Supplementary Material for: Sleep disorders and sleep disturbances in persons with multiple sclerosis: A population-based matched case-control study in Denmark

Introduction Adverse sleep is common in multiple sclerosis (MS). Population-based studies including adequate control groups are lacking. We hypothesized that the prevalence of sleep disorders and other sleep disturbances would be higher in persons with MS than in controls. Methods We conducted a population-based study linking individual-level data from the Danish MS Registry (n=21,943 persons with MS) and the Danish Population Registry (n=109,715 matched controls) with information on sleep disorders from the Danish National Patient Registry and other sleep disturbances assessed by dispensed prescription drugs from the Danish National Prescription Registry. Results Prevalence of diagnosed sleep disorders in terms of central hypersomnia (0.15% vs. 0.06%), sleep disturbances (1.05% vs. 0.70%), and sleep movements (0.22% vs. 0.13%) and other sleep disturbances identified by dispensed central acting (10.73% vs. 1.10%) and hypnotic use (30.65% vs. 20.13%) medication was statistically significantly higher among persons with MS when compared to controls. We found no statistically significant difference in the prevalence of sleep apnea and parasomnia between groups. Stratified by sex and age at MS diagnosis, results for differences between persons with MS and controls were similar. Conclusion In this registry-based study, we found that the prevalence of several diagnosed sleep disorders was higher persons with MS than in controls, that is those reflecting insomnia and daytime symptoms including hypersomnia. Other sleep disturbances identified by dispensed prescription medication was markedly higher in persons with MS than controls.引言 睡眠不良在多发性硬化（multiple sclerosis, MS）患者中极为常见，但目前尚缺乏设置合理对照组的基于人群的相关研究。本研究提出假设：与对照组人群相比，多发性硬化患者的睡眠障碍及其他睡眠紊乱患病率更高。 方法 本研究为基于人群的研究，将丹麦多发性硬化登记库（Danish MS Registry，纳入21943名多发性硬化患者）、丹麦人口登记库（Danish Population Registry，纳入109715名匹配对照人群）的个体水平数据，与丹麦国家患者登记库（Danish National Patient Registry）记录的睡眠障碍诊断信息，以及通过丹麦国家处方登记库（Danish National Prescription Registry）中处方药品配发情况评估的其他睡眠紊乱数据进行关联分析。 结果 与对照组相比，多发性硬化患者的确诊睡眠障碍患病率均显著更高，其中中枢性过度睡眠（central hypersomnia，0.15% vs. 0.06%）、睡眠紊乱（1.05% vs. 0.70%）、睡眠运动障碍（0.22% vs. 0.13%），以及通过中枢作用类药物（10.73% vs. 1.10%）和催眠药物（30.65% vs. 20.13%）配发情况识别出的其他睡眠紊乱，组间差异均具有统计学意义。本研究未观察到两组人群在睡眠呼吸暂停（sleep apnea）及异态睡眠（parasomnia）患病率上存在统计学显著差异。按多发性硬化确诊时的性别与年龄分层分析后，多发性硬化患者与对照组人群的上述差异结果保持一致。 结论 在这项基于登记库的研究中，本团队发现多发性硬化患者的多种确诊睡眠障碍患病率均高于对照组人群，即涵盖失眠及日间症状（包括过度睡眠）的相关睡眠障碍类别。通过处方药品配发情况识别出的其他睡眠紊乱，在多发性硬化患者中的发生率也显著高于对照组人群。