Contributions
Abstract: P380
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with Multiple Sclerosis (PwMS) frequently report fatigue. PwMS Fatigue can be severe/disabling. Sleep Apnea is a common cause of fatigue in PwMS. Periodic limb movements during sleep (PLMS), not commonly reported in PwMS. PLMS are characterized by leg movements or jerks which typically occur every 20 to 40 seconds during sleep. PLMS adversely impacts sleep by both causing sleep fragmentation and increasing energy cost during sleep as well as causing daytime somnolence. PwMS reported fatigue is typically subjective or quantified by patient reported outcomes. People affected by PLMS may be distinctly unaware and not self-report symptoms suggestive of PLMS unless specifically questioned. PLMS can be treated pharmacologically which can then improve sleep and reduce daytime fatigue PLMS can be easily investigated with Polysomnography (PSG), however, prior studies investigating PLMS in PwMS have been limited by small sample size.
Objective: To investigate the incidence/degree of PLMS during sleep in PwMS who report fatigue.
Methods: Retrospective analysis of PwMS who reported fatigue, and were not previously diagnosed as having Sleep Apnea or PLMS, and agreed to overnight PSG study.
Results: 292 PwMS (average age 47.3 ± 10.7 years, 81.4% female). No PwMS had a diagnosis of PLMS prior to undergoing PSG. PwMS reporting fatigue: 41% (n=121) had PLMS index (PLMS per hour, PLMS-I) >0. Of those PwMS with PSG identified PLMS: 10% had PLM-I 5-10 per hour, 5% had 11-21 PLMS-I, 12% had >21 PLMS-I. 38% (112/292) of PwMS experienced arousal due to PLMS (PLMS-AI). 34% (n=38) had 0< PLMS-AI< 5, 31% (n=35) had PLMS-AI 5-20, 14% (n=16) had PLMS-AI 20-50, and 21% (n=23) had PLMS-AI >50.
Conclusions: PLMS commonly occurs in PwMS who report fatigue. A group of PwMS who report fatigue have both significant >5 PLMS/hour and PLMS related arousals/hour. These factors increase the “work” of sleeping. PLMS may contribute to daytime sleepiness and should be recognized and potentially treated. The etiology of fatigue related to sleep problems in PwMS is multifactorial and is not just due to Obstructive Sleep Apnea.
Disclosure: (This study was supported by Teva):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
AG- Nothing to disclose
JS- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
AC: Nothing to disclose
KW: Nothing to disclose
LF- Nothing to disclose
MB- Nothing to disclose
Abstract: P380
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with Multiple Sclerosis (PwMS) frequently report fatigue. PwMS Fatigue can be severe/disabling. Sleep Apnea is a common cause of fatigue in PwMS. Periodic limb movements during sleep (PLMS), not commonly reported in PwMS. PLMS are characterized by leg movements or jerks which typically occur every 20 to 40 seconds during sleep. PLMS adversely impacts sleep by both causing sleep fragmentation and increasing energy cost during sleep as well as causing daytime somnolence. PwMS reported fatigue is typically subjective or quantified by patient reported outcomes. People affected by PLMS may be distinctly unaware and not self-report symptoms suggestive of PLMS unless specifically questioned. PLMS can be treated pharmacologically which can then improve sleep and reduce daytime fatigue PLMS can be easily investigated with Polysomnography (PSG), however, prior studies investigating PLMS in PwMS have been limited by small sample size.
Objective: To investigate the incidence/degree of PLMS during sleep in PwMS who report fatigue.
Methods: Retrospective analysis of PwMS who reported fatigue, and were not previously diagnosed as having Sleep Apnea or PLMS, and agreed to overnight PSG study.
Results: 292 PwMS (average age 47.3 ± 10.7 years, 81.4% female). No PwMS had a diagnosis of PLMS prior to undergoing PSG. PwMS reporting fatigue: 41% (n=121) had PLMS index (PLMS per hour, PLMS-I) >0. Of those PwMS with PSG identified PLMS: 10% had PLM-I 5-10 per hour, 5% had 11-21 PLMS-I, 12% had >21 PLMS-I. 38% (112/292) of PwMS experienced arousal due to PLMS (PLMS-AI). 34% (n=38) had 0< PLMS-AI< 5, 31% (n=35) had PLMS-AI 5-20, 14% (n=16) had PLMS-AI 20-50, and 21% (n=23) had PLMS-AI >50.
Conclusions: PLMS commonly occurs in PwMS who report fatigue. A group of PwMS who report fatigue have both significant >5 PLMS/hour and PLMS related arousals/hour. These factors increase the “work” of sleeping. PLMS may contribute to daytime sleepiness and should be recognized and potentially treated. The etiology of fatigue related to sleep problems in PwMS is multifactorial and is not just due to Obstructive Sleep Apnea.
Disclosure: (This study was supported by Teva):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
AG- Nothing to disclose
JS- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
AC: Nothing to disclose
KW: Nothing to disclose
LF- Nothing to disclose
MB- Nothing to disclose