A systematic review of the incidence and prevalence of sleep disorders and seizure disorders in multiple sclerosis

Background: Several studies have suggested that comorbid neurologic disorders are more common than expected in multiple sclerosis (MS). Objective: To estimate the incidence and prevalence of comorbid seizure disorders and sleep disorders in persons with MS and to evaluate the quality of studies included. Methods: The PUBMED, EMBASE, Web of Knowledge, and SCOPUS databases, conference proceedings, and reference lists of retrieved articles were searched. Two reviewers independently screened abstracts to identify relevant articles, followed by full-text review of selected articles. We assessed included studies qualitatively and quantitatively ( I2 statistic), and conducted meta-analyses among population-based studies. Results: We reviewed 32 studies regarding seizure disorders. Among population-based studies the incidence of seizure disorders was 2.28% (95% CI: 1.11–3.44%), while the prevalence was 3.09% (95% CI: 2.01–4.16%). For sleep disorders we evaluated 18 studies; none were population-based. The prevalence ranged from 0–1.6% for narcolepsy, 14.4–57.5% for restless legs syndrome, 2.22–3.2% for REM behavior disorder, and 7.14–58.1% for obstructive sleep apnea. Conclusion: This review suggests that seizure disorders and sleep disorders are common in MS, but highlights gaps in the epidemiological knowledge of these conditions in MS worldwide. Other than central-western Europe and North America, most regions are understudied.

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The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic review

Multiple Sclerosis Journal ◽

10.1177/1352458514564487 ◽

2015 ◽

Vol 21 (3) ◽

pp. 305-317 ◽

Cited By ~ 198

Author(s):

Ruth Ann Marrie ◽

Stephen Reingold ◽

Jeffrey Cohen ◽

Olaf Stuve ◽

Maria Trojano ◽

...

Keyword(s):

Multiple Sclerosis ◽

Psychiatric Disorders ◽

Psychiatric Comorbidity ◽

Population Based ◽

Depression And Anxiety ◽

Disease Modifying Therapy ◽

Full Text Review ◽

Meta Analyses ◽

Reduced Adherence

Background: Psychiatric comorbidity is associated with lower quality of life, more fatigue, and reduced adherence to disease-modifying therapy in multiple sclerosis (MS). Objectives: The objectives of this review are to estimate the incidence and prevalence of selected comorbid psychiatric disorders in MS and evaluate the quality of included studies. Methods: We searched the PubMed, PsychInfo, SCOPUS, and Web of Knowledge databases and reference lists of retrieved articles. Abstracts were screened for relevance by two independent reviewers, followed by full-text review. Data were abstracted by one reviewer, and verified by a second reviewer. Study quality was evaluated using a standardized tool. For population-based studies we assessed heterogeneity quantitatively using the I2 statistic, and conducted meta-analyses. Results: We included 118 studies in this review. Among population-based studies, the prevalence of anxiety was 21.9% (95% CI: 8.76%–35.0%), while it was 14.8% for alcohol abuse, 5.83% for bipolar disorder, 23.7% (95% CI: 17.4%–30.0%) for depression, 2.5% for substance abuse, and 4.3% (95% CI: 0%–10.3%) for psychosis. Conclusion: This review confirms that psychiatric comorbidity, particularly depression and anxiety, is common in MS. However, the incidence of psychiatric comorbidity remains understudied. Future comparisons across studies would be enhanced by developing a consistent approach to measuring psychiatric comorbidity, and reporting of age-, sex-, and ethnicity-specific estimates.

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Three Decades of Progress in Sleep Disorders and Sleep Health for Women

Gender and the Genome ◽

10.1177/2470289720941870 ◽

2020 ◽

Vol 4 ◽

pp. 247028972094187

Author(s):

Jennifer L. Marsella ◽

Katherine M. Sharkey

Keyword(s):

Sleep Disorders ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Future Research ◽

Sex And Gender ◽

Sleep Health ◽

Sleep Behavior ◽

Obstructive Sleep ◽

And Gender ◽

The Impact

Over the past 3 decades, significant strides have been made in the field of sleep medicine for women. The impact of sex and gender on sleep health and sleep disorders received little attention in the early 1990s, but driven by policies ensuring inclusion of women in medical research, more recent studies have identified sex differences in sleep and investigated gender differences in sleep disorders. Nevertheless, disparities remain: diagnosis of sleep disorders, such as obstructive sleep apnea, narcolepsy, and rapid eye movement (REM) sleep behavior disorder are often delayed and underdiagnosed in women. Future research should continue to examine how biological sex and identity across the gender spectrum influence sleep health and sleep disorders, allowing for more personalized health care for all patients.

