Öz
Amaç
Bu çalışmada, relapsing-remitting multipl skleroz (RRMS) hastalarında insomnia prevalansı ile depresyon, anksiyete, yorgunluk gibi faktörlerin uyku ve yaşam kalitesi üzerinde etkileri araştırıldı.
Gereç ve Yöntem
Yüz beş RRMS hastası ve 105 sağlıklı kontrol grubu incelendi. İnsomnia, depresyon, anksiyete, yorgunluk, uyku ve yaşam kalitesini ölçen ölçeklerle değerlendirildi.
Bulgular
RRMS hastalarında insomnia prevalansı, kontrol grubuna göre daha yüksekti (%31,7 vs. %17,1, p = 0,014). RRMS hastalarında depresyon, anksiyete ve yorgunluk düzeyleri artmış, uyku ve yaşam kalitesini belirgin şekilde bozulmuştu (p < 0,001). Kadın hastalarda yorgunluk, anksiyete ve depresyon seviyeleri erkeklere göre daha yüksek bulunurken yaşam kalitesi daha düşüktü (p < 0,001). Depresyon ve anksiyete düzeyleri, insomnia ve uyku kalitesindeki bozulmayı artırıcı etki göstermiştir.
Sonuç
RRMS hastalarında uyku ve yaşam kalitesini olumsuz etkileyen faktörler, özellikle depresyon, anksiyete ve yorgunluk, dikkatle değerlendirilmelidir. Bu durum, klinik yönetimde bireysel yaklaşımların önemini vurgulamaktadır.
Anahtar Kelimeler:
Multipl skleroz, insomnia, uyku kalitesi, anksiyete, depresyon
Kaynaklar
1
Koseoglu M, Ozben S, Gozubatik-Celik G, et al. Plasma copeptin levels in patients with multiple sclerosis. J Clin Neurosci. 2020;78:143-146.
2
Sakkas GK, Giannaki CD, Karatzaferi C, Manconi M. Sleep abnormalities in multiple sclerosis. Curr Treat Options Neurol. 2019;21(1):4.
3
Stanton BR, Barnes F, Silber E. Sleep and fatigue in multiple sclerosis. Mult Scler. 2006;12(4):481-486.
4
Morris G, Stubbs B, Köhler CA, et al. The putative role of oxidative stress and inflammation in the pathophysiology of sleep dysfunction across neuropsychiatric disorders: focus on chronic fatigue syndrome, bipolar disorder and multiple sclerosis. Sleep Med Rev. 2018;41:255-265.
5
Boeschoten RE, Braamse AMJ, Beekman ATF, et al. Prevalence of depression and anxiety in multiple sclerosis: a systematic review and meta-analysis. J Neurol Sci. 2017;372:331-341.
6
American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
7
Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173.
8
Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-1452.
9
Idiman E, Uzunel F, Ozakbas S, et al. Cross-cultural adaptation and validation of multiple sclerosis quality of life questionnaire (MSQOL-54) in a Turkish multiple sclerosis sample. J Neurol Sci. 2006;240(1-2):77-80.
10
Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the fatigue severity scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-85.
11
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897.
12
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571.
13
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
14
Izci B, Ardic S, Firat H, Sahin A, Altinors M, Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath. 2008;12(2):161-168.
15
Alhazzani AA, Alshahrani A, Alqahtani M, et al. Insomnia among non-depressed multiple sclerosis patients: a cross-sectional study. Egypt J Neurol Psychiatr Neurosurg. 2018;54(1):17.
16
Bamer AM, Johnson KL, Amtmann D, Kraft GH. Prevalence of sleep problems in individuals with multiple sclerosis. Mult Scler. 2008;14(8):1127-1130.
17
Bøe Lunde HM, Aae TF, Indrevåg W, et al. Poor sleep in patients with multiple sclerosis. PLoS One. 2012;7(11):49996.
18
Zhang GX, Zhang WT, Gao SS, Zhao RZ, Yu WJ, Izquierdo G. Sleep disorders in patients with multiple sclerosis in Spain. Neurologia (Engl Ed). 2021:S0213-4853(21)00080-3.
19
Hensen HA, Krishnan AV, Eckert DJ. Sleep-disordered breathing in people with multiple sclerosis: prevalence, pathophysiological mechanisms, and disease consequences. Front Neurol. 2018;8:740.
20
Manjaly ZM, Harrison NA, Critchley HD, et al. Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2019;90(6):642-651.
21
Moore H, Nair KPS, Baster K, Middleton R, Paling D, Sharrack B. Fatigue in multiple sclerosis: a UK MS-register based study. Mult Scler Relat Disord. 2022;64:103954.
22
Strober LB, Arnett PA. An examination of four models predicting fatigue in multiple sclerosis. Arch Clin Neuropsychol. 2005;20(5):631-646.
23
Abdulla FA, Albagmi FM, Al-Khamis FA. Factors that influence quality of life in patients with multiple sclerosis in Saudi Arabia. Disabil Rehabil. 2022;44(17):4775-4783.
24
Lobentanz IS, Asenbaum S, Vass K, et al. Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatigue and sleep quality. Acta Neurol Scand. 2004;110(1):6-13.
25
Patti F, Cacopardo M, Palermo F, et al. Health-related quality of life and depression in an Italian sample of multiple sclerosis patients. J Neurol Sci. 2003;211(1-2):55-62.
26
Spain LA, Tubridy N, Kilpatrick TJ, Adams SJ, Holmes AC. Illness perception and health-related quality of life in multiple sclerosis. Acta Neurol Scand. 2007;116(5):293-299.
27
Miller DM, Rudick RA, Baier M, et al. Factors that predict health-related quality of life in patients with relapsing-remitting multiple sclerosis. Mult Scler. 2003;9(1):1-5.
28
Ozakbas S, Akdede BB, Kösehasanogullari G, Aksan O, Idiman E. Difference between generic and multiple sclerosis-specific quality of life instruments regarding the assessment of treatment efficacy. J Neurol Sci. 2007;256(1-2):30-34.
29
Hanna M, Strober LB. Anxiety and depression in multiple sclerosis (MS): antecedents, consequences, and differential impact on well-being and quality of life. Mult Scler Relat Disord. 2020;44:102261.
30
Yalachkov Y, Soydaş D, Bergmann J, et al. Determinants of quality of life in relapsing-remitting and progressive multiple sclerosis. Mult Scler Relat Disord. 2019;30:33-37.
31
Nortvedt MW, Riise T, Myhr KM, Nyland HI. Quality of life in multiple sclerosis: measuring the disease effects more broadly. Neurology. 1999;53(5):1098.
32
Čarnická Z, Kollár B, Šiarnik P, Krížová L, Klobučníková K, Turčáni P. Sleep disorders in patients with multiple sclerosis. J Clin Sleep Med. 2015;11(5):553-557.
33
Peres DS, Rodrigues P, Viero FT, et al. Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: a systematic review and meta-analysis. Brain Behav Immun Health. 2022;24:100484.
