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Sleep disorders linked to cognitive decline in MS

Study findings reveal impact of insomnia and sleep apnea on women with Multiple Sclerosis



Sleep disorders may contribute to cognitive decline in women living with Multiple Sclerosis (MS), new research has revealed. 

Conditions including insomnia and sleep apnea can be a key factor in the cognitive dysfunction experienced by many women with MS, the study found. 

Using data from more than 60,000 women who live with chronic disease, the researchers found that those with MS were more likely to report sleep disorders.

The data, based on information gathered in the 2013 and 2017 Nurses’ Health Study, also reveals that sleep disorders identified in 2013 contributed to cognitive problems four years later, including memory and ability to follow instructions and conversations. 

Insomnia accounted for more than ten per cent of these outcomes, with sleep apnea present in 34 per cent of those with MS who struggled with the ability to follow instructions. 

“Sleep disorders have gained substantial recognition for their role in cognitive decline, which affects up to 70 per cent of people with Multiple Sclerosis,” said lead author Dr Tiffany Braley, director of the Multiple Sclerosis/Neuroimmunology Division and multidisciplinary MS Fatigue and Sleep Clinic at University of Michigan Health.

“Our results highlighted important pathways between sleep and perceptions of cognitive function in women with MS. 

“We have previously identified important associations between objective cognitive performance and sleep in people with MS, but little is known about how sleep and MS interact together to impact long-term cognitive outcomes, particularly among women who are less likely to be diagnosed with sleep disorders.”

Past studies have found that people with MS have a high burden of sleep disorders that have been shown to affect quality of life.

As people with MS are at risk for sleep and cognitive problems, researchers sought to examine cognitive outcomes among nurses with MS and sleep disorders.

“With this longitudinal study design, we are able to better estimate the burden of sleep disorders among nurses, compared to health care claims data of similar size, which include diagnosed people with sleep disorders,” said senior author Dr Galit Levi Dunietz, an epidemiologist and associate professor in the Department of Neurology’s Division of Sleep Medicine. 

“However, as sleep disorders are frequently under-diagnosed, health care claims data miss many people with sleep disorders who were not evaluated for these conditions.”

Interventions to delay cognitive decline in MS may be most effective in pre-symptomatic or early symptomatic stages, Dr Braley says.

“Perceived cognitive decline, even in the absences of objective changes, could be an important window of opportunity to identify treatable exacerbating factors, such as sleep disorders,” she said.