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EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke

European Respiratory Journal ◽

10.1183/13993003.01104-2019 ◽

2020 ◽

Vol 55 (4) ◽

pp. 1901104 ◽

Cited By ~ 7

Author(s):

Claudio L.A. Bassetti ◽

Winfried Randerath ◽

Luca Vignatelli ◽

Luigi Ferini-Strambi ◽

Anne-Kathrin Brill ◽

...

Keyword(s):

Sleep Disorders ◽

Systematic Reviews ◽

Stroke Risk ◽

Current Evidence ◽

Periodic Limb Movements ◽

Stroke Outcome ◽

Obstructive Sleep ◽

Increased Risk ◽

Meta Analyses ◽

The Impact

Sleep disorders are highly prevalent in the general population and may be linked in a bidirectional fashion to stroke, which is one of the leading causes of morbidity and mortality.Four major scientific societies established a task force of experts in neurology, stroke, respiratory medicine, sleep medicine and methodology, to critically evaluate the evidence regarding potential links and the impact of therapy. 13 research questions were evaluated in a systematic literature search using a stepwise hierarchical approach: first, systematic reviews and meta-analyses; second, primary studies post-dating the systematic reviews/meta-analyses. A total of 445 studies were evaluated and 88 included. Statements were generated regarding current evidence and clinical practice.Severe obstructive sleep apnoea (OSA) doubles the risk for incident stroke, especially in young to middle-aged patients. Continuous positive airway pressure (CPAP) may reduce stroke risk, especially in treatment-compliant patients. The prevalence of OSA is high in stroke patients and can be assessed by polygraphy. Severe OSA is a risk factor for recurrence of stroke and may be associated with stroke mortality, while CPAP may improve stroke outcome. It is not clear if insomnia increases stroke risk, while pharmacotherapy of insomnia may increase it. Periodic limb movements in sleep (PLMS), but not restless limb syndrome (RLS), may be associated with an increased risk of stroke. Preliminary data suggest a high frequency of post-stroke insomnia and RLS and their association with a less favourable stroke outcome, while treatment data are scarce.Overall, the evidence base is best for OSA relationship with stroke and supports active diagnosis and therapy. Research gaps remain especially regarding insomnia and RLS/PLMS relationships with stroke.

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The epidemiology of multiple sclerosis in the entre Douro e Vouga region of northern Portugal: a multisource population-based study

BMC Neurology ◽

10.1186/s12883-020-01755-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Mariana Branco ◽

Ivânia Alves ◽

Ana Martins da Silva ◽

Joaquim Pinheiro ◽

Maria José Sá ◽

...

Keyword(s):

Multiple Sclerosis ◽

Primary Care Physicians ◽

Western Europe ◽

Disease Onset ◽

Clinical Information ◽

Reference Population ◽

Population Based ◽

Prevalence Studies ◽

The North ◽

Northern Portugal

Abstract Background The prevalence of Multiple Sclerosis (MS) has been increasing worldwide and the north–south gradient of prevalence may be disappearing in the Northern hemisphere. The few previous prevalence studies performed in Portugal have reported a lower prevalence than the average for Western Europe. The aim of this study is to estimate the prevalence of MS in the Entre Douro e Vouga region, in Northern Portugal. Methods Multiple overlapping sources were used to ascertain all cases from the reference population: records from hospitals in the region and neighbouring regions; diagnostic databases of primary care physicians; and applications for disability benefits. The prevalence date was set at 1 January 2014. The reference population was 274,859 inhabitants. Patients’ neurologists were contacted to retrieve clinical information and confirm the diagnosis based. Results A total of 177 patients were identified after eliminating duplicates from different sources. The female to male ratio was 1.9 and the mean age at disease onset was 33.5 (standard deviation: 10.3). Clinically isolated syndrome accounted for 9.0% of patients, relapsing remitting for 58.8%, secondary progressive for 20.3% and primary progressive for 11.8%. The prevalence was estimated in 64.4 patients per 100,000 (95% confidence interval: 54.9;73.9). Conclusions In this study we report a higher point prevalence of MS than had been previously described in Portugal, but still far from the higher values recently reported in other Southern European countries.

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A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview

Multiple Sclerosis Journal ◽

10.1177/1352458514564491 ◽

2015 ◽

Vol 21 (3) ◽

pp. 263-281 ◽

Cited By ~ 128

Author(s):

Ruth Ann Marrie ◽

Jeffrey Cohen ◽

Olaf Stuve ◽

Maria Trojano ◽

Per Soelberg Sørensen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Reference Lists ◽

Population Based ◽

Study Quality ◽

Case Definitions ◽

Future Studies ◽

Source Populations ◽

Meta Analyses ◽

Study Designs

Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population.

