scholarly journals O047 Sleep quality and fatigue in children and adolescents with multiple sclerosis

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A20-A21
Author(s):  
J Tran ◽  
E Yiu ◽  
M Vandeleur ◽  
A Adams

Abstract Background Fatigue is common in children and adolescents with multiple sclerosis (MS) and its aetiology is assumed to be multifactorial, however, its relationship to sleep quality in this population remains unknown. This study aims to examine the prevalence of fatigue and sleep disturbance in this population and their relationship to mood, quality of life, physical activity, and MS disease characteristics. Methods Children with pediatric onset multiple sclerosis (POMS) aged 0–18 were recruited. Subjective sleep quality was assessed by the Pediatric Daytime Sleepiness Scale (PDSS), Sleep Disturbance Scale for Children (SDSC) and OSA-18. All children were referred for polysomnography (PSG) including transcutaneous CO2 and video monitoring. Fatigue was assessed using the PedsQL Multidimensional Fatigue Scale (PedsQL-MFS). Progress to date: Fifteen children with relapsing remitting MS (mean age 15.73±1.44, mean EDSS score 1.11±1.12) have been enrolled to date. 73% of children were fatigued according to the PedsQL-MFS (mean transformed score 52.04). 67% and 60% of children scored higher than the clinical cutoff for the PDSS (17.87) and SDSC (42.73) respectively. However, all children scored within the normal range for the OSA-18 (34.00). To date, eleven children have completed PSG. Intended outcome and impact: This is the first study utilising PSG to objectively assess sleep quality in children with POMS. Findings from this study will document the magnitude of sleep disturbance in this population and have implications for the management of fatigue and other related impairments observed in paediatric MS.

2020 ◽  
Author(s):  
Li Ran ◽  
Xuyu Chen ◽  
Mengying Li ◽  
Qi Chen ◽  
Yupeng Zhang ◽  
...  

Abstract Background: Hypertension is one of the most common and easy paroxysm diseases. Inadequately controlled hypertension has been related to poor sleep quality, which would be associated with worsening quality of life.Methods: A descriptive analyses was conducted to describe social demographic factors, while ANOVA and t-test were carried out to compare scores between different groups. The total score of life quality (MCS and PCS) was used as the dependent variable (Y), and the dimensions of sleep quality were used as the independent variable (X) for multiple line regression analysis (Stepwise) to evaluate the correlation between sleep quality and life quality.Results: The results of group comparison showed that the total PSQI score was significant at people’s residence (P<0.01). Correlation analysis indicated that subjective sleep quality, sleep disturbance, daytime dysfunction, age, concomitant diseases, and years of diagnosed hypertension had a significant association with the PCS scores (P<0.05 for all). Subjective sleep quality, sleep disturbance, daytime dysfunction, and monthly income had a significant association with the MCS scores (P<0.05 for all). Conclusion: The correlation analysis shows that sleep quality of hypertensive patients is related to quality of life. Considering the close relation among hypertension, sleep quality, and life quality, possible interventions like sleep hygiene was appealed to relieve hypertensive symptoms, promote sleep quality, and increase life quality.Trial registration: 2018-1602000-03-02


2021 ◽  
pp. 135245852110196
Author(s):  
Jan Hillert ◽  
Jon A Tsai ◽  
Mona Nouhi ◽  
Anna Glaser ◽  
Tim Spelman

Background: Teriflunomide and dimethyl fumarate (DMF) are first-line disease-modifying treatments for multiple sclerosis with similar labels that are used in comparable populations. Objectives: The objective of this study was to compare the effectiveness and persistence of teriflunomide and DMF in a Swedish real-world setting. Methods: All relapsing-remitting multiple sclerosis (RRMS) patients in the Swedish MS registry initiating teriflunomide or DMF were included in the analysis. The primary endpoint was treatment persistence. Propensity score matching was used to adjust comparisons for baseline confounders. Results: A total of 353 teriflunomide patients were successfully matched to 353 DMF. There was no difference in the rate of overall treatment discontinuation by treatment group across the entire observation period (hazard ratio (HR) = 1.12; 95% confidence interval (CI) = 0.91–1.39; p = 0.277; reference = teriflunomide). Annualised relapse rate (ARR) was comparable ( p = 0.237) between DMF (0.07; 95% CI = 0.05–0.10) and teriflunomide (0.09; 95% CI = 0.07–0.12). There was no difference in time to first on-treatment relapse (HR = 0.78; 95% CI = 0.50–1.21), disability progression (HR = 0.55; 95% CI = 0.27–1.12) or confirmed improvement (HR = 1.17; 95% CI = 0.57–2.36). Conclusion: This population-based real-world study reports similarities in treatment persistence, clinical effectiveness and quality of life outcomes between teriflunomide and dimethyl fumarate.


2013 ◽  
Vol 20 (2) ◽  
pp. 253-257 ◽  
Author(s):  
Mariko Kita ◽  
Robert J Fox ◽  
J Theodore Phillips ◽  
Michael Hutchinson ◽  
Eva Havrdova ◽  
...  

