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Friday, May 8, 2015

Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis

Fatemeh Moghaddam TabriziPhDMoloud RadfarPhD
From the Nursing and Midwifery Department, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
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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