Factors affecting the quality of life and quality of sleep in patients with relapsing-remitting form of multiple sclerosis

In the presence of other, more progressive symptoms and signs, sleep disorders are often overlooked in patients with multiple sclerosis (MS), although they have a significant negative impact on the quality of life of these patients. Diagnosing sleep disorders in people with MS in daily clinical practice is not performed routinely and satisfactorily. There is still no adequate therapy that is specific for sleep disorders in this population. Also, little is known about how the therapy used to modify the natural course of MS affects sleep quality. Therefore, ou aim was to identify factors influencing both quality of life and sleep quality in patients with relapsing-remitting MS (RRMS), with particular emphasis on the potential impact of recently approved disease-modifying therapies, including ocrelizumab, ofatumumab, fingolimod, and teriflunomide. This cross-sectional analytical study was conducted at the Neurology Clinic of the University Clinical Center (UKC) in Kragujevac. The study population consisted of patients diagnosed with relapsing-remitting multiple sclerosis (RRMS) who were undergoing treatment and clinical follow-up at the clinic. Eligible participants were recruited after receiving both oral and written explanations of the study protocol, and all participants provided written informed consent prior to enrollment. Approval for the study was obtained from the Ethics Committee of the University Clinical Center in Kragujevac (decision number 01/24–15, dated January 19, 2024).Participants were eligible for inclusion if they met the following criteria: (1) diagnosis of RRMS according to the 2017 McDonald criteria, confirmed on the basis of medical history, neurological examination, and brain magnetic resonance imaging (14); (2) age ≥ 18 years and (3) signed written informed consent to participate in the study. Patients were excluded if they met any of the following conditions: (1) diagnosis of a progressive form of MS; (2) diagnosis of RRMS in individuals younger than 18 years; (3) inability to provide written informed consent due to physical disability or cognitive impairment; (4) inability to complete questionnaires due to physical disability or cognitive impairment and (5) confirmed diagnosis of insomnia in addition to RRMS.Within this research, two primary dependent variables were analyzed: (1) the quality of life of patients with relapsing-remitting MS and (2) the quality of sleep of these patients. The quality of life was measured using the validated Serbian version of the MSQOL-54 questionnaire. Sleep quality was assessed using the validated Serbian version of the Pittsburgh Sleep Quality Index (PSQI). We assessed the impact of a number of independent and confounding variables on the dependent variables of interest.