Original scientific paper

https://doi.org/10.20471/acc.2022.61.04.05

Depression and Fatigue are Due to Obstructive Sleep Apnea in Multiple Sclerosis

Mario Mihalj orcid.org/0000-0001-5609-4868 ; Department of Neurology, Split University Hospital Center, Split, Croatia; School of Medicine, University of Split, Split, Croatia
Zrinka Janković ; School of Medicine, University of Split, Split, Croatia
Eni Jadrijević Kodžoman ; Department of Neurology, Split University Hospital Center, Split, Croatia
Gorana Veselica ; Department of Neurology, Split University Hospital Center, Split, Croatia
Ana Katić Ćurković ; Department of Neurology, Split University Hospital Center, Split, Croatia
Ana Repić Buličić ; Department of Neurology, Split University Hospital Center, Split, Croatia
Meri Matijaca ; Department of Neurology, Split University Hospital Center, Split, Croatia; Department of Neurology, Division of Neuroimmunology, Split University Hospital Center, Split, Croatia; School of Medicine, University of Split, Split, Croatia

Abstract

To our knowledge, there is no study investigating whether fatigue and depression
as the most commonly reported symptoms in multiple sclerosis (MS) and obstructive sleep apnea
(OSA) patients have arisen from primary mechanisms of MS or from secondary associated conditions
such as OSA in MS patients. The aim of our survey study was to determine whether depression and
fatigue in MS patients were associated with clinical features of OSA or with MS. We conducted
a self-administered survey using four validated questionnaires (STOP-BANG, Epworth Sleepiness
Scale, Fatigue Severity Scale and The Center for Epidemiologic Studies Depression Scale-Revised)
in 28 consecutive outpatients with proven MS. The prevalence of MS patients at an increased risk of
OSA was 29% and age was positively correlated with this risk (p=0.019). None of the clinical features
of MS patients (subtype, disability status, disease duration, modifying therapy, other medication) was
correlated with depression and fatigue. On the contrary, excessive daytime sleepiness as a hallmark
of OSA was significantly and positively associated with the level of depressive symptoms (p=0.004)
and level of fatigue (p=0.015). Also, depression was significantly and positively correlated with the
increased risk of OSA (p=0.015) and age of MS patients (p=0.016). Finally, a significant positive
correlation was found between fatigue severity and level of depressive symptoms (p=0.003). OSA is
a common disorder in MS patients. The clinical features and risk factors for OSA in MS patients are
associated with the two most commonly reported symptoms of depression and fatigue, thus supporting
the hypothesis that both symptoms are due to a secondary condition in MS.

Keywords

Depression; Fatigue; Multiple sclerosis; Obstructive sleep apnea

Hrčak ID:

301485

URI

https://hrcak.srce.hr/301485

Publication date:

1.12.2022.

Article data in other languages: croatian

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