Comparison of self-report sleep measures for individuals with multiple sclerosis and spinal cord injury

Arch Phys Med Rehabil., 2015 · DOI: 10.1016/j.apmr.2014.10.001 · Published: March 1, 2015

Simple Explanation

This study compares different methods of measuring sleep problems in people with multiple sclerosis (MS) and spinal cord injury (SCI). It uses questionnaires to understand how these conditions affect sleep. The researchers used two main questionnaires: the Medical Outcomes Study Sleep scale (MOS-S) and the Patient Reported Outcomes Information System (PROMIS). They compared the results from these questionnaires to see how well they matched up and if they accurately reflected sleep issues in these populations. The study found that one questionnaire (MOS-S) showed significant sleep disturbances in both MS and SCI patients, while the other (PROMIS) gave less clear results. This suggests that some sleep questionnaires may not be as accurate for people with neurological conditions.

Study Duration

Approximately 16 months

Participants

461 MS patients and 239 SCI patients

Evidence Level

Cross-sectional survey

Key Findings

1
Mean scores on the MOS-S Sleep Index II were significantly worse for both the MS and SCI samples than those of previously reported samples representative of the US general population.
2
The PROMIS-SD and PROMIS-SRI scores of the MS sample were also significantly different than those reported for the calibration cohort.
3
While the SCI sample’s scores were significantly different from those of the comparison cohort for the PROMIS-SRI (p=.045), the differences on the PROMIS-SD were not significant (p=.069).

Research Summary

The study investigated self-report measures of sleep disturbances and sleep-related impairments in individuals with multiple sclerosis (MS) or spinal cord injury (SCI). The Medical Outcomes Study Sleep (MOS-S) scale indicated significantly high levels of sleep-related problems in both MS and SCI cohorts, consistent with existing literature. The PROMIS-SD and PROMIS-SRI findings were more ambiguous, suggesting that more research is needed to understand how these instruments function in individuals with chronic neurological dysfunction.

Practical Implications

Choice of Sleep Assessment Tools

Researchers and clinicians should carefully consider the choice of self-report measures when assessing sleep disturbances in individuals with MS or SCI, as different tools may yield varying results.

Need for Condition-Specific Norms

There is a need for developing condition-specific norms for sleep questionnaires in neurological populations, as using general population norms may not accurately reflect the sleep experiences of these individuals.

Multidimensional Assessment

A comprehensive assessment of sleep in MS and SCI should include multiple dimensions, such as respiratory problems and somatic symptoms, which may not be adequately captured by all self-report measures.

Study Limitations

1
The distributions of MOS-S scores were not normal, ideally requiring non-parametric tests for comparisons, but median scores were unavailable for the general population cohort.
2
The study relied on self-report measures, which are subject to recall bias and may not accurately reflect objective sleep parameters.
3
The cross-sectional design limits the ability to draw causal inferences about the relationship between neurological conditions and sleep disturbances.

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