Study Examines Association between Multiple Sclerosis and Sleep Apnea

Researchers report that sleep apnea may be quite prevalent but under-recognized in patients with multiple sclerosis, and may significantly contribute to fatigue in these patients.

The association between multiple sclerosis (MS) and obstructive sleep apnea (OSA) has not been widely explored. However, new research published in the Feb. 15 issue of the Journal of Clinical Sleep Medicine suggests that OSA is highly prevalent in patients with MS, and may be a significant predictor of fatigue severity in these patients.

To better understand the risk and prevalence of OSA in MS patients and to further understand the possible relationship between fatigue severity, OSA, sleep quality and MS, Tiffany J. Braley, MD, and her colleagues at the University of Michigan in Ann Arbor surveyed 195 participants with MS. They used a questionnaire to measure participants’ overall sleep quality and quantity, and also asked patients to complete the Epworth Sleepiness Scale, Fatigue Severity Scale, Insomnia Severity Index, and STOP-Bang questionnaire. Additionally, researchers accessed participants’ medical records to evaluate additional OSA risk factors.

Despite the research’s cross-sectional design that did not allow for an examination of cause-and-effect relationships, investigators discovered a strong link between MS and OSA. Of the 195 participants surveyed, 41 patients (21%) had a diagnosis of OSA. Additionally 110 (56%) of all patients, and 38 (93%) of those participants diagnosed with OSA had a STOP-Bang score ≥ 3, which indicated an increased OSA risk.

According to the National Multiple Sclerosis Society, 400,000 people are diagnosed with multiple sclerosis. However, in a statement, lead author Braley said, “OSA may be a highly prevalent and yet under-recognized contributor to fatigue in persons with MS.”

“Our study suggests that clinicians should have a low threshold to evaluate MS patients for underlying sleep disturbances,” Braley claimed.

American Academy of Sleep Medicine President M. Safwan Badr, MD, said “Obstructive sleep apnea is a chronic illness that can have a destructive impact on your health and quality of life… People with multiple sclerosis who are found to have a high risk of OSA should be referred to a board certified sleep medicine physician for a comprehensive sleep evaluation.”