Fatigue und Schlafstörungen bei Patienten mit schubförmig remittierender MS (RRMS) unter Interferon β-1b-Therapie

Zusammenfassung

Hintergrund: Fatigue ist ein häufiges Symptom bei MS-Patienten mit multifaktorieller Genese. Untersucht wurde der Einfluss von Schlafstörungen auf Fatigue bei RRMS(relapsing remitting)-und CIS (Clinical isolated syndrome)-Patienten unter einer Therapie mit Interferon β-1b.

Methode: 73 Patienten wurden über einen Zeitraum von 12 Monaten an 3 Zeitpunkten (0/6/12 Monate) mittels Fragebögen (Fatigue, Schlafqualität, Restless Legs Beschwerden, Angst und Depression) und ambulanter Polysomnografie beurteilt. Eine vollständige Analyse war für 46 Patienten (35 Frauen und 11 Männer, 35,5±7,6 Jahre alt, EDSS 2±1,4) möglich.

Ergebnisse: 50% der Patienten beklagten Schlafstörungen. RLS-Beschwerden nahm von 14 in Visite 1 (N=14) zu auf 20 in Visite 3 (N=20). Das Ausmaß der Fatigue korrelierte mit Schlafstörungen und RLS-Beschwerden.

Schlussfolgerung: Schlafstörungen und eine RLS-Symptomatik sind bei MS häufig aber wenig untersucht. Durch Therapie dieser Symptome ist auch ein kausaler Therapieansatz hinsichtlich der Fatigue denkbar. Studie mit größerer Patientenzahl und Vergleich unterschiedlicher Immunmodulatoren sind notwendig.

Abstract

Background: Fatigue is a frequently present symptom in multiple sclerosis and is caused by multiple factors. The influence of sleep disturbances on fatigue in patients with relapsing remitting multiple sclerosis or clinical isolates syndrome treated with interferon β-1b was investigated.

Method: 73 patients were included and reinvestigated after 6 and 12 months. They completed questionnaires asking about fatigue, sleep quality, restless legs syndrome (RLS), anxiety and depression. Polysomnography was carried out at month 0 and 12. 46 patients (35 women, 11 men, 35.5±7.6 years old, EDSS 2.0±7.6) completed all investigations.

Results: 50% of the patients complained of sleep problems. The number of patients with RLS symptoms increased (14 at visit 1, 20 at visit 3). Severity of fatigue correlated with sleep disturbances and RLS symptoms.

Conclusion: Sleep disturbances and RLS are common but frequently disregarded in multiple sclerosis. Treating these symptoms may open a causal therapy of fatigue. Studies with higher numbers of patients and comparison of different immune-modulating therapies are necessary.

Schlüsselwörter

Multiple Sklerose - Fatigue - Schlafstörungen - Restless Legs Syndrom - Interferon β-1b

Key words

multiple sclerosis - fatigue - sleep disturbances - restless legs syndrome - interferon β-1b

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