Sleep Disorders and Fatigue among Patients with MS: The Role of Depression, Stress, and Anxiety

Abstract

Sleep disorders and fatigue represent prominent symptoms frequently experienced by individuals with multiple sclerosis (MS). Some psychological factors such as depression, stress, and anxiety seem to have a relationship with such problems. This study aimed to examine the role of depression, stress, and anxiety in predicting sleep disorders and fatigue among patients with MS. Employing a cross-sectional descriptive-correlational design, the study involved a sample size of 252 participants selected through purposive sampling based on inclusion and exclusion criteria. We utilized a demographic information questionnaire along with the Mini-Sleep Questionnaire (MSQ), Fatigue Severity Scale (FSS), and Depression, Anxiety, and Stress Scale (DASS-21) to collect data and analyzed them applying SPSS22, incorporating statistical measures including Pearson correlation and regression. The results of the Pearson correlation coefficient showed that sleep disorders had a positive and significant relationship with depression (r = 0.56; $P<0.001$), stress (r = 0.40; $P<0.001$), and anxiety (r = 0.52; $P<0.001$). There was no significant relationship between age and the development of sleep disorders in total score (r = −0.001; $P<0.985$), but age had a relationship with insomnia (r = −0.146; $P<0.021$) and oversleeping (r = 0.153; $P<0.015$). Age and fatigue did not have a significant relationship as well (r = −0.044; $P<0.941$). In addition, fatigue had a positive and significant relationship with depression (r = 0.52; $P<0.001$), stress (r = 0.48; $P<0.001$), and anxiety (r = 0.54; $P<0.001$). The results of the regression analysis also showed that depression, stress, and anxiety predict 0.37% of the total variance of sleep disorders (F = 48.34; $P<0.001$) and 0.35% of the total variance of fatigue (F = 44.64; $P<0.001$). Our findings suggest that depression, stress, and anxiety play a significant role in predicting sleep disorders and fatigue among patients with MS. This study has been reported in accordance with the TREND checklist for nonrandomized trials.