Treatments used by people living with MS to get to sleep or stay asleep, and impacts on sleep quality and daytime sleepiness

Abstract

BACKGROUND: Strategies used by people living with MS to get to sleep and stay asleep, and whether they impact sleep quality and daytime sleepiness is not clear. METHODS: Australian MS Longitudinal Study participants (n = 1590) self-reported treatments used for sleep, sleep quality and daytime sleepiness. Prescription medications that could influence sleep were identified from administrative data collected <3 months prior to self-reports. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness using the Epworth Sleepiness Scale (ESS). Effects of prescription medications on sleep outcomes were examined using inverse probability weighted regression adjustment (IPWRA), to account for confounding by indication. RESULTS: Using treatment strategies to improve sleep was common, with 72 % utilising ≥1 and 47 % utilising ≥3 treatments. Poor sleepers were more likely to use any strategy (80 % vs 52 %), multiple strategies (50 % vs 33 %), sleep hygiene behaviours (62 % vs 42 %), and medications (51 % vs 13 %), vs good sleepers. Benzodiazepine users had worse sleep quality, selective serotonin reuptake inhibitors users had worse daytime sleepiness, even after adjusting for the reasons for medication use and factors associated with sleep quality or daytime sleepiness. CONCLUSION: Using treatment strategies to get to sleep or stay asleep was common. As expected, those with sleep in the clinically poor range were most likely to use any strategies, and multiple strategies. Most prescription medications had no impact on sleep after adjusting for confounding; but participants using benzodiazepines had poorer sleep quality, and selective serotonin reuptake inhibitors users had poorer daytime sleepiness.