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Fatigue, sleep disorders, anaemia and pain in the multiple sclerosis prodrome

Multiple Sclerosis Journal ◽

10.1177/1352458520908163 ◽

2020 ◽

pp. 135245852090816 ◽

Cited By ~ 3

Author(s):

Fardowsa LA Yusuf ◽

José MA Wijnands ◽

Elaine Kingwell ◽

Feng Zhu ◽

Charity Evans ◽

...

Keyword(s):

Multiple Sclerosis ◽

Sleep Disorders ◽

Symptom Onset ◽

Population Based ◽

Matched Cohort ◽

Physician Visits ◽

Clinical Databases ◽

Form Part ◽

Population Controls ◽

Age And Sex

Background: There is increasing evidence of prodromal multiple sclerosis (MS). Objective: The aim of this study was to determine whether fatigue, sleep disorders, anaemia or pain form part of the MS prodrome. Methods: This population-based matched cohort study used linked administrative and clinical databases in British Columbia, Canada. The odds of fatigue, sleep disorders, anaemia and pain in the 5 years preceding the MS cases’ first demyelinating claim or MS symptom onset were compared with general population controls. The frequencies of physician visits for these conditions were also compared. Modifying effects of age and sex were evaluated. Results: MS cases/controls were assessed before the first demyelinating event (6863/31,865) or MS symptom onset (966/4534). Fatigue (adj.OR: 3.37; 95% CI: 2.76–4.10), sleep disorders (adj.OR: 2.61; 95% CI: 2.34–2.91), anaemia (adj.OR: 1.53; 95% CI: 1.32–1.78) and pain (adj.OR: 2.15; 95% CI: 2.03–2.27) during the 5 years preceding the first demyelinating event were more frequent among cases, and physician visits increased for cases relative to controls. The association between MS and anaemia was greater for men; that between MS and pain increased with age. Pre-MS symptom onset, sleep disorders (adj.OR: 1.72; 95% CI: 1.12–2.56) and pain (adj.OR: 1.53; 95% CI: 1.32–1.76) were more prevalent among cases. Conclusion: Fatigue, sleep disorders, anaemia and pain were elevated before the recognition of MS. The relative anaemia burden was higher in men and pain more evident among older adults.

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Retinal migraine

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0009 ◽

2020 ◽

pp. 92-97

Author(s):

Brian M. Grosberg ◽

C. Mark Sollars

Keyword(s):

Multiple Sclerosis ◽

Bipolar Disorder ◽

Abdominal Pain ◽

Low Back Pain ◽

Sleep Disorders ◽

Population Based ◽

Sleep Apnoea ◽

Cross Sectional ◽

Relationship Of ◽

The Relationship

The relationship between migraine and a large number of other diseases has been studied to varying degrees. Both clinical and population-based studies, cross-sectional and longitudinal, have been performed, indicating a relationship of migraine with ischaemic stroke, epilepsy, vertigo, psychiatric disorders, sleep disorders, pain disorders, and others. The association of migraine with depression is one of the most extensively studied comorbidities. The bidirectional nature of this comorbidity indicates possible shared genetic factors. Furthermore, the risk of migraine chronification is increased in migraine patients with a depression. Also, anxiety and bipolar disorder show clear associations with migraine. Sleep disorders have been reported to occur more often in migraineurs than in persons without migraine. A clear association was found for restless legs syndrome and familial advanced sleep phase syndrome. Furthermore, associations have been described with insomnia, daytime sleepiness, sleep apnoea, and narcolepsy. Among pain disorders associated with migraine are low back pain, fibromyalgia, and abdominal pain. The magnitude and the background of these comorbidities remain unclear, and should be further investigated. Other described comorbidities of migraine include syncope, movement disorders, asthma and allergies, gynaecological disturbances, obesity, diabetes, multiple sclerosis, and cancer.

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The incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in multiple sclerosis: A systematic review

Multiple Sclerosis Journal ◽

10.1177/1352458514564488 ◽

2014 ◽

Vol 21 (3) ◽

pp. 332-341 ◽

Cited By ~ 24

Author(s):

Ruth Ann Marrie ◽

Nadia Reider ◽

Olaf Stuve ◽

Maria Trojano ◽

Per Soelberg Sorensen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Irritable Bowel Syndrome ◽

