Sleep-Related Breathing Disorders in Multiple Sclerosis: Prevalence, Features and Associated Factors

Davide Sparasci, Francesco Fanfulla, Raffaele Ferri, Debora Aricò, Daniela Distefano, Emanuele Pravatà, Raphael Heinzer, José Haba-Rubio, Mathieu Berger, Gianna Carla Riccitelli, Claudio Gobbi, Chiara Zecca, Mauro Manconi

Research output: Contribution to journalArticlepeer-review


Background: Multiple sclerosis (MS) represents a risk factor for sleep disorders, but there are conflicting results about the prevalence and severity of sleep-related breathing disorders (SRBD) in MS. Most available data come from self-administered questionnaires. Objective: To conduct a polysomnographic study in MS focused on SRBD, compared to a group of healthy controls (HC), also considering the neuroimaging findings. To evaluate the impact of SRBD on vigilance, fatigue and depression in MS. Methods: In this cross-sectional, observational, instrumental study, 67 MS patients (men/women: 20/47; mean age: 50.6±8.2 years) underwent PSG and maintenance of wakefulness test. Findings were compared to 67 age-, sex-, BMI-matched HC, by using parametric (Student’s t-test) and nonparametric statistics (chi-squared test). A subgroup analysis was then performed, evaluating the influence of brainstem (mesencephalic, pontine and medullary) lesions at neuroimaging on instrumental and clinical data: MS patients with at least one brainstem lesion vs MS patients without vs HC. Results: The frequency of SRBD was comparable in MS patients and HC. No MS patient had a central apnea index ≥2/h. The respiratory disturbance index (RDI) did not correlate to clinical parameters such as fatigue and depression. Patients with MS were drowsier than HC (47% vs 26%, p = 0.019) and showed a worse sleep pattern, in terms of duration, efficiency and architecture. Conclusion: Our study does not provide evidence of an association between MS-specific symptoms such as fatigue, sleepiness, depression and central or obstructive apneas, even in the presence of brainstem lesions.

Original languageEnglish
Pages (from-to)741-750
Number of pages10
JournalNature and Science of Sleep
Publication statusPublished - 2022


  • multiple sclerosis
  • polysomnography
  • sleep quality
  • sleep-related breathing disorders

ASJC Scopus subject areas

  • Applied Psychology
  • Behavioral Neuroscience


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