Dimmick Hannah L, Jewett Gordon, Korngut Lawrence W, Ferber Reed
Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Muscle Nerve. 2025 Jan;71(1):33-42. doi: 10.1002/mus.28282. Epub 2024 Oct 30.
INTRODUCTION/AIMS: Fluctuating symptoms and fatigue are common issues in myasthenia gravis (MG), but it is unclear if these symptoms are related to physical activity or sleep patterns. This study sought to determine the day-to-day relationship between patient-reported symptoms and physical activity and sleep over 12 weeks.
Sixteen participants with generalized MG wore a wrist-mounted accelerometer continuously for the study duration and reported their symptoms and fatigue each evening. Cumulative link mixed models were used to analyze whether clinical and demographic characteristics, physical activity, and sleep were related to symptom severity and fatigue over the study period. Three types of models were constructed: a cohort model, a model in which data was scaled to each participant, and individual models.
The cohort model indicated that higher disease severity, female sex, more comorbidities, less physical activity, more inactive time, and lower quantity of sleep were significantly associated with increased symptom severity and fatigue (p < .05). However, in the within-participant scaled model, there were almost no significant associations with physical activity or sleep. In the individual models, some participants showed similar results to the cohort model, but others showed no associations or the opposite response in some variables.
While physical activity and sleep were associated with self-reported symptoms and fatigue within this population, this was not necessarily applicable to individuals. This demonstrates the importance of an individualized analysis for determining how physical activity and sleep may impact outcomes in MG, with implications for clinical and self-management.
引言/目的：症状波动和疲劳是重症肌无力（MG）的常见问题，但这些症状是否与体力活动或睡眠模式有关尚不清楚。本研究旨在确定患者报告的症状与12周内体力活动和睡眠之间的日常关系。
16名全身型MG患者在研究期间持续佩戴腕式加速度计，并在每晚报告他们的症状和疲劳情况。使用累积链接混合模型分析临床和人口统计学特征、体力活动和睡眠在研究期间是否与症状严重程度和疲劳有关。构建了三种类型的模型：队列模型、数据按每个参与者进行缩放的模型和个体模型。
队列模型表明，疾病严重程度较高、女性、合并症较多、体力活动较少、不活动时间较多以及睡眠量较低与症状严重程度和疲劳增加显著相关（p < 0.05）。然而，在参与者内部缩放模型中，与体力活动或睡眠几乎没有显著关联。在个体模型中，一些参与者的结果与队列模型相似，但其他参与者在某些变量上没有关联或呈现相反的反应。
虽然体力活动和睡眠与该人群自我报告的症状和疲劳有关，但这不一定适用于个体。这证明了个体化分析对于确定体力活动和睡眠如何影响MG结局的重要性，对临床和自我管理具有启示意义。
