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MS research update - Sleep problems and daytime sleepiness - 30 May 2012

People with MS report significant problems with going to sleep and staying asleep as well as often being very sleepy during the day.

In this study, 205 people with MS completed questionnaires to assess quality of sleep, daytime sleepiness, fatigue, anxiety, depression and quality of life. More than half were "poor sleepers" and this corresponded with more disability, fatigue, depression and pain and a lower quality of life. Being a "poor sleeper" did not always mean that someone experienced high levels of daytime sleepiness.

25 people, who also experienced fatigue, were assessed by polysomnography (using electrodes to measure the amount and quality of sleep) and using the Multiple Sleep Latency Test (MSLT) which measures the time from the start of a daytime nap to the first signs of sleep. Vigilance (maintaining attention and alertness), measured using the MSLT, did not correspond to feelings of sleepiness or accounts of sleep disruption reported using other tests.

The researchers concluded that people with MS who experienced disturbed sleep and daytime sleepiness should be assessed immediately and treated so that quality of life can be improved.

Neau JP, Paquereau J, Auche V, et al.
Sleep disorders and multiple sclerosis: a clinical and polysomnography study.
Eur Neurol. 2012 May 23;68(1):8-15. [Epub ahead of print]

Does pregnancy affect longer term disability?

It is well known that pregnancy affects the risk of a relapse for a woman with MS. In the last three months of pregnancy the risk of a relapse goes down significantly but the risk increases significantly in the three months after giving birth.

This study looked at whether there was any affect of pregnancy on disability in the longer term by examining the medical records of 2105 women with MS in the British Columbia region of Canada.

They found that those who had children after the beginning of MS symptoms, took the longest time to reach an Expanded Disability Status Scale (EDSS) score of 6. The average time for this group was 23 years. In comparison, women who had children before the onset of MS, took an average of 13 years to reach an EDSS score of 6.0.

However, very importantly, this difference could be accounted for by the age at which MS symptoms began. Consequently, pregnancy had no effect on the time at which someone would reach an EDSS score of 6. The researchers believe that women with MS should be reassured that pregnancy does not affect disability in the long term.

Ramagopalan S, Yee I, Byrnes J, et al.
Term pregnancies and the clinical characteristics of multiple sclerosis: a population based study.
J Neurol Neurosurg Psychiatry. 2012 May 23. [Epub ahead of print]

Research by topic areas...


Martinelli V, Ghezzi A, Montanari E, et al.
Disclosing the diagnosis of multiple sclerosis: The Profile Project.
J Neurol. 2012 May 26. [Epub ahead of print]

Symptoms and symptom management

Johnson CM.
Managing fatigue in patients with multiple sclerosis.
Nursing. 2012 Jun;42(6):26-9.

Minardi D, Muzzonigro G.
Sacral neuromodulation in patients with multiple sclerosis.
World J Urol. 2012 Feb;30(1):123-8.

Disease modifying treatments

Fragoso YD, Boggild M, Macias-Islas MA, et al.
The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis.
Clin Neurol Neurosurg. 2012 May 25. [Epub ahead of print]

Freedman MS, Wolinsky JS, Wamil B, et al.
Teriflunomide added to interferon-β in relapsing multiple sclerosis: A randomized phase II trial.
Neurology. 2012 May 23. [Epub ahead of print]


Wallin MT, Culpepper WJ, Coffman P, et al.
The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service.
Brain. 2012 Jun;135(Pt 6):1778-1785.

Assessment tools

Carpinella I, Cattaneo D, Bertoni R, et al.
Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.
IEEE Trans Neural Syst Rehabil Eng. 2012 May;20(3):351-60.

Causes of MS

Tselis A.
Epstein-Barr virus cause of multiple sclerosis.
Curr Opin Rheumatol. 2012 May 19. [Epub ahead of print]

Psychological aspects

Crivelli L, Farez MF, González CD, et al.
Alerting Network Dysfunction in Early Multiple Sclerosis.
J Int Neuropsychol Soc. 2012 May 24:1-7. [Epub ahead of print]

Physical activity

Coote S, O'Dwyer C.
Comparative validity of accelerometer based measures of physical activity for people with multiple sclerosis.
Arch Phys Med Rehabil. 2012 May 23. [Epub ahead of print]

McLoughlin JV, Barr CJ, Sturnieks D, et al.
Effect of wearing a dorsiflexion assist orthosis on mobility, perceived fatigue and exertion during the six-minute walk test in people with multiple sclerosis: a randomised cross-over protocol.
BMC Neurol. 2012 May 25;12(1):27. [Epub ahead of print]

Chee JN, Gage WH, McIlroy WE, et al.
Foot placement patterns of female rollator users with multiple sclerosis in the community.
Disabil Rehabil. 2012 May 24. [Epub ahead of print]

Pregnancy and childbirth

Pakpoor J, Disanto G, Lacey MV, et al.
Breastfeeding and multiple sclerosis relapses: a meta-analysis.
J Neurol. 2012 May 23. [Epub ahead of print]


Fernandez O, Alvarez-Cermeno JC, Arroyo-Gonzalez R, et al.
Review of the novelties presented at the 27th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) (I).
Rev Neurol. 2012 Jun 1;54(11):677-691.

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