Sleep Apnea and Fatigue

Does OSA Contribute to Fatigue for Those with Multiple Sclerosis?

A recent study published in the February 15 issue of the Journal of Clinical Sleep Medicine suggests that obstructive sleep apnea (OSA) may be a significant contributing factor to the fatigue very commonly experienced by people with multiple sclerosis (MS). The study involved 195 MS patients who completed a questionnaire and survey which attempted to ascertain their daytime sleepiness, fatigue level, insomnia severity and risk of OSA. The results showed that one-fifth of the respondents had OSA, a rate considerably higher than that found in the general population (OSA affects around seven percent of men and five percent of women in the United States); furthermore, the results indicated that more than half of the MS patients were at an increased risk for OSA. Given that risk for OSA correlated to a significant degree with fatigue severity, the study may ultimately lead to the conclusion that OSA is a major contributor to fatigue in those with MS.

The cross-sectional nature of the study did not permit an analysis of cause-and-effect relationships; thus, it was impossible establish causality between OSA (or risk of OSA) and fatigue in patients with MS. However, the study clearly implies that physicians treating patients with MS should be more assertive in investigating sleep disturbances. “OSA may be a highly prevalent and yet under-recognized contributor to fatigue in persons with MS,” noted head author and chief researcher Tiffany J. Braley, MD, MS, an Assistant Professor of Neurology from the University of Michigan Multiple Sclerosis and Sleep Disorders Centers in Ann Arbor, Mich. “Our study suggests that clinicians should have a low threshold to evaluate MS patients for underlying sleep disturbances.”

Though it did not allow for any major definitive inferences, this new study may prove to be a helpful stepping stone in the ongoing effort to relieve fatigue in patients diagnosed with MS. Further research needs to be conducted to demonstrate the causal connection between OSA and fatigue.


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