Multiple Sclerosis Reported Fatigue: Obstructive Sleep Apnea & Abnormalities in Sleep Architecture in a Community Cohort (I3-1.005)

OBJECTIVE: To explore the correlation of polysomnography documented first night sleep abnormalities in a large cohort of patients with MS who report fatigue. BACKGROUND: Fatigue can impact quality of life (QOL), employment, driving safety, and possibly cognition. Fatigue is a common and disabling symptom in patients with multiple sclerosis (MS). The presence and degree of fatigue in patients with MS primarily relies on patient self-report. Identifying contributing factors to and the subsequent treatment of fatigue in MS can be difficult. Self-reported data: fatigue, sleep disturbance, the presence of obstructive sleep apnea (OSA) may be unreliable. Studies utilizing polysomnography (PSG) to evaluate fatigue in patients with MS are limited by small sample size. The characterization of sleep disorders and abnormalities in patients with MS has been limited to date. Better understanding of abnormalities of sleep architecture in patients with MS might be important to understand the nature of MS fatigue and how to address this common problem. DESIGN/METHODS: Retrospective analysis of patients with MS who reported fatigue, and who underwent overnight PSG studies. RESULTS: 206 MS patients were identified who reported fatigue and successfully completed PSG. None of these patients with fatigue were identified to have disturbed sleep architecture prior to undergoing PSG study. PSG documented OSA (AHI蠅5) was identified in: 68% (N=206). Sleep Latency (Normal 30min 105/207 (51%), > 60min 52/207=25%. REM Latency (Normal 80-110minutes) 115/181 (63%) who achieved REM had REM Latency >110min, 63/181 (35%) REM latency >180min, 25/206 (12%) never achieved REM. CONCLUSIONS: The presence of OSA, abnormalities of sleep latency and REM sleep latency in MS patients who report fatigue may be more common than previously considered. PSG should be considered in all MS patients who report fatigue. Treatment of MS fatigue due to OSA needs further analysis. Study Supported by: no outside support received. Disclosure: Dr. Gudesblatt has received personal compensation for activities with Biogen Idec, Medtronic Inc., Teva Neuroscience, Genzyme Corp., Novartis and Sanofi-Aventis Pharmaceuticals Inc. as a consultant and/or speaker. Dr. Zarif has nothing to disclose. Dr. Bumstead has received personal compensation for activities with Biogen Idec and Teva Neuroscience. Dr. Fafard has nothing to disclose. Dr. Buhse has received personal compensation for activities with Biogen Idec, Teva Neuroscience, Bayer Pharmaceuticals Corporation, and Questcor. Dr. Buhse has received research support from Bayer Pharmaceuticals Corporation. Dr. Brass has received personal compensation for activities with UCB Pharma. Dr. Bardhi has nothing to disclose. Dr. Xian has nothing to disclose.