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Insufficient sleep during adolescence and risk of multiple sclerosis: results from a Swedish case-control study
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  • Published on: 6 June 2023
    RE: Insufficient sleep during adolescence and risk of multiple sclerosis: results from a Swedish case-control study

    Åkerstedt et al. conducted a case-control study with 2075 cases and 3164 controls to investigate the association between sleep and risk of multiple sclerosis (MS) (1). Sleep duration, circadian disruption and sleep quality during adolescence were used for sleep variables. The authors calculated the adjusted OR with 95% CIs using logistic regression models, and short sleep (<7 hours/night) and low sleep quality were significantly associated with increased risk of developing MS. I have a question regarding the ways of multivariate analysis.

    The ratio in the number of cases and controls is about 1.5 in this study. If the authors selected unconditional logistic regression analysis, OR might become conservative. If the authors selected conditional logistic regression analysis, the increased number of controls is preferable to make stable estimation. Instead of selecting a case-control study with a matching procedure, using all pooled data without a matching procedure can be selected for the analysis (2).

    Anyway, a recall method has a possibility of including bias and risk assessment of MS with subjective sleep variables should be paid with caution.

    References
    1. Åkerstedt T, Olsson T, Alfredsson L, et al. Insufficient sleep during adolescence and risk of multiple sclerosis: results from a Swedish case-control study. J Neurol Neurosurg Psychiatry 2023;94(5):331-6.
    2. Hamajima N, Hirose K, Inoue M, et al. Case-control studies: matched controls...

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    Conflict of Interest:
    None declared.