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Poor quality of sleep and fatigue and their relationship with the functional status of patients with Multiple sclerosis

Aim: The aim of this study is to assess the quality of sleep in patients with Multiple sclerosis and evaluate the effect of the quality of sleep on fatigue. Investigate the relationship between the quality of sleep, fatigue and functional status of patients with Multiple sclerosis. Material/Methods: This is a prospective research conducted on patients with Multiple sclerosis treated at the Neurology Clinic at the Clinical Hospital Centre Osijek. The general questionnaire consists of demographic questions and the patient's self-assessment of their quality of life. The Functional Assessment Of Chronic Illness Therapy (FACIT) questionnaire (Croatian version - FAMS) was used to assess the six aspects of functional status. A higher score indicates a better functional status. The quality of sleep was assessed using the seven sub-scales of the Pittsburgh Sleep Quality Inventory (PSQI). A higher PSQI score indicated a poorer quality of sleep. The presence of fatigue was investigated using the three sub-scales of the Modified Fatigue Impact Scale (MFIS) where a higher MFIS score indicated the presence of a more severe fatigue. Results: The results are preliminary. Out of the total number of participants (50), 17 (34%) were male. The average age was 43, 9 (≠11, 8) years, while the average disease duration was 10, 04 (≠8, 3) years. 19 (38%) of the participants are employed, 33 (64%) are in a married/non-married relationship. Mean score of the quality of sleep was 7, 73 (≠ 4, 4) and fatigue 41 (≠21, 8). A considerable poorer quality of sleep on the "sleep latency" sub- scale (p=0, 027) and the "daytime dysfunction" sub-scale (p=0, 014) was noted in patients who do not work. Women scored considerably lower on the "sleep duration" sub-scale (p=0, 048) and considerably higher on the "sleep disturbances" sub-scale (p=0, 009). Female participants experience considerably higher fatigue levels, especially on the cognitive sub-scale (p=0, 046). Participants whose disease duration is over 10 years experience a more severe fatigue (p=0, 040), especially on the physical (p=0, 046) and psycho-social (p=0, 011) sub- scales. Patients with poor quality of sleep also experience more severe fatigue (p<0, 001) and have a worse functional status (p<0, 001). The results also showed a negative correlation between patients' functional status and the quality of sleep (=-0, 648 p<0, 001) and between functional status and the presence of fatigue (=-0, 812 p<0, 001). Conclusion: Preliminary results indicate a connection between poor quality of sleep and more profound levels of fatigue. Better quality of sleep and less severe fatigue is associated with enhanced functional status and quality of life. Through monitoring, early detection of sleep difficulties and patient education, nurses can contribute to the prevention of most aspects that cause poor quality of sleep. Such results emphasize the need for future research in this area and a continuing assessment of these issues.

multiple sclerosis, functional status, healthcare, fatigue, sleep

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