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The relationship between obstructive sleep apnea and age, gender, EDSS, disease duration, and BMI in people with multiple sclerosis who report fatigue: more than size matters
Author(s): ,
A. Cascone
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
A. Giannuzzi
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
J. Srinivasan
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
K. Wissemann
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
M. Taddeo
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
L. Fafard
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
B. Bumstead
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
M. Buhse
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
M. Zarif
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
M. Gudesblatt
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
ECTRIMS Online Library. Srinivasan J. Oct 12, 2018; 228869; P1027
Jared Srinivasan
Jared Srinivasan
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Abstract: P1027

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Background: Fatigue is a common and disabling symptom in patients with MS (PwMS). The presence and degree of fatigue in patients with MS primarily relies on patient self-report. Identifying contributing factors to the fatigue that the MS patient reports can be difficult. Patient reported information relating fatigue, sleep disturbance and the presence of OSA may be unreliable. Studies utilizing polysomnography (PSG) to evaluate fatigue in patients with MS are typically limited by the small patient sample size. A full characterization of the spectrum of sleep disorders in patients with MS has been limited to date. The presence of OSA is defined by PSG with an Apnea-Hypopnea Index (AHI) ≥5. BMI is frequently utilized to identify patients at risk for OSA (BMI>25) or other sleep disorders. The Expanded Disability Status Scale (EDSS) defines MS disability on examination.
Objective: To explore the relationship between obstructive sleep apnea (OSA) and age, gender, EDSS score, disease duration, and BMI in PwMS who report fatigue.
Methods: Retrospective analysis of PwMS who reported fatigue, were not previously diagnosed as having OSA and who agreed to have overnight PSG studies.
Results: 292 PwMS (average age 47.3 ± 10.7 years, 81.4% female). 61% of PwMS who reported fatigue (n=177) had PSG identified OSA (AHI ≥5). AHI related to age (R=0.254). The incidence of OSA in PwMS: age < 30 years old (n=19): 26%, age 30-40 (n=62): 52%, age 40-50 (n=106): 58%, age 50-60 (n=75): 73%, and age >60 (n=28): 82%. No significant relationship between OSA and gender was identified. OSA in PwMS with EDSS 0-2.5 (n=96): 57%, EDSS 3.0-5.5 (n=25): 63%, and EDSS 6.0-8.0 (n=25): 89%. OSA in PwMS disease duration < 5 years (n=130): 57%, disease duration between 5-10 years (n=76): 57%, disease duration between 10-15 years (n=51): 67%, and disease duration greater than 15 years (n=18): 72%. OSA was identified in PwMS BMI< 28 (n=93): 57% and BMI≥28 (n=131): 71%.
Conclusion: Undiagnosed OSA is common in PwMS who report fatigue. Incidence of OSA in PwMS appears to increase with age. OSA incidence in PwMS increases with EDSS, but is still common in those with low EDSS scores. While OSA is more common in people with high BMI, low BMI does not preclude a diagnosis of OSA. Increasing BMI is not direct relationship with the incidence of OSA in PwMS. Accurate identification and intervention of specific causes of fatigue in PwMS might improve treatment outcomes.
Disclosure: (This study was supported by Teva):
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
AG- Nothing to disclose
JS- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
AC: Nothing to disclose
KW: Nothing to disclose
LF- Nothing to disclose
MB- Nothing to disclose

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