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The Relationship Among Multiple Sclerosis–Related Symptoms, Sleep Quality, and Sleep Hygiene Behaviors

Newland, Pamela; Lorenz, Rebecca A.; Smith, Judith M.; Dean, Emily; Newland, John; Cavazos, Patricia

Journal of Neuroscience Nursing: February 2019 - Volume 51 - Issue 1 - p 37–42
doi: 10.1097/JNN.0000000000000409

ABSTRACT Aims and Objectives: The aim of this study was to examine the relationships among multiple sclerosis (MS)–related symptoms, sleep hygiene behaviors, and sleep quality in adults with MS who self-report fatigue. Background: Fatigue is a frequent, prevalent symptom among adults with MS. Few studies have examined the relationship among fatigue and other symptoms with sleep quality and sleep behaviors. Design: This is a descriptive correlational study. Methods: A convenience sample of 39 adults with MS were recruited for the study. Instruments used included the revised MS Related Symptom Scale and the Pittsburgh Sleep Quality Index. Correlations examined the relationships among fatigue and other MS symptoms with sleep quality and sleep hygiene behaviors. Results: The frequency of several symptoms correlated with poor sleep quality, and fatigue frequency was higher in those who used electronic devices and practiced poor sleep hygiene behaviors. Nursing Implications: Nurses should incorporate interventions for symptoms that impact sleep quality. These findings suggest that sleep hygiene education should be a part of routine clinical care. Conclusion: Adults with MS experience the burden of many symptoms that impact sleep quality. Interventions that include education to improve symptoms, sleep hygiene behaviors, and sleep quality are needed.

Questions or comments about this article may be directed to Pamela Newland, PhD RN CMSRN, at She is an Associate Professor, Goldfarb School of Nursing at Barnes Jewish College, St Louis, MO.

Rebecca A. Lorenz, PhD RN, is Associate Professor, University at Buffalo School of Nursing, Buffalo, NY.

Judith M. Smith, PhD RN GCNS-BC, is Professor, Goldfarb School of Nursing at Barnes Jewish College, St Louis, MO.

Emily Dean, BSN, is Staff Nurse, Barnes Jewish Hospital, St Louis, MO.

John Newland, BS, Pediatric Computing Facilities Development, Department of Pediatrics, Washington University in St. Louis, St Louis, MO.

Patricia Cavazos, PhD, is Associate Professor, Department of Psychiatry, Washington University School of Medicine, St Louis, MO.

This study was funded by a research grant from the Academy of Medical Surgical Nurses. RedCap provided grant support (Supported by Clinical and Translational Science Award Grant [UL1 TR000448] and Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842).

Dr Newland is on the board of JNN. Otherwise, the authors declare no conflicts of interest.

© 2019 American Association of Neuroscience Nurses