Predictors of poor sleep quality in multiple sclerosis: The independent role of anxiety and restless legs syndrome

Abstract

Study objectives Sleep disturbances are common in multiple sclerosis (MS) and significantly affect patients' quality of life. However, the specific predictors of poor sleep quality in MS remain underexplored. This study aimed to determine the prevalence of poor sleep quality and to identify clinical and psychological factors independently associated with poor sleep in patients with MS. Methods This cross-sectional observational study included 103 consecutively enrolled MS patients during a one-month recruitment period. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), with scores >5 indicating poor sleep. Other measures included the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scales. Participants were grouped as good or poor sleepers, and predictors of poor sleep were determined using multivariate logistic regression. Results Poor sleep quality was identified in 53.4 % of patients. Poor sleepers had significantly higher ISI, ESS, FSS, PHQ-9, GAD-7, and S-LANSS scores and reported lower EQ-5D-3L-based quality of life (all p Conclusions Poor sleep is prevalent in MS and independently associated with anxiety symptoms and RLS. These findings highlight the need for targeted screening and treatment of these comorbidities to improve sleep and overa…