Sleep Quality, Dysfunctional Sleep Beliefs, and Health-Related Quality of Life and Functioning in People With Multiple Sclerosis.

BACKGROUND

People with multiple sclerosis (MS) are more prone to sleep disturbances than the general population. Poor sleep is associated with diminished health-related quality of life and functioning (HRQOL/F) in people with MS and may trigger unhelpful thoughts and beliefs about sleep. This study aimed to examine the relationship between self-reported sleep quality, dysfunctional sleep beliefs, and HRQOL/F in a sample of people with MS.

METHODS

Participants (N = 200) completed the Pittsburgh Sleep Quality Index (PSQI), the Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS-16), and HRQOL/F patient-reported outcome measures (PROMs). Separate multivariable linear regressions were modeled, each including 1 PROM as the dependent variable. For each PROM, 2 models were fit: one with the PSQI score as the predictor and one with the DBAS-16 score. All models included demographic and/or clinical factors as covariates. Two-way interactions between each PSQI and DBAS-16 score and each demographic and/or clinical factor were added to the models. Mediation analysis was performed where each PROM was the outcome, the PSQI score was the predictor, and the DBAS-16 score was the mediator.

RESULTS

Worse self-reported sleep quality and a greater degree of dysfunctional sleep beliefs were significantly associated with worse t scores for global HRQOL/F physical and mental health outcomes and several Quality of Life in Neurological Disorders (Neuro-QoL) scales. Dysfunctional sleep beliefs significantly mediated the association between PSQI and HRQOL/F mental health outcomes and several Neuro-QoL scales, and significant interactions between PSQI, DBAS-16, and demographic/clinical factors were revealed.

CONCLUSIONS

Sleep quality and dysfunctional sleep beliefs are important correlates of HRQOL/F in people with MS. In clinical settings, thorough assessment and intervention targeting these factors are warranted.