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Poor sleep and multiple sclerosis: associations with symptoms of multiple sclerosis and quality of life
  1. Laura L Laslett1,
  2. Cynthia Honan2,
  3. Jason A Turner2,
  4. Baye Dagnew1,3,
  5. Julie A Campbell1,
  6. Tiffany K Gill4,
  7. Sarah Appleton4,5,
  8. Leigh Blizzard1,
  9. Bruce V Taylor1,
  10. Ingrid van der Mei1
  1. 1Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  2. 2School of Psychological Sciences, University of Tasmania, Launceston, Tasmania, Australia
  3. 3College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
  4. 4Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
  5. 5Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Adelaide, South Australia, Australia
  1. Correspondence to Dr Laura L Laslett, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Laura.Laslett{at}


Background Sleep difficulties are common in people with multiple sclerosis (MS), but whether associations between poor sleep quality and quality of life are independent of MS symptoms, obesity and other MS-related factors remains unclear.

Methods Cross-sectional analyses of data from the Australian MS Longitudinal Study (n=1717). Sleep was assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and International Restless Legs Syndrome Study Group Rating Scale; health-related quality of life using the Assessment of Quality-of-Life 8-D.

Results Poor sleep quality was common (67%), and more common than in community samples. Sleep measures clustered independently within MS symptoms. The clusters ‘fatigue and cognitive’, ‘feelings of anxiety and depression’, ‘pain and sensory’, were independently associated with poor sleep quality. Quality-of-Life utility scores were a clinically meaningful 0.19 units lower in those with poor sleep. Sleep quality, daytime sleepiness and restless leg syndrome were associated with reduced quality of life, independent of MS-related symptoms and body mass index.

Conclusion Poor sleep quality is common in MS and was strongly associated with worse health-related quality of life, independent of other MS symptoms and did not cluster with other common MS symptoms. Improving sleep quality may substantially improve quality of life in people with MS.


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  • Presented at European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), 2021; and Progress in MS Research, Hobart, 2022.

  • Contributors LLL had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: CH and IvdM. Acquisition, analysis or interpretation of data: all authors. Drafting of the manuscript: LLL, BVT and IvdM. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: LLL Obtained funding: BVT and IvdM.

  • Funding This study was funded by MS Research Australia.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.