Objectives. To assess the relationship between nocturnal polysomnographic (PSG) findings and a group of key self-reported symptoms—fatigue, tiredness, lack of energy, and sleepiness—among sleep-laboratory referred patients with and without multiple sclerosis (MS). Methods. PSG and questionnaire data from MS patients and matched controls were analyzed retrospectively. Associations between symptoms of fatigue, tiredness, lack of energy, sleepiness, and PSG variables of interest were examined among MS patients and controls. Results. More MS patients than controls reported fatigue, tiredness, and lack of energy to occur often or almost always (Chi-square for each), but sleepiness was reported similarly by both groups ( ). Among MS patients, tiredness correlated with sleepiness (Spearman correlation ), and a trend emerged toward correlation between fatigue and sleepiness (Spearman correlation ). Decreased sleep efficiency on PSGs correlated with fatigue, tiredness, and lack of energy in MS patients (Spearman correlation , 0.029, and 0.048, resp.), but not sleepiness or any symptom among controls. Conclusion. In comparison to controls, MS patients report more fatigue, tiredness, and lack energy, but not sleepiness. Fatigue and related symptoms may arise from MS itself or in relation to reduced sleep efficiency. 1. Introduction Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that causes myelin destruction and axonal damage in the brain and spinal cord. It is the leading cause of nontraumatic neurological disability among young adults and is associated with a variety of debilitating symptoms, including fatigue. Fatigue is the most common symptom experienced by persons with MS, affecting up to 90% of patients at some point in their disease course [1–3]. Fatigue imposes significant socioeconomic consequences, including loss of work hours and employment , and is a prominent cause of diminished quality of life among individuals with MS . Despite its prevalence in MS as well as other medical conditions, there is no unified definition for fatigue. Consequently, there is potential for considerable overlap between fatigue and other subjective terms commonly used by MS patients to describe lack of energy or alertness, including sleepiness. Sleep disorders are traditionally recognized for their contributions to excessive daytime sleepiness. However, many subjects in the general population who have sleep disorders such as obstructive sleep apnea report that problems with fatigue, tiredness, or lack of energy supersede problems with
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