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Friday, May 8, 2015
Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis
Background: Quality of life (QOL) is impaired in multiple sclerosis (MS) in part due to physical disability. MS-associated fatigue (MSF) and poor sleep are common and treatable features of MS, which affect QOL.
Objective: The objective of this study was to assess the association between fatigue, sleep quality, and quality of life in people with MS.
Materials and Methods: Cross-sectional data were collected from 217 MS patients, who were referred to the outpatient MS center of Urmia, Iran, in 2013. Health-related quality of life (MS Quality of Life-54), fatigue (Fatigue Severity Scale, FSS), and sleep quality (Pittsburgh Sleep Quality Inventory, PSQI) were assessed. Expanded Disability Status Scale (EDSS) scores were also provided by a qualified neurologist.
Results: We included 217 patients in the analysis. The mean ± SD age of patients was 32.6 ± 9.6 years, and 79% were female. One hundred fifty-two (70.1%) of the patients were classified as poor sleepers based on PSQI scores. One hundred twenty-two (56.4%) presented with significant fatigue based on FSS results. The mean physical (PCS) and mental (MCS) health composite scores of the MSQOL-54 were 40.12 (SE 1.27) and 43.81 (SE 1.61), respectively. There was a strong statistically significant positive correlation between PCS scores and MCS (r = 0.58, P < .001), FSS (r = 0.49, P < .001), and PSQI (r = 0.52, P < .001) scores. MCS scores were strongly correlated with FSS (r = 0.53, P < .001) and PQSI (r = 0.35, P < .001) scores. Age exhibited significant negative correlations with PCS (r = −0.21, P < .05) and MCS (r = −0.58, P < .001) scores, and was significantly correlated with FSS (r = 0.23, P < .05) and PSQI (r = 0.21, P < .05) scores. EDSS scores were strongly correlated with FSS scores.
Conclusions: We observed strong correlations between QOL, fatigue, and sleep quality in a large community-based sample of individuals with MS. These findings support routinely screening and monitoring fatigue severity and sleep quality and their effects on QOL.
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