Lung Disease ◽

Chronic Lung Disease ◽

World Literature ◽

Population Based ◽

Case Definitions ◽

Renal Disorders ◽

Irritable Bowel ◽

Meta Analyses

Background: As new disease-modifying therapies emerge a better knowledge of the risk of comorbid disease in multiple sclerosis (MS) is needed. Objective: To estimate the incidence and prevalence of comorbid gastrointestinal, musculoskeletal, ocular, pulmonary, and renal disorders in MS. Methods: We systematically reviewed the world literature by searching PUBMED, EMBASE, SCOPUS, the Web of Knowledge, and reference lists of retrieved articles. For selected articles, one reviewer abstracted data using a standardized form. The abstraction was verified by a second reviewer. The quality of all selected studies was assessed. For population-based studies we quantitatively assessed studies using the I2 statistic, and conducted random effects meta-analyses. Results: Study designs were heterogeneous with respect to populations, case definitions, and methods of ascertainment. Incidence of the studied comorbidities was rarely reported. Irritable bowel syndrome and chronic lung disease had a prevalence of more than 10% in the MS population. Irritable bowel syndrome, fibromyalgia, cataracts and glaucoma were more common than expected in the MS population. Conclusion: Although they have been the subject of less study than other comorbidities, irritable bowel syndrome, arthritis, and chronic lung disease are common in the MS population and occur more often than expected when compared to the general population.

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Sleep disorders in essential tremor: systematic review and meta-analysis

SLEEP ◽

10.1093/sleep/zsaa039 ◽

2020 ◽

Vol 43 (9) ◽

Cited By ~ 1

Author(s):

Félix Javier Jiménez-Jiménez ◽

Hortensia Alonso-Navarro ◽

Elena García-Martín ◽

José A G Agúndez

Keyword(s):

Systematic Review ◽

Sleep Disorders ◽

Essential Tremor ◽

Sleep Disturbances ◽

Sleep Problems ◽

Meta Analysis ◽

Behavior Disorder ◽

Search Term ◽

Sleep Behavior ◽

Meta Analyses

Abstract Sleep disorders are frequent in patients diagnosed with essential tremor (ET). The present review focuses on sleep disorders and the results of polysomnographic studies performed in patients with ET. For this purpose we performed a systematic review crossing the search term “essential tremor” with “sleep,” “sleep disorders,” “sleep disturbances” and “polysomnography,” and with specific sleep disorders, according to the International Classification of the Sleep Disorders—Third Edition, using the PubMed, EMBASE, MEDLINE, and Web of Science Databases. The most frequent sleep problems reported by patients with ET were the bad quality of sleep and excessive daytime somnolence (the latter could be related to drugs commonly used for the treatment of ET). Probable rapid eye movement sleep behavior disorder, coexistent restless legs syndrome, insomnia, and nocturia were not infrequent complaints, while the presence of other sleep disorders in patients with ET was restricted to anecdotal reports or not described. Meta-analyses of previous reports showed that patients with ET (according to the PRISMA and MOOSE guidelines) showed higher scores in the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale than controls and lower scores than those of patients diagnosed with Parkinson’s disease. Studies using polysomnography in patients with ET are scarce and do not permit to establish valid conclusions regarding polysomnographic features in this disorder.

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Nocturnal awakening with headache and its relationship with sleep disorders in a population-based sample of adult inhabitants of São Paulo City, Brazil

Cephalalgia ◽

10.1177/0333102410368440 ◽

2010 ◽

Vol 30 (12) ◽

pp. 1477-1485 ◽

Cited By ~ 14

Author(s):

Ligia Mendonça Lucchesi ◽

Jose Geraldo Speciali ◽

Rogerio Santos-Silva ◽

Jose Augusto Taddei ◽

Sergio Tufik ◽

...

Keyword(s):

Risk Factors ◽

Sleep Disorders ◽

Sleep Apnea Syndrome ◽

Life Quality ◽

Female Gender ◽

Population Based ◽

Sao Paulo ◽

São Paulo ◽

Obstructive Sleep ◽

Nocturnal Awakening

Our aim was to estimate the prevalence of nocturnal awakening with headache (NAH) in the population of São Paulo City according to gender, age (20–80 years old) and socioeconomic classes and its relationship to sleep disorders, sleep parameters, anxiety, depression, fatigue, life quality and obesity. We used a population-based survey with a representative three-stage cluster sample. Questionnaires and scales were applied face-to-face, and polysomnography was performed in 1101 volunteers, aged 42 ± 14 years, 55% women. The complaint of NAH occurring at least once a week had a prevalence of 8.4%, mostly in women, obese subjects and those aged 50–59 years-old. We observed associations of NAH with insomnia, restless leg syndrome (RLS), nightmares and bruxism, but not obstructive sleep apnea syndrome. In a logistics regression model, risk factors for NAH were female gender, odds ratio (OR) (95% confidence interval [CI]) 4.5 (2.8–7.3); obesity, OR 1.9 (1.1–3.3); age between 50 and 59 years, OR 2.4 (1.2–4.7); severe anxiety, OR 8.1 (3.6–18.1); RLS, 2.7 (1.2–5.6); and nightmares, 2.2 (1.3–3.7). Our study shows that NAH was highly prevalent in the population of São Paulo and suggests that this phenomenon has specific characteristics with specific risk factors: obesity, RLS and nightmares.

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