Hypnotic use and fatigue in multiple sclerosis

被引:17
作者
Braley, Tiffany J. [1 ,2 ]
Segal, Benjamin M. [1 ,2 ]
Chervin, Ronald D. [1 ,3 ]
机构
[1] Univ Michigan, Dept Neurol, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Multiple Sclerosis Ctr, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Sleep Disorders Ctr, Ann Arbor, MI 48109 USA
关键词
Multiple sclerosis; MS; Fatigue; Fatigue severity scale; Hypnotic; Diphenhydramine; Insomnia; Sleepiness; COGNITIVE-BEHAVIORAL THERAPY; RESTLESS LEGS SYNDROME; CHRONIC PRIMARY INSOMNIA; OBSTRUCTIVE SLEEP-APNEA; DIPHENHYDRAMINE; PHARMACOKINETICS; PHARMACODYNAMICS; EPIDEMIOLOGY; PREVALENCE; MEDICATION;
D O I
10.1016/j.sleep.2014.09.006
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: Sleep disturbances and fatigue are common in patients with multiple sclerosis (MS), but little is known about hypnotic use patterns in MS, or the relationship between these medications and fatigue. The objectives of this study were to investigate the prevalence of prescription and over-the-counter (OTC) hypnotic use among MS patients, and to assess the relationships between fatigue severity and hypnotic use among persons with MS. Methods: Data on hypnotic use frequency, hypnotic agents of choice, and clinical characteristics were extracted from medical records and a survey dataset from 190 MS patients who completed questionnaires regarding sleep quality, sleep quantity, nocturnal symptoms, sleepiness (Epworth Sleepiness Scale), obstructive sleep apnea risk (STOP-Bang questionnaire), insomnia (Insomnia Severity Index), and fatigue level (Fatigue Severity Scale - FSS). Results: Eighty-nine subjects (47%) endorsed hypnotic use occasionally, frequently, or always. OTC diphenhydramine-containing products accounted for the majority of utilization, reported by 47 (25%). The occurrence of occasional or more frequent hypnotic use correlated with daytime fatigue (Spearman rho = 0.28, P = 0.0002), but not sleepiness. Regression of FSS scores on hypnotic use confirmed the association [beta (SE) = 0.55 (0.21), P = 0.0092] after adjustment for clinical and sleep-related confounds. In separate, similarly adjusted models, the use of OTC hypnotics but not prescription hypnotics was independently associated with higher FSS scores [0.54 (0.22), P = 0.0159]. An analogous association was observed more specifically for the use of diphenhydramine-containing products (0.49 (0.24), P = 0.044). Conclusions: Hypnotic use is highly prevalent among MS patients. Carryover effects from hypnotic agents, and in particular OTC diphenhydramine-containing products, could contribute to daytime fatigue. (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码:131 / 137
页数:7
相关论文
共 37 条
[1]   Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology - A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health [J].
Allen, RP ;
Picchietti, D ;
Hening, WA ;
Trenkwalder, C ;
Walters, AS ;
Montplaisi, J .
SLEEP MEDICINE, 2003, 4 (02) :101-119
[2]  
Amarenco G, 1995, REV NEUROL, V151, P722
[3]  
[Anonymous], 2013, DIAGN STAT MAN MENT, V5th, DOI [DOI 10.1176/APPI.BOOKS.9780890425596.893619, 10.1176/appi.books.9780890425596.893619.]
[4]  
APA, 2013, DIAGN STAT MAN MENT
[5]  
Barbier A. J., 2007, CNS & Neurological Disorders-Drug Targets, V6, P31, DOI 10.2174/187152707779940790
[6]   Impact of psychotherapy on insomnia symptoms in patients with depression and multiple sclerosis [J].
Baron, Kelly Glazer ;
Corden, Marya ;
Jin, Ling ;
Mohr, David C. .
JOURNAL OF BEHAVIORAL MEDICINE, 2011, 34 (02) :92-101
[7]   Validation of the Insomnia Severity Index as an outcome measure for insomnia research [J].
Bastien, Celyne H. ;
Vallieres, Annie ;
Morin, Charles M. .
SLEEP MEDICINE, 2001, 2 (04) :297-307
[8]   National Use of Prescription Medications for Insomnia: NHANES 1999-2010 [J].
Bertisch, Suzanne M. ;
Herzig, Shoshana J. ;
Winkelman, John W. ;
Buettner, Catherine .
SLEEP, 2014, 37 (02) :343-+
[9]   Allergy medication in Japanese volunteers: treatment effect of single doses on nocturnal sleep architecture and next day residual effects [J].
Boyle, Julia ;
Eriksson, Malin ;
Stanley, Neil ;
Fujita, Tomoe ;
Kumagi, Yuji .
CURRENT MEDICAL RESEARCH AND OPINION, 2006, 22 (07) :1343-1351
[10]   Obstructive Sleep Apnea and Fatigue in Patients with Multiple Sclerosis [J].
Braley, Tiffany J. ;
Segal, Benjamin M. ;
Chervin, Ronald D. .
JOURNAL OF CLINICAL SLEEP MEDICINE, 2014, 10 (02) :155-162