Contributions
Abstract: P708
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with multiple sclerosis (PwMS) commonly report fatigue. Fatigue in PwMS, which can be disabling, has been reported to be related to many factors including sleep disordered breathing (SDB). SDB can be caused by obstructive sleep apnea (OSA), upper airway resistance (UARS) and also central sleep apnea (CSA). Presence/degree of fatigue in PwMS is primarily assessed with patient self-reported outcomes (PROs). The Modified Fatigue Impact scale (MFIS) and Fatigue Severity Scale (FSS) are PROs commonly used to screen for fatigue in PwMS, but neither screen for sleep apnea. Central sleep apnea (CSA) is defined by polysomnography (PSG) as Central Apnea-Hypopnea Index (AHI) ≥5. MRI Brain abnormalities in PwMS include central nervous system demyelination and axonal damage as well as atrophy. The relationship of these abnormalities to CSA is unclear. The incidence of CSA in PwMS is uncertain. PSG studies in PwMS have been limited by small sample size to date.
Objective: To explore the incidence/severity of central sleep apnea in PwMS who report fatigue.
Methods: Retrospective analysis of PwMS who reported fatigue, were not previously diagnosed as having OSA, and agreed to overnight polysomnography studies.
Results: 292 PwMS (average age 47.3 ± 10.7 years, 81.4% female) completed PSG. PwMS had central AHI values identified in 77% (225/292). However, only 6% of this cohort had CSA. Average age of PwMS with CSA was 48.69 ± 9.6 and 54% were female. 36% PwMS with CSA (EDSS score 0-2.5), 27% (EDSS score 3.0-5.5), and 36% (EDSS score >6.0). 73% of PwMS had BMI ≥ 28. The presence of CSA was not related to MFIS or FSS score (R=0.064, p=0.523; R=0.032, p=0.737 respectively).
Conclusions: CSA is uncommon in PwMS who report fatigue and undergo PSG. Despite PwMS having varied types/degrees of CNS damage, CSA as a consequence of or related to such damage appears uncommon. While CSA is not primary reason for fatigue in PwMS, it may contribute to the presence/severity of fatigue in select PwMS.
Disclosure: Disclosures (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: P708
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with multiple sclerosis (PwMS) commonly report fatigue. Fatigue in PwMS, which can be disabling, has been reported to be related to many factors including sleep disordered breathing (SDB). SDB can be caused by obstructive sleep apnea (OSA), upper airway resistance (UARS) and also central sleep apnea (CSA). Presence/degree of fatigue in PwMS is primarily assessed with patient self-reported outcomes (PROs). The Modified Fatigue Impact scale (MFIS) and Fatigue Severity Scale (FSS) are PROs commonly used to screen for fatigue in PwMS, but neither screen for sleep apnea. Central sleep apnea (CSA) is defined by polysomnography (PSG) as Central Apnea-Hypopnea Index (AHI) ≥5. MRI Brain abnormalities in PwMS include central nervous system demyelination and axonal damage as well as atrophy. The relationship of these abnormalities to CSA is unclear. The incidence of CSA in PwMS is uncertain. PSG studies in PwMS have been limited by small sample size to date.
Objective: To explore the incidence/severity of central sleep apnea in PwMS who report fatigue.
Methods: Retrospective analysis of PwMS who reported fatigue, were not previously diagnosed as having OSA, and agreed to overnight polysomnography studies.
Results: 292 PwMS (average age 47.3 ± 10.7 years, 81.4% female) completed PSG. PwMS had central AHI values identified in 77% (225/292). However, only 6% of this cohort had CSA. Average age of PwMS with CSA was 48.69 ± 9.6 and 54% were female. 36% PwMS with CSA (EDSS score 0-2.5), 27% (EDSS score 3.0-5.5), and 36% (EDSS score >6.0). 73% of PwMS had BMI ≥ 28. The presence of CSA was not related to MFIS or FSS score (R=0.064, p=0.523; R=0.032, p=0.737 respectively).
Conclusions: CSA is uncommon in PwMS who report fatigue and undergo PSG. Despite PwMS having varied types/degrees of CNS damage, CSA as a consequence of or related to such damage appears uncommon. While CSA is not primary reason for fatigue in PwMS, it may contribute to the presence/severity of fatigue in select PwMS.
Disclosure: Disclosures (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