Assessing variables associated with sleep problems and use of sleep medications in multiple sclerosis

Recent research suggests sleep disturbances are common in individuals with multiple sclerosis (MS). In order to improve treatment of sleep disorders in MS, a better understanding of factors that contribute to MS sleep disturbance and use of sleep medications in this population is needed. Individuals with MS (N=473) involved in an ongoing longitudinal self-report survey were asked to report on use of over-the-counter and prescription sleep medications. Participants completed the MOS Sleep scale and other common symptom measures. Multiple regression was used to evaluate factors associated with sleep problems and descriptive statistics were generated to examine use of sleep medications. The majority of participants did not use over-the-counter (78%) or prescription (70%) sleep medications. Individuals who used prescription medications tended to use them every day (19.5%) with a smaller percent (10.6%) reporting intermittent use. 7.8% of the sample used over-the-counter medications every day while 14.2% of the sample reported intermittent use. Variables associated with sleep problems included depression, nighttime leg cramps, younger age, pain, female sex, fatigue, shorter duration of MS, and nocturia. Results indicate depression explains the majority of variance in sleep problems (33%), with other variables explaining significantly less variance. Persons with MS have significant sleep problems yet little is known about causes of sleep disturbance and appropriate use of medications as treatment. More research is needed to explore the possibility of under-treatment of sleep disorders in this population. In addition, clinicians should consider the interrelationship between depression and sleep problems when treating either symptom in this population.