Multiple sclerosis (MS) has a significant impact on health-related quality of life (HRQoL) with symptoms adversely affecting many aspects of everyday living. BG-12 (dimethyl fumarate) demonstrated significant efficacy in the phase III studies DEFINE and CONFIRM in patients with relapsing–remitting MS. In CONFIRM, HRQoL was worse in patients with greater disability at baseline, and who relapsed during the study, and improved with BG-12 treatment. Mean Short Form-36 Physical Component Summary scores for BG-12 increased over 2 years and scores for placebo decreased. Coupled with clinical and neuroradiological benefits, these HRQoL results further support BG-12 as an effective oral treatment for relapsing MS.


2021 ◽  
Author(s):  
Dandan Zhang ◽  
Jing Wang ◽  
Xixi Gu ◽  
Zhifeng Gu ◽  
Liren Li ◽  
...  

Abstract Purpose Sleep disturbance is common in meningioma patients and may lead to disease aggravation and decreases health-related quality of life (HRQoL). However, the sleep quality of meningioma patients newly diagnosed and ready for surgery has not been well clarified in China. This study aims to evaluate the prevalence, correlates, and impact of sleep disturbance among Chinese meningioma patients. Methods In this cross-sectional study, meningioma patients were recruited from the Affiliated Hospital of Nantong University from January 2020 to November 2020. A series of questionnaires were applied: the 0–10 Numerical Rating Scale (NRS), the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Epworth Sleepiness Scale (ESS), the Short-Form 36 (SF-36), the Pittsburgh Sleep Quality Index (PSQI). Independent samples t test, Mann-Whitney U test, chi-square analysis, Pearson/Spearman correlation, and binary logistic regression were used to analyze the data. Results 100 meningioma patients completed the questionnaires. Sleep disturbance affected 43% of the meningioma patients and was linked to many concomitant symptoms, such as headache, fatigue, anxiety and depression. Binary logistic regression indicated that fatigue and headache were predictors of sleep disturbance in meningioma patients. Meanwhile, severe sleep disturbance led to lower quality of life. Conclusions These findings demonstrated that a considerable number of meningioma patients newly diagnosed and ready for surgery suffered from sleep disturbance, potentially contributing to impair HRQoL. Medical personnel should pay more attention to meningioma patients with sleep disturbance and take effective measures to improve sleep quality, with the ultimate goal to improve their HRQoL.


2018 ◽  
Vol 35 (8) ◽  
pp. 1109-1117 ◽  
Author(s):  
Kwo-Chen Lee ◽  
Ya-Ling Hsieh ◽  
Pi-Chu Lin ◽  
Yun-Ping Lin

Background: Sleep disturbance commonly has a negative impact on the well-being of family caregivers (FCs) of terminally ill patients with cancer. The effect of sleep disturbance on FCs has not been explored through long-term follow-up studies in Taiwan. Objective: The purposes of this study were to (1) identify the trajectory of sleep quality of FCs of terminally ill patients with cancer in Taiwan and (2) examine the determinants of sleep disturbance through a longitudinal follow-up until patient death. Methods: A prospective, longitudinal study was conducted among 95 FCs of terminally ill patients with cancer. The FCs’ sleep quality was measured subjectively by using the Pittsburgh Sleep Quality Index and objectively by wearing a wrist actigraphy for 48 hours each month during the 6-month follow-up assessments. The trajectory and determinants of sleep quality were identified using a generalized estimation equation approach. Results: The FCs’ sleep quality significantly decreased as the patient’s death approached. Family caregivers who were women or older, had a relative with a longer survival period after diagnosis, reported higher levels of depression and fatigue, and provided lower levels of assistance to their relatives experienced more sleep disturbance. Conclusion: The sleep quality of Taiwanese FCs significantly deteriorated as the death of the terminally ill patients with cancer approached. Early detection of the FCs’ sleep disturbance, increasing their self-awareness of sleep problems, and providing nonpharmacological interventions and psychosocial support may be helpful for FCs to improve their quantity and quality of sleep.


2020 ◽  
pp. 147451512094136 ◽  
Author(s):  
Valentina Spedale ◽  
Michela Luciani ◽  
Alessandro Attanasio ◽  
Stefania Di Mauro ◽  
Rosaria Alvaro ◽  
...  

Background: Sleep disturbance is one of the most common symptoms among heart failure patients. Sleep disturbance reduces quality of life and leads to higher rates of mortality. It may affect the ability of patients to perform adequate self-care. Although some research has evaluated the association between sleep quality and heart failure self-care, a synthesis of the most recent available evidence is lacking. Aims: This systematic review aimed to assess the association between sleep quality and self-care in adults with heart failure. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was used. Medline, CINAHL, PsycINFO and SCOPUS were searched. Observational, case-control and cohort studies were considered. The quality of the studies was evaluated with the Joanna Briggs Institute’s Critical Appraisal Tools. Results: Six articles were included. Association between sleep quality and self-care was reported by three studies. One of these did not find an association between sleep disturbance and heart failure self-care, while the other two studies did. An association between sleep quality and medication adherence was reported by three studies. All three of these studies found associations between these two variables. Studies have measured similar but different constructs. Two studies assessed sleep quality, while four other studies measured excessive daytime sleepiness. Half of the studies examined self-care, while the other half measured medication adherence. Conclusions: Although the evidence should be strengthened, sleep quality seems to affect self-care in heart failure patients. The mechanism underlying the effect of sleep quality on heart failure self-care remains unclear. Future longitudinal interaction analyses could be useful to clarify this mechanism.


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