The Link Between Sleep Apnea and MS

By Gina Roberts-Grey

Fatigue and sleep woes are commonly experienced by those living with multiple sclerosis (MS), an autoimmune disorder that affects the brain and spinal cord. A recent study from Pennsylvania State University noted that while depression plays a role in MS-related fatigue, sleep disturbance is the biggest contributor.

Now a new study offers an explanation for sleep-related fatigue experienced by those living with MS, noting that obstructive sleep apnea (OSA) is prevalent in people with MS. The study also suggests OSA may be a contributor to the fatigue that is one of the most common and debilitating symptoms of MS.

The scientists found that one-fifth of MS patients surveyed had OSA; more than half were found to have an elevated risk for OSA based on screenings.

“OSA may be a highly prevalent and yet under-recognized contributor to fatigue in persons with MS,” said lead author and principal investigator Dr. Tiffany J. Braley, an assistant professor of Neurology at the University of Michigan Multiple Sclerosis and Sleep Disorders Centers. “Our study suggests that clinicians should have a low threshold to evaluate MS patients for underlying sleep disturbances.”

Because fatigue is a common symptom of MS, many patients excuse away their troubles to sleep. But experts caution that’s a mistake, as OSA often can be easily and effectively treated with continuous positive airway pressure, or CPAP.

“Obstructive sleep apnea is a chronic illness that can have a destructive impact on your health and quality of life,” said American Academy of Sleep Medicine President M. Safwan Badr in a statement. “People with multiple sclerosis who are found to have a high risk of OSA should be referred to a board-certified sleep medicine physician for a comprehensive sleep evaluation.”

If you’ve been diagnosed with MS, it’s wise to discuss the possibility of OSA with your doctor, especially if you’re experiencing fatigue but typically don’t snore at night.

Snoring is thought to be the most identifying symptom of OSA. And those who don’t snore (or whose snoring doesn’t disturb their sleep partner) often assume they don’t have OSA.

But experts caution that’s not always the case. “Patients with MS as well as those without the disease may have OSA without snoring. That’s why it’s important to discuss the possibility of having OSA with your doctor whenever you begin experiencing fatigue,” said Dr. Murray Grossan, an ear, nose and throat specialist in Los Angeles.

If your doctor suspects you have OSA, chances are you’ll be referred for a sleep study to monitor your breathing, oxygen levels and other functions that help diagnosis OSA and determine the severity of the disorder.