Comparison of Sleep Problems in Individuals with Spinal Cord Injury and Multiple Sclerosis

Abstract

Study Objectives: Sleep problems are common in spinal cord injury (SCI) and multiple sclerosis (MS). However, the degree to which sleep problems differ between these distinct clinical populations has not been evaluated. In this study, we examined self-reported sleep problems in individuals with SCI and those with MS, and compared these clinical groups on the Medical Outcomes Study Sleep Scale (MOS-SS). Methods: Participants were 1,677 individuals (SCI = 581; MS = 1,096) enrolled in longitudinal study of self-reported health outcomes in SCI and MS. Univariate and multivariate analysis of covariance examined group differences on global sleep problems and domain-specific subscales of the MOS-SS. Results: Individuals with SCI reported an average of 30 fewer min of sleep per night (Sleep Quantity subscale) and significantly greater difficulty initiating and maintaining sleep (Sleep Disturbance subscale) compared to individuals with MS. However, groups did not differ on global sleep problems (Sleep Problems Index 9). Conclusions: Although global sleep problems are more common in SCI and MS than in the general population, these groups exhibit differing sleep problem profiles, and thus may require unique treatment approaches to address the specific domains of sleep affected. For individuals with SCI, an additional focus on increasing sleep quantity and reducing sleep disruptions may be warranted.

Sleep-Disordered Breathing and Spinal Cord Injury

“…Although adverse consequences of SDB in the general population are widely accepted, SDB in patients with SCI/D has received little attention, despite its high frequency and adverse consequences, 1,6,17 including higher mortality. 6,[23][24][25][26][28][29][30][31] Cardiovascular conditions have surpassed respiratory causes of mortality in patients with cervical SCI/D, 26,31 and SDB may contribute to increased cardiovascular mortality.…”

“…Sleep disturbances, including sleepdisordered breathing (SDB), are common albeit underrecognized in individuals with spinal cord injury or disease (SCI/D). 1,2 This review explores the relationship between SCI/D and SDB, discusses the pathogenesis of SDB after acute and chronic SCI/D, outlines a diagnostic and management approach, and identifies barriers to optimal management of this condition.…”

Sleep-Disordered Breathing and Spinal Cord Injury: Challenges and Opportunities

“…The majority of SCI individuals report poor sleep quality and increased rates of sleep disturbances compared to the general population, including patients with other neurological disorders that share similar morbidity (3). The mechanisms underlying sleep disturbances in SCI are multi-factorial and may include pain, bladder dysfunction, depression, circadian dysfunction and medication use.…”