Examining sleep, fatigue, and daytime sleepiness in pediatric multiple sclerosis patients

2011 ◽  
Vol 18 (4) ◽  
pp. 481-488 ◽  
Author(s):  
Abu-Bakar Zafar ◽  
Jayne Ness ◽  
Sarah Dowdy ◽  
Kristin Avis ◽  
Khurram Bashir
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Sleep Hygiene ◽  
Control Group ◽  
Stability Dimension ◽  
Multiple Sclerosis Patients ◽  
Historical Controls

Background: About 2–5% of patients with multiple sclerosis (MS) experience their first symptoms before age 18. Sleep disorders occur frequently in MS. The prevalence of sleep problems and their impact on fatigue and daytime sleepiness in pediatric MS is unknown. Objective: To determine whether pediatric MS patients have more sleep disturbances, fatigue, and daytime sleepiness compared with an age-, sex-, and race-matched control group. Methods: Patients and age-, sex-, and race-matched controls were surveyed to quantify daytime sleepiness via the modified Epworth Sleepiness Scale, sleep quality and hygiene through the Adolescent Sleep Wake and Hygiene Scale, respectively, and fatigue using the PediatricQL Multidimensional Fatigue Scale. Results: Pediatric MS patients ( n = 30) and age-, sex-, and race-matched controls ( n = 52) had similar levels of fatigue; however, when compared with previously published historical controls, both groups reported worse fatigue across all dimensions ( p < 0.05). Pediatric MS patients also had similar sleep quality compared with the matched controls, but reported better sleep hygiene on the ‘sleep stability’ dimension ( p < 0.05). In addition, pediatric MS patients had less daytime sleepiness than the matched controls ( p < 0.05). Conclusion: Although patients with MS reported similar levels of fatigue, they have better sleep hygiene, which could possibly account for the decreased amount of excessive daytime sleepiness. Also, when compared with historical controls, the MS and control samples reported more fatigue. Thus, caution must be taken when using published control data, especially when not properly matched.

scholarly journals The Relationship Between a Baby's Age and Sleepiness in a Sample of Mothers

2021 ◽  
Vol 12 ◽  
Author(s):  
Mar Sánchez-García ◽  
María José Cantero ◽  
Eva Carvajal-Roca
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Daytime Sleepiness ◽  
Positive Relationship ◽  
Sleep Problems ◽  
Initial Period ◽  
Practical Importance ◽  
Sleep Disruption ◽  
Control Group ◽  
The Relationship

One question of great practical importance for the parents, and especially the mother, after the birth of a baby, refers to how long the time during which they have to go with less and more fragmented sleep actually lasts. Most of the studies only explore this issue up to 6 months of the newborn's life, and less is known about the sleep problems the mothers may have after this initial period. The objective of this study is to examine the relationship between the sleep disruption and daytime sleepiness of mothers with infants until 2 years old compared to a group of women currently not at care of babies. To this end, a sample of 113 women, 67 currently bringing up a baby of under 2 years old, and the remainder without a baby at their care under 6 years old, reported sleep duration, sleep interruptions, sleep quality, and responded to questionnaires of sleep quality and daytime sleepiness. The relationship between the age of the children and the comparison between the groups was used to highlight the sleep problems of the mothers taking care of the infant. The results showed that there was a positive relationship between the age of the infant and the duration of the sleep of the mothers and that the duration of sleep for them was similar to those of the women in the control group about 6 months after the infant was born. However, fragmentation of sleep, daytime sleepiness, and sleep problems were still higher than in the control group for mothers with children between 6 and 12 months old.

scholarly journals Who sleeps better? Sleep patterns and sleep disturbances in adolescents with recurrent abdominal pain or inflammatory bowel disease and healthy controls

2021 ◽  
Vol 3 (1) ◽  
pp. 83-93
Author(s):  
Ann-Kristin Manhart ◽  
◽  
Angelika A. Schlarb ◽  
Keyword(s):  
Abdominal Pain ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Recurrent Abdominal Pain ◽  
Control Group ◽  
Healthy Controls ◽  
Healthy Control ◽  
Inflammatory Bowel ◽  
Sleep Difficulties

