Peculiarities of sleep disturbances and the manifestation of anxiety-depressive states in patients with multiple sclerosis
Authors: Korniichuk Yu.V. , Shulga O.D. , Zheshko O.M. , Fedotova T.V. 
Published: December 2024

Background. Multiple sclerosis (MS) is one of the most common neurological d iseases affecting young people. The specificity of the course of this disease often causes patients with MS to experience conditions accompanied by anxiety, depressive disorders, feelings of loneliness, helplessness, and sleep disturbances. In patients with MS, anxiety and depression is a serious and long-lasting problem that arises as a result of the patient's worries about the uncertain consequences of the course of the disease, the potential severity of symptoms. In addition, another factor in the occurrence of these conditions is neuroinflammation of the brain, which causes a violation of the function of monoaminergic neurotransmitters. There are data that about half of all patients diagnosed with MS have complaints of sleep disturbances caused by physical and psychological factors. In turn, sleep disturbance leads to daytime dysfunction, increased fatigue, increased or occurrence of anxiety-depressive states, and a decrease in the pain threshold. The most common sleep disorders in patients with MS are: insomnia, sleep apnea, restless legs syndrome (RLS), and REM sleep behavior disorders (RBD).

Purpose – of this study is to investigate the characteristics of sleep disorders and the manifestation of anxiety and depression in patients diagnosed with multiple sclerosis, considering factors such as age, gender, and duration of the disease.

Materials and Methods. Theoretical methods (analysis, generalization, and systematization of medical literature on sleep disorders and the manifestation of anxiety and depression in MS patients, using databases such as Scopus, Web of Science, and PubMed); psychodiagnostic methods (including the Hamilton Anxiety Rating Scale (HAM-A), Hospital Anxiety and Depression Scale (HADS), PHQ-9 Scale, SF-36 Quality of Life Questionnaire, and the Pittsburgh Sleep Quality Index (PSQI)) [1]; statistical methods (calculations of mean group values, Fisher’s exact test (j-coefficient), and correlation analysis).

Results. The experimental study was conducted on the basis of the neurology department of the Volyn Regional Clinical Hospital of the Volyn Regional Council. The total volume of the participants was 38 people (the age of the respondents was from 25 to 64 years). The results of the diagnosed patients were analyzed according to the following criteria: age, gender, and duration of the disease. According to WHO recommendations, the respondents were divided into groups by age: group 1A – from 18 to 43 years inclusive and group 1B – from 44 to 64 years. According to gender, we distinguished the following groups of diagnosed patients: group 2A – women(24 people) and group 2B – men (14 people). According to the results of the distribution of patients according to the time since the diagnosis of MS, the following were distinguished: group 3A – persons with a diagnosis of MS less than 10 years and group 3B – patients with a diagnosis of MS more than 10 years.

Conclusions. People with MS are characterized by anxiety, depression, sleep problems, daytime dysfunction (decreased enthusiasm, sleepiness during social activities, etc.). However, they show a moderate level of vital activity, without demonstrating a significant decrease in social contacts and the level of communication associated with a significant deterioration of the physical and emotional state. In terms of age, it was noted that young people are more prone to depression-anxiety disorders, compared to middle-aged people. However, the quality of sleep in young people is higher than in middle-aged patients. Whereas, according to gender, it was determined that women are more prone to anxiety and depression, but are more viable and able to function adequately in society than men. It is recorded that the quality of sleep in women is somewhat higher compared to men. According to the duration of the disease, it was noted that patients with a diagnosis of MS up to 10 years have a higher level of anxiety and a tendency to depression than patients with a shorter history of the disease. However, patients who have been sick for more than 10 years take longer to fall asleep, their sleep duration is longer, but they more often experience a decrease in enthusiasm when performing tasks, feel sleepy during daytime activities compared to patients whose disease duration is less than 10 years.