1046 Sleep Problems Predict Pain One Month After Diagnosis and Twelve Months Later Among People with Multiple Sclerosis

Abstract Introduction Sleep problems and pain are commonly experienced by people with multiple sclerosis (PwMS). This study aimed to determine whether sleep problems assessed one month after receiving an MS diagnosis associated with pain intensity and/or pain interference at this time or predicted these pain outcomes 12 months after diagnosis. Methods This secondary analysis used data from the prospective observational LAND (‘Life After New Diagnosis’) study and was restricted to those with an MS diagnosis who provided complete Medical Outcomes Study (MOS) Sleep Scale questionnaire data. Linear regression was used to quantify associations between sleep variables (MOS-Sleep problems index and dimension scores ‘sleep disturbance’, ‘sleep adequacy’, and ‘awaken short of breath or headache’) and pain intensity (past-week average, 0-10 Numeric Rating Scale) and pain interference (PROMIS Short Form 6a), adjusted for age, sex, number of years of education, comorbidities, and, in longitudinal models, baseline level of the outcome (pain intensity or pain interference). A p value < 0.05 was used to determine statistical significance. Results The sample (N=174) was predominantly female (69.5%) and white (86.2%), with a mean age of 39.8 years (standard deviation 11.2). The most common MS disease course was relapsing/remitting (52.3%); 35.6% were yet to be categorized. One month after diagnosis, there was a significant, cross-sectional association between MOS-Sleep problems index score and pain intensity (B=0.04, 95% confidence interval (CI): 0.02-0.05, p< 0.001) and pain interference (B=0.17, 95% CI: 0.11-0.24, p< 0.001). Dimension scores for ‘sleep disturbance’, ‘sleep adequacy’, and ‘awaken short of breath or headache’ were also significantly associated with the pain outcomes at this time. In longitudinal analyses, MOS-Sleep problems index score one month after diagnosis predicted pain intensity (B=0.02, 95 %CI: 0.007-0.04, p=0.003) and pain interference (B=0.11, 95% CI: 0.05-0.17, p< 0.001) 12 months after diagnosis. Higher scores for ‘sleep disturbance’ and ‘sleep adequacy’ one month after diagnosis also predicted both pain outcomes 12 months after diagnosis. Conclusion As a modifiable factor, sleep presents a viable constituent of multicomponent pain management for PwMS. Research is needed to determine whether improving sleep reduces pain in this population. Support (if any) The LAND study was funded by the National Multiple Sclerosis Society (RG4986A1/1).