Background: Sleep difficulties play an important role in the maintenance and course of chronic abdominal pain disorders (RAP and IBD). Particularly among adolescents with inflammatory bowel diseases (IBD) or recurrent abdominal pain (RAP), adequate sleep seems to be important, as the diseases self and the associated symptoms can cause distress and impair daytime functioning. Hence it seems adequate to take a closer look concerning the sleep difficulties within the different conditions of abdominal pain especially in comparison to a healthy control. To our knowledge no former study compared sleep problems in youths with RAP and IBD as well as healthy controls. Thus the aim of the present study was to 1) evaluate sleep problems in the RAP and IBD and 2) compare the sleep problems of these abdominal pain diseases with a healthy control group. Methods: 129 adolescents (14-25 years) took part in the online survey, with 58 suffering from IBD, 23 had RAP and 48 healthy controls. Adolescents completed sleep questionnaires as PSQI, SDSC or NEQ. Data was analysed by conducting MANOVAs to test differences between the three groups followed by a post-hoc analyses. Results: Significant differences between both patient groups and healthy controls regarding sleep quality as well as sleep disturbances were found. Results indicate that especially young IBD patients suffered more often from poor sleep quality, sleep disturbances as well as daily effects of nightmares than the control group. The comparison of adolescents with RAP and healthy controls showed elevated scores concerning sleep disturbances for RAP patients. However, IBD and RAP adolescents did not differ significantly concerning most sleep measurements. Discussion: The study at hand was the first to compare adolescents with IBD and RAP regarding sleep difficulties. Adolescents with IBD and RAP have an impaired sleep quality as well as a higher rate of sleep disturbances and suffer from daily effects of nightmares than the control group. Therefore sleep disturbances should be also addressed when treating IBD and RAP patients to prevent further impairments.

scholarly journals Sleep problems are associated with hypersensitivity to touch in children with autism

2018 ◽  
Author(s):  
Tzischinsky Orna ◽  
Meiri Gal ◽  
Manelis Liora ◽  
Bar-Sinai Asif ◽  
Fluser Hagit ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Children With Autism ◽  
Sensory Profile ◽  
Control Group ◽  
Sensory Abnormalities ◽  
Autism Group ◽  
Hyper Sensitivity

AbstractBackgroundSensory abnormalities and sleep disturbances are highly prevalent in children with autism, but the potential relationship between these two domains has rarely been explored. Understanding such relationships is important for identifying children with autism who exhibit more homogeneous symptoms.MethodsHere we examined this relationship using the Caregiver Sensory Profile and the children’s sleep habit questionnaires, which were completed by parents of 69 children with autism and 62 frequency age-matched controls.ResultsIn line with previous studies, children with autism exhibited more severe sensory abnormalities and sleep disturbances than age-matched controls. The sleep disturbance scores were strongly associated with touch and oral sensitivities in the autism group and with touch and vestibular sensitivities in the control group. Hyper sensitivity towards touch, in particular, exhibited the strongest relationship with sleep disturbances in the autism group and single-handedly explained 24% of the variance in sleep disturbance scores. In contrast, sensitivity in other sensory domains such as vision and audition was not associated with sleep quality in either group.ConclusionsWhile it is often assumed that sensitivities in all sensory domains are similarly associated with sleep problems, our results suggest that hyper sensitivity towards touch exhibits the strongest relationship to sleep disturbances when examining children autism. We speculate that hyper sensitivity towards touch interferes with sleep onset and maintenance in a considerable number of children with autism who exhibit severe sleep disturbances. Studies that examine the effects of tactile sensory therapies/aids on sleep quality and behavioral improvement in these children are, therefore, highly warranted.

