Patients with multiple sclerosis (MS) tend to have poor sleep quality, and this is strongly associated with worse health-related quality of life independent of other symptoms of the disease, according to a new study published in the Journal of Neurology, Neurosurgery and Psychiatry.

Based on these findings, the authors concluded that improving sleep quality could improve the quality of life of people living with MS. “Interventions must include strategies to manage MS symptoms, sleep complaints and symptom-independent mechanisms of poor sleep,” they wrote.

It was already known that MS affects sleep quality and that people with the disease have difficulty sleeping. However, the exact link between sleep quality and quality of life was unclear. It was also not known whether sleep quality could influence overall quality of life in patients with MS, independent of other symptoms, such as obesity. 

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Here, a team of researchers led by Ingrid van der Mei, PhD, from Menzies Institute for Medical Research, University of Tasmania in Hobart, Australia, analyzed data from the Australian MS Longitudinal Study, which contains information about 1717 patients. 

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They found that 67% of patients in the database had poor sleep quality, which was more common than in the general population.

“Sleep measures clustered independently within MS symptoms,” the researchers reported, stating that the “fatigue and cognitive” dysfunction, “feelings of anxiety and depression,” and “pain and sensory” clusters were independently associated with poor sleep quality.

The quality of life score of patients with poor sleep quality was 0.19 units lower than that of those without poor sleep quality. This was a clinically meaningful difference.

The researchers also found that factors such as sleep quality, daytime sleepiness, and restless leg syndrome “were associated with reduced quality of life.” This was independent of other symptoms related to MS or body mass index.


Laslett LL, Honan C, Turner JA, et al. Poor sleep and multiple sclerosis: associations with symptoms of multiple sclerosis and quality of life. J Neurol Neurosurg Psychiatry. Published online July 27, 2022. doi:10.1136/jnnp-2022-329227