Background: Sleep disorders are more prevalent in people with multiple sclerosis (pwMS) than in the general population. This study aimed to examine the clinical and sociodemographic factors ...contributing to sleep disorders in pwMS. Method: The participants in this cross-sectional study were pwMS from the Isfahan Province in Iran. Sleep disorders were assessed using the Insomnia Severity Index (ISI), International Restless Legs Syndrome Study Group (IRLSSG), Berlin, and STOP-Bang questionnaires. A logistic regression model was applied to determine the accuracy of independent factors in predicting sleep impairment. A multivariate logistic regression analysis was conducted to examine the impact of multiple sclerosis (MS) types on sleep disorder severity predictability by independent variables. Result: A total of 796 pwMS were included in the current study, 693 with relapsing-remitting MS and 103 with secondary-progressive MS. Rest leg syndrome (RLS) and insomnia disorders were not present in 48.1% and 50.5% of the pwMS, respectively. According to STOP-Bang and Berlin, 87.3% and 88.4% of patients had a low-severity risk for obstructive sleep apnea (OSA), respectively. The logistic regression showed that age, gender, and Expanded Disability Status Scale (EDSS) were associated with the risk of OSA (p < 0.05). RLS severity was also correlated with age and EDSS (p < 0.05). The association between sleep disorder severity and independent variables was not affected by MS type in multivariate logistic regression. Conclusion: In this study, we found that sleep disorders such as RLS, insomnia, and OSA are common among pwMS in Iran. Sociodemographic factors, as well as disease characteristics, can have an impact on sleep disorders among pwMS.
Background: Patients with neurological disorders have been vaccinated in response to the global COVID-19 pandemic. This study aimed to determine the factors contributing to COVID-19 infection and ...acute relapse and compare adverse effects following COVID-19 vaccination among patients with multiple sclerosis (pwMS) and other neurological disorders (OND). Method: This prospective observational study was conducted between September 2021 and September 2022 in Isfahan, Iran, to collect demographic and clinical data on pwMS and OND patients, COVID-19 infection, vaccination, and adverse effects. Headache, migraine, low back pain, epilepsy, myasthenia gravis, Parkinson's disease, stroke, Alzheimer's disease, motor neuropathy, myopathy, major depressive disorder, obsessive-compulsive disorder, and brain tumor were considered OND. Logistic and Poisson regression were used to investigate the relationship between clinical indicators and COVID-19 infection and acute disease relapse after COVID-19 vaccination. Results: This study included 1306 participants, 818 of whom had MS and 488 had OND. Among pwMS, age (OR=1.030, 95%CI: 1.007–1.054, p=0.012), exacerbated neurological symptoms after COVID-19 infection (OR=1.920, 95%CI: 1.028–3.586, p=0.029) were associated with the higher risk of COVID-19 infection after vaccination, and the presence of adverse effects following the second dose of the vaccine compared to no adverse effects after second dose (OR=0.576, 95%CI: 0.374–0.887, p=0.012) was correlated with the lower risk. While OND patients with inactivated vaccine compared to vector-based vaccine (RR=0.424, 95%CI: 0.188–0.958, p=0.009) were at a lower risk of COVID-19 infection after vaccination. The risk of acute disease relapse following COVID-19 vaccination in pwMS and OND patients was not significantly influenced by demographic and clinical characteristics. Conclusion: The risk of COVID-19 infection after COVID-19 vaccination in pwMS was associated with some demographic characteristics and COVID-19-related data, while OND patients did not exhibit these relationships. Consequently, these factors should be considered after COVID-19 vaccination in pwMS.