Daytime sleepiness, sleep disturbance and functioning impairment in bipolar disorder

2013 ◽  
Vol 25 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Julio C. Walz ◽  
Pedro V. Magalhães ◽  
Ramiro Reckziegel ◽  
Monise Costanzi ◽  
Larriany Giglio ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Sleep Disturbance ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Control Group ◽  
Multivariable Model ◽  
Healthy Control ◽  
Short Test ◽  
Functioning Assessment

ObjectiveTo verify the prevalence and clinical impact of excessive daytime sleepiness (EDS) in outpatients with bipolar disorder.MethodsEighty‐one outpatients with bipolar disorder and 79 healthy control subjects were recruited. Patients were required not to be acutely manic or depressed. We used the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Functioning Assessment Short Test to assess sleepiness, sleep problems and functioning, respectively.ResultsPatients had a higher prevalence of sleepiness (40%) than the control group (18%). Sleepiness and sleep disturbance had independent impacts on disability in the multivariable model.ConclusionsThis study suggests that EDS is a relevant clinical dimension in patients with bipolar disorder. It is a frequent symptom that often overlaps with other sleep disturbances. This study also reveals that once present it has the potential to increase functional impairment.

scholarly journals Excessive daytime sleepiness and its determinants: do they have a pattern with study semesters among postgraduate medical resident doctors?

2017 ◽  
Vol 5 (1) ◽  
pp. 382
Author(s):  
Siddalingaiah H. S. ◽  
Aditi Chaudhuri ◽  
Chandrakala D. ◽  
Amarjeet Singh
Keyword(s):  
Sleep Quality ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Problems ◽  
Sleep Hygiene ◽  
Work Hours ◽  
Intervention Package ◽  
Related Factors ◽  
Cross Sectional ◽  
Quality Sleep

Background: Residency is a stressful period in the career of a medical professional. Excessive daytime sleepiness (EDS) is a major problem among resident doctors due to long work hours, stress, sleep deprivation, shift work, lack of sleep hygiene and other lifestyle related factors. The sleep problems and related factors need to be studied among resident doctors to know if any cumulative effect exists. Methods: A cross sectional study design with pre-validated sleep assessment proforma, Epworth sleepiness scale (ESS), and sleep hygiene index (SHI) as study tools which were self-administered among a total of 428 enrolled eligible resident doctors. Results: A total of 350 resident doctors returned the filled proforma, ESS and SHI (response rate 81.7%). Prevalence of EDS was found to be highest in 2nd (51.1%), 3rd (55.2%) and 5th (47.1%) semesters. Socio-demographic factors did not vary much across semesters except for slight increase in quantity of coffee/tea intake. No major changes in shift pattern, total sleep hours were found across semesters but work hours differed significantly. Sleep latency was least in 3rd semester where EDS was highest. Similarly, sleep quality, sleep hygiene and weekly sleep hours were least in 2nd and 3rd semester where EDS prevalence was high. In addition, as per visual analogue scale ratings by resident doctors, those in 2nd and 3rd semesters were maximally tired and maximally sleepy which is consistent with the finding of high prevalence of EDS in these semesters as recorded by ESS. Conclusions: Sleep quality, sleep quantity, sleep hygiene and weekly work hours emerged as important and sensitive predictors of EDS across study semesters. These components must be present in any intervention package to address EDS especially in the first three semesters of residency program and other similar occupational settings. 

scholarly journals Effect of Eszopiclone on Sleep Disturbances and Daytime Fatigue in Multiple Sclerosis Patients

2011 ◽  
Vol 13 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Hrayr Attarian ◽  
Garrick Applebee ◽  
Angela Applebee ◽  
BingXia Wang ◽  
Melissa Clark ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Pilot Trial ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Double Blind ◽  
End Point ◽  
Multiple Sclerosis Patients ◽  
The Impact

