
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.affiliation: b Graduate School Kosice Institute for Society and Health, Safarik University , Kosice , Slovakia.|c Department of Community & Occupational Health , University Medical Center Groningen, University of Groningen , Groningen , the Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000150:complications* / Q000503:physiopathology; D005221:Fatigue / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D010146:Pain / Q000150:complications* / Q000503:physiopathology; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult