Multiple Sclerosis Rehabilitation Unit, Milan, Italy.
Mult Scler. 2010 Feb;16(2):238-47. doi: 10.1177/1352458509354551. Epub 2009 Dec 22.
Poor sleep is common in MS and it contributes to fatigue. The beta interferons produce systemic effects which may not adapt and may induce fatigue.
To verify whether subjective poor sleep and fatigue during chronic therapy correspond to reduced sleep efficiency obtained by actigraphy at home.
42 ambulatory relapsing remitting MS patients with mild disability were monitored for at least 7 nights. Habitual sleep quality and fatigue were assessed with the MOS sleep measure and the Fatigue Severity Scale. Sleep logs provided daily sleep quality assessments during actigraphy at home. Patients were grouped according to their current treatment: no therapy, glatiramer acetate, IFNbeta 3 times a week, and IFNbeta once a week.
Sleep efficiency was reduced by an average of 5% in 2/3 of the nights following IFNbeta injections compared to the other nights, and daily sleep ratings correlated with actigraphy. Patients on glatiramer acetate also showed a lower sleep efficiency than patients without therapy. Actigraphy data were only modestly correlated with MOSsm scores, not with fatigue. Long term adaptation of sleep effects of immunomodulant agents is incomplete and needs to be considered in treatment planning and assessment of sleep in MS.
多发性硬化症患者中普遍存在睡眠质量差的问题，且这会导致疲劳。β干扰素会产生全身作用，可能无法适应，从而导致疲劳。
验证慢性治疗期间的主观睡眠质量差和疲劳是否与家庭活动记录仪得出的睡眠效率降低有关。
对 42 名处于缓解期的活动能力轻度受损的复发缓解型多发性硬化症患者进行了至少 7 个晚上的监测。使用 MOS 睡眠量表和疲劳严重程度量表评估习惯性睡眠质量和疲劳。睡眠日志提供了家庭活动记录仪期间的日常睡眠质量评估。根据患者的当前治疗方法对其进行分组：无治疗、那他珠单抗、IFNβ每周 3 次和 IFNβ每周 1 次。
与其他晚上相比，IFNβ 注射后的两到三个晚上，平均有 5%的睡眠时间效率降低，且日间睡眠评分与活动记录仪相关。接受那他珠单抗治疗的患者睡眠效率也低于未接受治疗的患者。活动记录仪数据与 MOSsm 评分的相关性仅为中度，与疲劳无相关性。免疫调节剂的睡眠作用的长期适应不完全，在治疗计划和多发性硬化症的睡眠评估中需要考虑到这一点。