The prevalence of moderate-to-severe sleep problems is significantly higher among people with multiple sclerosis (MS) than in the general population. In 2002, we found a significant relationship between fatigue and disrupted sleep in patients with relapsing-remitting MS (RRMS). The objectives of this study were to determine whether eszopiclone (Lunesta; Sunovion Pharmaceuticals Inc, Marlborough, MA) was superior to placebo in improving sleep among patients with MS-related fatigue and sleep complaints (primary end point); and to assess the impact of improved sleep on daytime fatigue and functioning (secondary end point). This was a double-blind, placebo-controlled pilot trial lasting 7 weeks. Thirty ambulatory adults under age 65 years with RRMS, fatigue, and sleep disturbances were randomized to receive either eszopiclone or placebo. The outcome measures included subjective and objective changes in sleep-onset latency (SOL), total sleep time (TST), wakefulness after sleep onset (WASO), sleep efficiency (SE), fatigue scales, and neuropsychological measures of daytime functioning. Compared with placebo, eszopiclone was superior only in increasing TST. Fatigue improved in both groups, but there was no statistically significant correlation between increased TST and improved fatigue, and no statistically significant differences were observed between the two groups. Thus, in this study, eszopiclone did not improve sleep sufficiently to improve fatigue in MS patients. This result may be due to the multifactorial nature of sleep disturbances and fatigue in people with MS.

Assessment of biochemical determinants in Multiple Sclerosis patients following the oral administration of β-D-Mannuronic acid [M2000]

2020 ◽  
Vol 17 ◽  
Author(s):  
Mohamad Reza Nikouei Moghaddam ◽  
Monireh Movahedi ◽  
Maryam Bananej ◽  
Soheil Najafi ◽  
Nahid Beladi Moghadam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Uric Acid ◽  
Vitamin D3 ◽  
Chronic Inflammatory Disease ◽  
Toxic Effects ◽  
Control Group ◽  
Therapeutic Effects ◽  
Mannuronic Acid ◽  
Anti Inflammatory ◽  
Multiple Sclerosis Patients

Background: Multiple sclerosis is an autoimmune chronic inflammatory disease of the central nervous system that can lead to some serious disabilities. Despite using various immunomodulatory and anti-inflammatory drugs that have therapeutic effects, they cannot reduce its progression completely, and have some unwanted side effects too. The immunomodulatory and anti-inflammatory effects of the β-D-Mannuronic acid [M2000] have been proven in several surveys, and the present research was designed to determine its toxicity and therapeutic effects in MS patients. Methods: This study was performed on 15 MS patients who took 25 mg/kg/day the oral form of the β-D-Mannuronic acid for six months, and 15 healthy people as a control group. Serum levels of Urea, Creatinine, GGT, Vitamin D3, Uric acid, and Anti-Phospholipids were compared to evaluate the therapeutic and possible toxic effects of this drug after this period. Results: Non- toxic effects through the study of Urea, Creatinine, GGT, and non-significant changes in Uric acid and AntiPhospholipids levels, besides a significant rise in Vitamin, D3 levels in the M2000 treated cases were found. Conclusions: Our results suggested that β-D-Mannuronic acid is a safe drug and has no toxicity when administered orally and also has some therapeutic effects in MS patients.

scholarly journals Changes in Cerebrospinal Fluid Balance of TNF and TNF Receptors in Naïve Multiple Sclerosis Patients: Early Involvement in Compartmentalised Intrathecal Inflammation

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1712
Author(s):  
Roberta Magliozzi ◽  
Francesco Pezzini ◽  
Mairi Pucci ◽  
Stefania Rossi ◽  
Francesco Facchiano ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Immune Cell ◽  
Protein Pattern ◽  
Fold Change ◽  
Cortical Lesion ◽  
Control Group ◽  
Lesion Volume ◽  
Mri Features ◽  
Csf Levels ◽  
Multiple Sclerosis Patients

