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Yıl:2018; Cilt: 5; Sayı: 3>> Özet
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Türk Uyku Tıbbı Dergisi; 2018;5(3):91-98
Multipl Skleroz Hastalarında Yorgunluk ve Uyku Bozukluklarının Demografik ve Polisomnografik Olarak İncelenmesi
AÖ Sıvacı, AB Demir, ÖF Turan, Ö Taşkapılıoğlu, İ Bora, G Ocakoğlu
Uludağ Universitesi, Bursa
Amaç: Multipl skleroz (MS) hastalarında demografik, klinik ve polisomnografik verilerle yorgunluk ve uyku bozukluklarını araştırmak ve yaşam kalitesi üzerine etkilerini göstermektir. Gereç ve Yöntem: Çalışmaya polisomnografi (PSG), Yorgunluk Şiddeti ölçeği, Epworth Uykululuk ölçeği (EUÖ), Pittsburg Uyku Kalitesi indeksi, Beck Depresyon ve Anksiyete envanteri ile değerlendirilen 30 MS hastası alındı. İnterferon kullanan (n=16) ve kullanmayan (n=14) hastalar, tüm parametrelerde birbirleriyle karşılaştırıldı; EUÖ ve PSG verileri 19 sağlıklı kişiden oluşan bir kontrol grubu ile karşılaştırıldı. Kısa form-36 (SF-36) verileri ise toplum normlarıyla karşılaştırıldı. Bulgular: Hastaların %86,7’sinde santral yorgunluk olduğu görüldü. PSG’de, interferon kullanmayanların evre N2 uyku süresi, kullananlara göre anlamlı olarak daha uzun kaydedildi (p<0,001). PSG’ye göre, toplam uyku süresi, uyku etkinliği, evre N3 ve hızlı göz hareketi süresi, solunum bozukluğu indeksi ortalaması, uyku latansı ve toplam bacak hareketlerinin ortalama değeri, hasta grubunda kontrol grubuna göre anlamlı oranda yüksek bulundu (p<0,001). SF-36’nın tüm parametreleri hastalarda anlamlı olarak daha düşüktü (p<0,001). Evre N3 uyku süresi uzunluğu, SF-36’nın fiziksel bileşen özeti ile ilişkili bulundu (p<0,001). Sonuç: MS hastalarında yüksek düzeyde yorgunluk, ek olarak nesnel ve öznel uyku parametrelerinde önemli ölçüde bozukluklar bulunmaktadır. Çalışmamızda bu hastaların yaşam kalitesindeki tüm bileşenlerin önemli ölçüde azaldığı ortaya konmaktadır. Ayrıca çalışmamız derin uyku süresinin fiziksel aktivite ile ilişkili olduğunu göstermiş, MS hastalarında uyku değerlendirmesinin önemini vurgulamıştır
A Demographic and Polysomnographic Investigation of Fatigue and Sleep Disorders in Patients with Multiple Sclerosis
Objective: To investigate fatigue and sleep disorders based on demographic, clinical and polysomnographic data and show their effects on the quality of life in multiple sclerosis (MS) patients. Materials and Methods: Thirty MS patients were enrolled in the study depending on the results of the polysomnography (PSG), Fatigue Severity scale, Epworth Sleepiness scale (ESS), Pittsburgh Sleep Quality Iindex, Beck Depression and Anxiety inventories. Patients, using (n=16) and non-using (n=14) interferon, were compared with each other in all parameters; ESS and PSG data were compared with a control group consisting of 19 healthy people. Short form-36 (SF-36) data were also compared with the society norms. Results: Central fatigue was observed in 86.7% of the patients. PSG data revealed that stage N2 sleep duration of those who did not use interferon was significantly longer than those who used it (p<0.001). According to the PSG, total sleep time, sleep efficiency, stage N3 and rapid eye movement time, mean respiratory disturbance index, sleep latency and the mean value of total leg movements were significantly higher in the patient group than in the control group (p<0.001). All parameters of SF-36 were significantly lower in patient group (p<0.001). The stage N3 sleep time length was found related with physical component summary of SF-36 (p<0.001). Conclusion: MS patients have high level of fatigue and additionally there are weighty disturbances in objective and subjective sleep parameters. Our findings were revealed that all the components of quality of life decreased significantly in these patients. Furthermore, our study showed that deep sleep duration was related with physical activity and emphasized the importance of sleep evaluation in MS patients

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