Veauthier Christian, Gaede Gunnar, Radbruch Helena, Gottschalk Sandra, Wernecke Klaus-Dieter, Paul Friedemann
Hanse-Klinikum, Department of Neurology, Stralsund, Germany.
Clin Neurol Neurosurg. 2013 Sep;115(9):1826-30. doi: 10.1016/j.clineuro.2013.05.018. Epub 2013 Jun 12.
In a previous polysomnographic cross-sectional study we found a significant relationship between sleep disorders and multiple sclerosis (MS) related fatigue. The purpose of this open follow-up observation was to compare the impact of treatment of sleep disorders on MS related fatigue measured with the Modified Fatigue Impact Scale (MFIS).
Non-randomized follow-up observation: treated versus untreated patients, subgroups according to compliance with sleep medical treatment recommendations (univariate, multivariate analysis, multiple logistic regression). 66 MS patients were followed after polysomnography, 49 patients with relevant sleep disorders and 17 without.
Mean MFIS scores decreased from 41.2 to 26.2 (p=0.025) in patients with good compliance (GC; n=18), from 42.4 to 32.1 (p=0.12) in patients with moderate compliance (MC; n=12), and from 41.6 to 35.5 (p=0.17) in non-compliant patients (NC; n=17). Mean MFIS values increased in patients without sleep disorders from 22.9 to 25.4 (NSD; n=12, p=0.56). In multiple logistic regression, treatment of sleep disorders predicted decrease of MFIS-values (GC versus NSD odds ratio 13.4; p=0.015; 95% confidence interval (CI) 1.7-107.2, MC versus NSD odds ratio 13.8; p=0.028; 95% CI 1.3-143.3).
Sleep medical treatment may improve MS related fatigue when patients adhere to treatment recommendations.
在之前的一项多导睡眠图横断面研究中，我们发现睡眠障碍与多发性硬化症（MS）相关疲劳之间存在显著关联。这项开放性随访观察的目的是比较睡眠障碍治疗对采用改良疲劳影响量表（MFIS）测量的MS相关疲劳的影响。
非随机随访观察：治疗组与未治疗组患者，根据对睡眠医学治疗建议的依从性进行亚组分析（单变量、多变量分析、多重逻辑回归）。66例MS患者在进行多导睡眠图检查后接受随访，其中49例有相关睡眠障碍，17例无睡眠障碍。
依从性良好（GC；n = 18）的患者，MFIS平均得分从41.2降至26.2（p = 0.025）；依从性中等（MC；n = 12）的患者，MFIS平均得分从42.4降至32.1（p = 0.12）；不依从（NC；n = 17）的患者，MFIS平均得分从41.6降至35.5（p = 0.17）。无睡眠障碍的患者（NSD；n = 12），MFIS平均得分从22.9升至25.4（p = 0.56）。在多重逻辑回归分析中，睡眠障碍治疗可预测MFIS值降低（GC组与NSD组的优势比为13.4；p = 0.015；95%置信区间（CI）为1.7 - 107.2，MC组与NSD组的优势比为13.8；p = 0.028；95%CI为1.3 - 143.3）。
当患者遵循治疗建议时，睡眠医学治疗可能改善MS相关疲劳。
