Fatigue in Multiple Sclerosis Patients Caused by Poor Sleep

Primary fatigue associated with multiple sclerosis (MS) is generally considered to be related to centrally mediated processes of the disease, while secondary fatigue is believed to be a result of the host of factors that can accompany MS, such as depression or sleep disturbance.

Poor sleep can contribute to fatigue related to multiple sclerosis (MS), according to findings published in the journal Frontiers in Neurology.

Researchers from the Kessler Foundation in West Orange, New Jersey aimed to add to the body of literature surrounding the impact of sleep quality on quality of life for MS patients. Previously, MS-related fatigue has been considered as either primary or secondary, the authors wrote. They noted that the difference is that primary fatigue is generally considered to be related to centrally mediated processes of the disease while secondary fatigue is believed to be a result of the host of factors that can accompany MS, such as depression or sleep disturbance.

“Fatigue is detrimental to daily functioning and well being,” explained study leader Lauren Strober, PhD, in a press release. “It clearly interferes with a person’s ability to participate fully in the community and the workplace. If we can determine what contributes to fatigue in MS, we can improve quality of life and keep people engaged in work and social activities.”

Strober found that sleep is likely the dominant factor in fatigue with MS, which aligned with the current body of research surrounding the topic. In Strober’s study, which examined 107 employed individuals with MS, about two thirds of participants (61 percent) reported poor sleep. Sleep disturbances accounted for a quarter of the variance in fatigue in this population. Depression accounted for an additional 7 percent.

“Routine screening for sleep problems and treatment of sleep disturbances may reduce fatigue and its debilitating effects,” Strober concluded.

Additional research conducted by Strober centers on the impact of MS on employment in individuals with the disease. The unemployment rate in this population can climb as high as 80 percent, the statement noted.

As previously reported on MD Magazine, researchers believe that regional damage in the brain could be a significant contributing factor to fatigue for MS patients. The researchers in that study were able to predict fatigue in MS patients using the right inferior temporal gyrus and the right anterior thalamic radiation damage. The researchers of this study believe in the future, longitudinal studies would offset the limitations of the use of MRIs in the study to demonstrate a pathogenetic link between atrophy and fatigue severity.

Another study reported by MD Magazine commented that task length could contribute to fatigue in patients with MS. In that study, experimental tasks were completed in order to investigate the relationship between subjective and objective cognitive decline. The investigators determined that MS patients showed high fatigue compared to the control participants in tasks both evaluating processing speed and working memory. The authors of that study indicated task length is an important factor in cognitive fatigue in MS patients and should be considered in further investigations.