psychiatric disorders can all cause sleep disorders. Any sort of
chronic pain may also impair sleep. Neurological disorders such as
neurodegenerative diseases, strokes, headache syndromes, and
neuromuscular disorders are associated with sleep disorders. Immune
molecules called cytokines affect sleep, each individually in
different ways (e.g. IL-1, -2, -15, -18, TNF, Interferon). Different
combinations of cytokines expressed during infection for example may
have different overall effects on sleep. On the other hand psychiatric
disorders such as depression, anxiety disorders, and panic attacks may
be the underlying cause for approximately half of all cases of
insomnia. However, care should be taken not to confuse the symptoms of
psychiatric and medical diseases resulting in misdiagnosis.
According to a Harvard publication,"... the majority of MS patients
experience severe fatigue, resembling the lassitude experienced during
viral infections. MS fatigue can be chronic, lasting for months or
years, or it can have a relapsing-remitting pattern much like typical
MS "flares" (episodes of neurologic dysfunction). Recent studies
suggest that this fatigue may have many causes, including substances
secreted by immune cells (cytokines), disrupted sleep, or MS-induced
changes in brain neurotransmitters." Similar studies have been done
regarding ME and CFS. In both diseases, depending on how they are
defined, infections are considered to be etiological in subgroups.
J Neurol Sci. 2011 Aug 1. [Epub ahead of print]
Sleep disturbances in multiple sclerosis.
Caminero A, Bartolom=E9 M.
Abstract
OBJECTIVES:
The frequency of sleep disturbances in multiple sclerosis (MS), and
their impact on the quality of life of MS patients, have traditionally
been underestimated. Here we review the most common sleep disorders
seen in this disease, their prevalence, pathophysiology, clinical
manifestations and current treatments.
METHOD:
We begin with a brief description of epidemiological data on sleep
disturbances in MS, explain how these disturbances increase potential
associated morbidities, and discuss the bidirectional relationship
established between these two comorbid conditions (i.e. MS worsens
sleep disturbances and vice versa). We then analyze the main
dyssomnias and parasomnias described in MS: insomnia, circadian rhythm
disorders, drug-induced sleep disturbances, restless legs syndrome
(RLS) and periodic leg movements (PLM), respiratory disorders during
sleep, narcolepsy-cataplexy syndrome and REM sleep behavior disorder
(RBD).
We also review the relationship between sleep disturbances and chronic
fatigue syndrome, which is very frequent in MS patients.
CONCLUSION:
Sleep disturbances are more common in MS patients than in the general
population and limit these patients' quality of life. Therefore, we
believe that these disturbances should be a focal point in any
multidisciplinary treatment for MS.
Copyright =A9 2011 Elsevier B.V. All rights reserved.
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