Patients with ambulatory multiple sclerosis (MS) who experience severe fatigue should be screened for obstructive sleep apnea (OSA), according to findings from an ongoing trial presented at the 7th Joint ECTRIMS-ACTRIMS Meeting, held October 25-October 28, 2017, in Paris, France.
Researchers sought to determine the prevalence of OSA in patients with MS. A total of 87 patients (35% men) were initially evaluated, and of these, 74 met the eligibility criteria and underwent polysomnography. OSA was defined by an Apnea-Hypopnea Index (AHI) of ≥15 events per hour on a complete overnight polysomnography, as scored by the American Academy of Sleep Medicine Research criteria. All patients were taking stable immunomodulating medications.
To be included, patients had to have the following: Expanded Disability Status Scale score ≤7, Fatigue Severity Scale score ≥4, Pittsburgh Sleep Quality index score >5, and Montreal Cognitive Assessment score ≥26.
The mean age of the patients was 49 years with a mean body mass index of 28±6 kg/m2. Of 74 patients, 54 had OSA (mean AHI, 37±21/hour; oxygen desaturation index, 6.4±8.5/hour, and respiratory arousal index, 34±20/hour).
The researchers’ clinical eligibility criteria had a positive predictive value of 73% for OSA (95% CI, 61%-83%) and 40% for severe OSA (AHI >30 events/hour; 95% CI, 29%-53%).
The results indicate that an OSA diagnosis should be considered in patients with ambulatory MS who present with severe fatigue and poor subjective sleep quality, the researchers concluded.
Trojan DA, Duquette P, Khadadah S, et al. Prevalence of sleep apnea in multiple sclerosis patients meeting clinical eligibility criteria for the Sleep Apnea in Multiple Sclerosis Positive Airway Pressure (SAMSPAP) trial. Presented at: 7th Joint ECTRIMS-ACTRIMS Meeting. October 25-28, 2017; Paris, France. Abstract P414.