Sleep in MS: more important than we thought

  • New Australian research has shown that sleep difficulties are far more common among people with MS than in the general community.
  • Poor sleep substantially affected quality of life, independent of 13 other MS symptoms measured.
  • For many people with MS, improving sleep could make a meaningful difference to their quality of life.

Poor sleep quality is common in people with MS and has been associated with lower quality of life and even higher mortality in previous studies. Some of the risk factors for poor sleep include a greater level of disability and specific MS symptoms, including fatigue, depression, anxiety and cognitive difficulties.

However, it has been unclear whether poor sleep itself is associated with reduced quality of life in people with MS, or whether this is due only to the effects poor sleep has on other symptoms of MS. This is important because it has implications on whether treating poor sleep is likely to make a clinically meaningful difference to the health of people with MS.

A new study from the University of Tasmania’s Menzies Institute for Medical Research has examined this question in people with MS in Australia through the Australian MS Longitudinal Study (AMSLS). The AMSLS is one of MS Australia’s collaborative research platforms and is a survey-based research study that has been running since 2001 and now has approximately 2500 people completing research surveys each year.

The study is designed to provide real-life data about MS, which can be used by all MS medical and support services to effect change for the better for those with MS, their families and carers.

What did the researchers do?

The major aim of the study was to determine whether poor sleep is associated with reduced quality of life in people with MS, independent of their other MS symptoms.

To examine this, researchers surveyed 1717 people with MS within the AMSLS. They investigated how common sleep problems were, how sleep problems related to 13 common MS symptoms, and whether poor sleep affected health-related quality of life, even after other MS symptoms were taken into account. Health-related quality of life was measured using a survey (called AQoL-8D) that encompasses independent living, mental health, coping, pain, senses, self-worth and happiness.

What did the researchers find?

More than two-thirds of people with MS (68%) experienced poor sleep. This is up to twice the rate of sleep problems in the general community (33%-45%).

Poorer sleep was associated with being younger, overweight or obese, having a recent MS relapse, higher disability levels and three groups of MS symptoms (‘pain and sensory’, ‘feelings of anxiety and depression’ and ‘fatigue and cognition’).

The effect of sleep and MS symptoms on quality of life were also measured. Study author Dr Laura Laslett says, “Interestingly, sleep dysfunction stood out as being strongly associated with health-related quality of life, independent of other symptoms of MS.”  

She added, “I think the most important take-home message from this research is that both sleep and MS symptoms are independently related to quality of life, and that effects of sleep on quality of life are not just secondary to MS symptoms.”

What does this mean for people with MS?

We don’t yet fully understand what drives poor sleep in MS. Changes in the brain in MS are present in people with MS who have sleep disorders and likely also impact sleep.

The study also showed that specific MS symptoms, including anxiety, fatigue, depression and cognitive issues, were associated with poorer sleep. These could be impacting sleep, and vice versa. Further research is needed to find the most effective ways to address sleep problems in MS. If you are experiencing sleep problems, please consult your MS healthcare team.

Head of Research at MS Australia, Dr Julia Morahan, says, “This is such an important study because it gives us another potential lever to improve health in MS. We are so grateful to the AMSLS participants who generously give their time and information to help others with MS.”

 Help us manage MS better through the AMSLS

The AMSLS runs surveys throughout the year to help understand how MS is affecting people’s daily lives, so we can provide better supports.

The topics are diverse: from the economic impact of MS and impact of co-occurring health conditions, through to support from MS Nurses and pain in MS. Our current survey is examining how MS impacts a person’s sense of self, or “self-concept” so that psychological supports can be tailored to this.

We are actively seeking more people with MS to help with life-changing research. If you are interested, please follow the links to find out more or become a participant; or you can contact the AMSLS study team directly at

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Sleep in MS: more important than we thought