Physical activity, sleep may improve psychological outcomes in MS

WEST PALM BEACH, Florida — Physical activity levels and sleep correlated with psychological outcomes in MS, according to data presented at the ACTRIMS Forum.

“Despite effective drug therapies, youth with MS report high levels of fatigue, depression and cognitive impairment,” Samantha Stephens, PhD, of the Hospital for Sick Children in Toronto, said during a virtual presentation. “They also experience worse disease burden and early onset of disability. In our lab, we have focused on how changes in lifestyle behaviors may improve these MS symptoms and reduce disease burden and disability in this cohort.”

In a cross-sectional study, Stephens and colleagues aimed to examine associations among sleep parameters, sedentary behavior and physical activity levels, and psychological outcomes in youth with MS and healthy controls. They recruited 25 youth with MS followed at a pediatric center in Toronto, as well as 25 age- and sex-matched healthy controls. Researchers collected data using an Actiwatch and GT3X accelerometer, which participants wore for 7 days. Participants completed standardized questionnaires for depression, fatigue and quality of life. Sleep efficiency, sleep time, wake after sleep onset and latency composed Actiwatch data, and time spent in sedentary behavior, light physical activity and moderate to vigorous physical activity composed GT3X data.

Participants with MS had higher BMI compared with healthy controls but did not differ in sleep efficiency, sleep time, insomnia, latency, sedentary behavior or physical activity. Stephens and colleagues noted that among those with MS, sleep efficiency “paradoxically” correlated with more sedentary behavior minutes (P = .05), whereas lower sleep efficiency correlated with more sedentary behavior minutes in healthy controls (P < .01). They also noted less sleep time, sleep onset latency and insomnia correlated with more sedentary behavior (P < .01) in MS and higher sleep efficiency with improved sleep/rest fatigue. Among those with MS, less insomnia was associated with lower depression, fatigue (P < .01) and better quality of life (P < .01). Researchers observed no association between sleep metrics and psychological outcomes in healthy controls; however, moderate to vigorous physical activity correlated with lower cognitive fatigue (P < .05), increased quality of life (P < .5) and higher vigorous physical activity with lower depression (P < .05). Among those with MS, greater light physical activity correlated with lower sleep onset latency (P < .05), while higher moderate to vigorous physical activity was associated with reduced sleep/rest fatigue (P < .05) and vigorous physical activity with higher quality of life (P < .05).

“Future studies are needed to confirm these findings and perhaps will inform future behavioral interventions,” Stephens said during the presentation.