Sleep problems in multiple sclerosis: Conflicting results from two patient-reported outcome measures.

TitleSleep problems in multiple sclerosis: Conflicting results from two patient-reported outcome measures.
Publication TypeJournal Article
AuthorsBamer AM, Amtmann D, Cook KF, Johnson KL
JournalInternational Journal of MS Care

Background: Our prior research, along with other published studies, suggests that individuals with multiple sclerosis (MS) have significantly more problems sleeping than the general population. The PROMIS network recently released a set of patient-reported outcome measures that included shortform measures of both sleep and wake disturbance. Objectives: To compare levels of sleep difficulties in people with MS as measured by the newly developed PROMIS scales and by the older Medical Outcomes Study Sleep Scales (MOSSS). Methods: Community-dwelling individuals with MS (N = 461) involved in an ongoing longitudinal study of outcomes completed a self-report mail survey. Included in the survey were the PROMIS sleep and wake dysfunction short forms, as well as MOSSS. All measures were scored based on recommendations of scale developers, and summary statistics (mean ± SD) were calculated. The PROMIS scales were developed such that the general US population mean is centered at 50 with a standard deviation of 10. Comparison population data for the MOSSS were reported by Hays and Spritzer in the MOS manual and original publication, and included chronically ill patients and the general US population. Results: Using the MOSSS, study participants reported more difficulties with sleep disturbance (33.1 ± 25.2), sleep adequacy (48.7 ± 27.5), daytime somnolence (37.3 ± 23.7), and overall sleep problems (36.2 ± 19.1) than the comparison populations published by Hays and Spritzer. Using the PROMIS scale, participants reported similar levels of sleep (50.8 ± 10.1) and wake (52.6 ± 9.2) disturbance as the general US population. Conclusion: Summary results of the PROMIS sleep scales suggest that levels of sleep problems in individuals with MS may actually be similar to those of the general US population. Content analyses of the scales suggested that there is significant overlap in item and content coverage between the MOSS and PROMIS scales. Results from the different scales suggest substantially different conclusions about difficulties with sleep in people with MS. Additional research needs to be done to examine the properties of both scales in this population and identify which scale(s) should be used to measures sleep in individuals with MS.

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