An imbalance of TNF signalling in the inflammatory milieu generated by meningeal immune cell infiltrates in the subarachnoid space in multiple sclerosis (MS), and its animal model may lead to increased cortical pathology. In order to explore whether this feature may be present from the early stages of MS and may be associated with the clinical outcome, the protein levels of TNF, sTNF-R1 and sTNF-R2 were assayed in CSF collected from 122 treatment-naïve MS patients and 36 subjects with other neurological conditions at diagnosis. Potential correlations with other CSF cytokines/chemokines and with clinical and imaging parameters at diagnosis (T0) and after 2 years of follow-up (T24) were evaluated. Significantly increased levels of TNF (fold change: 7.739; p < 0.001), sTNF-R1 (fold change: 1.693; p < 0.001) and sTNF-R2 (fold change: 2.189; p < 0.001) were detected in CSF of MS patients compared to the control group at T0. Increased TNF levels in CSF were significantly (p < 0.01) associated with increased EDSS change (r = 0.43), relapses (r = 0.48) and the appearance of white matter lesions (r = 0.49). CSF levels of TNFR1 were associated with cortical lesion volume (r = 0.41) at T0, as well as with new cortical lesions (r = 0.56), whilst no correlation could be found between TNFR2 levels in CSF and clinical or MRI features. Combined correlation and pathway analysis (ingenuity) of the CSF protein pattern associated with TNF expression (encompassing elevated levels of BAFF, IFN-γ, IL-1β, IL-10, IL-8, IL-16, CCL21, haptoglobin and fibrinogen) showed a particular relationship to the interaction between innate and adaptive immune response. The CSF sTNF-R1-associated pattern (encompassing high levels of CXCL13, TWEAK, LIGHT, IL-35, osteopontin, pentraxin-3, sCD163 and chitinase-3-L1) was mainly related to altered T cell and B cell signalling. Finally, the CSF TNFR2-associated pattern (encompassing high CSF levels of IFN-β, IFN-λ2, sIL-6Rα) was linked to Th cell differentiation and regulatory cytokine signalling. In conclusion, dysregulation of TNF and TNF-R1/2 pathways associates with specific clinical/MRI profiles and can be identified at a very early stage in MS patients, at the time of diagnosis, contributing to the prediction of the disease outcome.

scholarly journals AB0562 SLEEP HYGIENE: COULD IT BE A CONFOUNDING FACTOR FOR SLEEP QUALITY IN SYSTEMIC SCLEROSIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1578.2-1578
Author(s):  
N. Gokcen ◽  
A. Komac ◽  
F. Tuncer ◽  
A. Yazici ◽  
A. Cefle
Keyword(s):  
Systemic Sclerosis ◽  
Sleep Quality ◽  
Disease Activity ◽  
Beck Depression Inventory ◽  
Sleep Disturbances ◽  
Activity Index ◽  
Univariate Analysis ◽  
Sleep Hygiene ◽  
Healthy Controls ◽  
Clinical Variables

