Every person diagnosed with multiple sclerosis experiences it differently. Most experience a difficulty in keeping their sense of self and holding onto their abilities.
The researchers at University of Michigan, keeping this aspect of intellectuality in mind, are looking for a new way to improve cognitive functions like attention, mental processing, and memory in MS patients. They are doing this by examining sleep.
Patients diagnosed with MS are at a higher risk of developing obstructive sleep apnea (OSA). OSA is a condition in which the patient repeatedly stops breathing for long periods during sleep due to the throat collapsing. OSA is known to lead to a decline in mental functioning.
A new pilot study at the University of Michigan, which has been published in Sleep, is the first of its kind to link the severity of OSA with mental functioning in MS patients.
The co-author and principal investigator of the study, Tiffany Braley, MD, MS, states that researchers are wondering whether some of the processing and thinking difficulties experienced by MS patients are coming from the disease itself or if they are caused by sleep problems. This theory is developed because OSA is a treatable condition commonly seen in MS patients.
Almost half of the American population suffers with an MS diagnosis. It is the leading cause of non-traumatic neurological disability in young adults.
Dr. Braley and her team analyzed 38 MS patients who had questionable sleep patterns and cognitive decline. They performed seven cognitive tests, including tasks in calculation, reproduction of figures and pictures, as well as word list recalls. Additionally, the patients spent the night in the Michael S. Aldrich Sleep Disorders Lab in order to have a sleep study performed. Out of the 38 patients, 33 of them met OSA criteria.
There was a direct correlation between sleep apnea and poorer cognitive function on several of the testing measures, researchers state. Of particular note were the problems associated with memory and attention, especially memory for images and words, as well as working memory. Working memory plays a big role in solving problems and making decisions. These were all associated closely with lack of sleep.
The severity of OSA measures had a variance of 11-23% in test performance. The researchers found that there was indeed a relationship between poor cognitive functioning and other sleep quality measures.
Dr. Braley states that the current treatments for MS can prevent further decline and neurological damage, but they do not necessarily help with any of the damage that already exists. Their focus on sleep, therefore, is part of the big picture initiative that will aim to identify conditions that may have been overlooked in the past and may be negatively affecting MS patients. Successful identification and treatment of OSA could be a great start to finding new ways to improve cognitive performance in patients with MS.
What are the Next Steps?
Findings will be replicated in a larger sample of patients with multiple sclerosis. They will use CPAP (positive airway pressure therapy) to treat those who have been diagnosed with OSA. CPAP is always the first treatment given to someone with OSA. The next clinical trial will be an investigation into whether cognitive dysfunction in MS patients with OSA can actually be treated. Meanwhile, the researchers are looking to inspire a bigger discussion within the neurological community regarding this topic.
It is the hope of the investigators that neurologists will start asking their MS patients about their sleep habits and patterns. There should be encouragement to openly discuss these issues with their neurologists.
Most MS patients rate fatigue as one of their most troublesome symptoms. Sleep problems are treatable, so the researchers in this study believe physicians should refer their MS patients who report sleep disturbances and excessive fatigue to sleep specialists.
Author: Rachael Herman is a professional writer with an extensive background in medical writing, research, and language development. Her hobbies include hiking in the Rockies, cooking, and reading.
© 2020 American Sleep Association.