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Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

ABSTRACT: BACKGROUND:Nearly 70% of individuals with multiple sclerosis (MS) experience sleep disturbances. Increasing physical activity in people with MS has been shown to produce a moderate improvement in sleep quality, and exercise has been shown to improve sleep quality in non-neurologically impaired adults. OBJECTIVE:The purpose of this pilot randomized controlled trial study was to examine the effect of two exercise interventions on sleep quality and daytime sleepiness in individuals with MS. METHODS:Twenty-eight individuals with relapsing-remitting or secondary progressive MS were randomized into one of two 12-week exercise interventions: a supervised, moderate-intensity aerobic exercise (AE) program or an unsupervised, low-intensity walking and stretching (WS) program. Only individuals who were???70% compliant with the programs were included in analysis (n?=?12 AE; n?=?10 WS). RESULTS:Both groups demonstrated a moderate improvement in sleep quality, although only the improvement by the WS group was statistically significant. Only the AE group demonstrated a significant improvement in daytime sleepiness. Change in sleep quality and daytime sleepiness was not correlated with disease severity or with change in cardiovascular fitness, depression, or fatigue. CONCLUSION:The mechanisms for improvement in sleep quality and daytime sleepiness need further investigation, but may be due to introduction of zeitgebers to improve circadian rhythm.

SUBMITTER: Siengsukon CF

PROVIDER: S-EPMC5433327 | biostudies-literature | 2016 Jan-Dec

REPOSITORIES: biostudies-literature

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Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

Siengsukon Catherine F CF Aldughmi Mayis M Kahya Melike M Bruce Jared J Lynch Sharon S Ness Norouzinia Abigail A Glusman Morgan M Billinger Sandra S

Multiple sclerosis journal - experimental, translational and clinical 20160101

<h4>Background</h4>Nearly 70% of individuals with multiple sclerosis (MS) experience sleep disturbances. Increasing physical activity in people with MS has been shown to produce a moderate improvement in sleep quality, and exercise has been shown to improve sleep quality in non-neurologically impaired adults.<h4>Objective</h4>The purpose of this pilot randomized controlled trial study was to examine the effect of two exercise interventions on sleep quality and daytime sleepiness in individuals w ...[more]

PMID: 28607746

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Project description:BACKGROUND:Sleep disorders and fatigue are common in multiple sclerosis (MS). The underlying causes are not fully understood, and prospective studies are lacking. Therefore, we conducted a prospective, observational cohort study investigating sleep quality, fatigue, quality of life, and comorbidities in patients with MS. METHODS:Patients with relapsing-remitting MS or clinically isolated syndrome treated with interferon beta-1b were followed over two years. The primary objective was to investigate correlations between sleep quality (PSQI), fatigue (MFIS), and functional health status (SF-36). Secondary objectives were to investigate correlations of sleep quality and daytime sleepiness (ESS), depression (HADS-D), anxiety (HADS-A), pain (HSAL), and restless legs syndrome (RLS). We applied descriptive statistics, correlation and regression analyses. RESULTS:139 patients were enrolled, 128 were available for full analysis. The proportion of poor sleepers (PSQI?5) was 55.47% at the beginning and 37.70% by the end of the study (106 and 41 evaluable questionnaires, respectively). Poor sleepers performed worse in MFIS, SF-36, ESS, HADS-D, and HADS-A scores. The prevalence of patients with RLS was low (4.5%) and all were poor sleepers. Poor sleep quality was positively correlated with fatigue and low functional health status. These relationships were corroborated by multivariable-adjusted regression analyses. ESS values and poor sleep quality at baseline seem to predict sleep quality at the one-year follow-up. No variable predicted sleep quality at the two-year follow-up. CONCLUSIONS:Our results confirm the high prevalence of poor sleep quality among patients with MS and its persistent correlation with fatigue and reduced quality of life over time. They highlight the importance of interventions to improve sleep quality. TRIAL REGISTRATION:The study was registered at clinicaltrials.gov: NCT01766063 (registered December 7, 2012). Registered retrospectively (first patient enrolled December 6, 2012).

Project description:BACKGROUND:Neighborhood characteristics have been linked to health outcomes. Various mechanisms link neighborhoods and health outcomes; sleep patterns may be 1 contributor; however, little is known about the social determinants of disordered sleep. We examined the association of neighborhood characteristics with sleep duration and daytime sleepiness. METHODS:Participants (n = 801) enrolled as pairs (55 without pair), from 10 churches in the Stroke Health and Risk Education project; 760 were included for analysis (41 withdrew). Sleep duration (hours of sleep at night) and daytime sleepiness (adaptation of Berlin questionnaire; range, 0-3 [more daytime sleepiness]) were self-reported. Neighborhood characteristics included disadvantage, per capita violent crime (census tract level), and safety (self-reported and individual level). We fit generalized linear mixed models and multinomial and binomial logistic regression models to examine the associations between neighborhood characteristics and sleep outcomes while accounting for the clustering within churches and pairs, before and after adjustment for self-reported confounders (age, gender, income, education, body mass index, depressive symptoms, hypertension, and diabetes). RESULTS:The mean hours of sleep duration is 6.7 ± 1.2, and the mean daytime sleepiness is 0.8 ± 0.9. Neighborhood characteristics were not associated with sleep duration. Higher perceived neighborhood safety was associated with an 18.4% lower odds of daytime sleepiness in the unadjusted model (odds ratio, 0.82 [95% confidence interval, 0.69-0.96]). The association was attenuated in the fully adjusted model. Neighborhood disadvantage and violent crime were related to lower daytime sleepiness; however, associations were not statistically significant. CONCLUSION:Self-reported neighborhood safety was associated with lower daytime sleepiness. Future exploration of the pathways linking neighborhood characteristics and sleep is warranted.

Dataset Information

Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

Publications

Randomized controlled trial of exercise interventions to improve sleep quality and daytime sleepiness in individuals with multiple sclerosis: A pilot study.

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