Background:Sleep disturbances have been described in Systemic Sclerosis (SSc). Confounding factors related to sleep quality are also investigated. Although sleep hygiene plays an important role in sleep quality, as far as we know, there are not enough data to show the effect of sleep hygiene on sleep quality of SSc.Objectives:To investigate sleep hygiene, its impact on sleep quality, and its association with demographic-clinical factors in patients with SSc, rheumatoid arthritis (RA), and healthy controls.Methods:The study was designed as cross-sectional. Forty-nine patients with SSc who fulfilled the 2013 ACR/EULAR classification criteria for SSc, 66 patients with RA who fulfilled 1987 revised classification criteria, and 30 healthy controls were included in the study. All participants were female. Demographic and clinical variables were documented. Disease activity index of both SSc and RA was calculated. SSc patients were assessed by questionnaires including Short Form 36 (SF-36), The Health Assessment Questionnaire Disability Index (HAQ-DI), Beck Anxiety and Beck Depression Inventory, Pittsburg Sleep Quality Index (PSQI), Sleep Hygiene Index (SHI). Additionally, RA patients and healthy controls were estimated by HAQ-DI, Beck Anxiety and Beck Depression Inventory, PSQI, and SHI. Logistic regression analysis was used to determine the predictors of sleep quality.Results:Preliminary results of the study were given. The baseline demographics were similar among groups. When comparing groups according to HAQ-DI, Beck Anxiety and Beck Depression Inventory, PSQI, and SHI, we found higher scores in SSc and RA rather than healthy controls (p<0.001, p=0.001, p=0.001, p<0.001, p=0.003; respectively). While depression and sleep hygiene were determined as the risk factors of sleep quality in SSc in univariate analysis, depression (OR=1.380, 95%CI: 1.065−1.784, p=0.015) and sleep hygiene (OR=1.201, 95%CI: 1.003−1.439, p=0.046) were also found in multivariate logistic model. In RA patients, while health status, depression, and anxiety were found as risk factors according to the univariate analysis, depression (OR=1.120, 95%CI: 1.006−1.245, p=0.038) was the only factor according to multivariate logistic model (Table).Conclusion:Although depression is a well-known clinical variable impacting on sleep quality, sleep hygiene should also be kept in mind as a confounding factor.References:[1]Milette K, Hudson M, Körner A, et al. Sleep disturbances in systemic sclerosis: evidence for the role of gastrointestinal symptoms, pain and pruritus. Rheumatology (Oxford). 2013 Sep;52(9):1715-20.[2]Sariyildiz MA, Batmaz I, Budulgan M, et al. Sleep quality in patients with systemic sclerosis: relationship between the clinical variables, depressive symptoms, functional status, and the quality of life. Rheumatol Int. 2013 Aug;33(8):1973-9.TableUnivariate logistic regression analysis of clinical variables to assess predictors of sleep qualitySystemic sclerosisRheumatoid arthritisOR (95% CI)pOR (95% CI)pHAQ-DI1.019 (0.882−1.177)0.8011.089 (1.011−1.173)0.025BDI score1.293 (1.082−1.547)0.0051.129 (1.036−1.230)0.006BAI score1.080 (0.997−1.169)0.0591.122 (1.038−1.214)0.004SHI1.200 (1.060−1.357)0.0041.048 (0.965−1.137)0.264Disease activitya0.707 (0.439−1.138)0.1531.446 (0.839−2.492)0.185aDisease activity was calculated by Valentini disease activity index for SSc and DAS28-CRP for RA.Disclosure of Interests:None declared

scholarly journals A brief sleep focused psychoeducation program for sleep-related outcomes in new mothers: a randomized controlled trial

SLEEP ◽  
2020 ◽  
Vol 43 (11) ◽  
Author(s):  
Liora Kempler ◽  
Louise A Sharpe ◽  
Nathaniel S Marshall ◽  
Delwyn J Bartlett
Keyword(s):  
Sleep Quality ◽  
Daytime Sleepiness ◽  
Linear Mixed Model ◽  
Intervention Group ◽  
Control Group ◽  
Poor Sleep ◽  
Maternal Sleep ◽  
Pregnancy And Postpartum ◽  
Secondary Outcomes ◽  
Insomnia Symptoms

Abstract Study Objectives Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep, and depression. Methods A total of 215 healthy expectant first-time mothers were cluster randomized (1:1) to receive either a 2 × 1.5 h psychoeducation intervention and a set of booklets, or a set of booklets only. Participants completed questionnaires during pregnancy (pre-intervention), and 6 weeks and 4 months postpartum. A post hoc subset of questionnaires was collected at 10 months postpartum. The primary hypothesis was the intervention group would have improved postpartum sleep quality, and reduced levels of insomnia symptoms, fatigue, and daytime sleepiness compared to the control group. Secondary outcomes included depression, anxiety, and stress. Results Linear mixed model analyses failed to confirm a group by time interaction on primary or secondary outcomes across all time points. There was no effect of the intervention on outcomes at 6 weeks, or 10 months postpartum. A significant time by group interaction was found at 4 months, favoring the intervention for sleep quality (p = 0.03) and insomnia symptoms (p = 0.03), but not fatigue or daytime sleepiness. Conclusions Prenatal sleep psychoeducation did not produce a sustained effect on maternal sleep throughout the postpartum period. There was little evidence of benefits on depressive symptoms. Clinical Trial Registration ACTRN12611000859987

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