Sleep and work productivity loss in multiple sclerosis: An Australian study

BACKGROUND: People with multiple sclerosis frequently experience poor sleep quality and work productivity loss, both impacted by MS symptoms. OBJECTIVES: This study examined associations between sleep measures (sleep quality and daytime sleepiness) and work productivity loss, and the mediating effects of other MS symptoms. METHODS: Participants (N = 526) were from the Australian Multiple Sclerosis Longitudinal Study. The Work Productivity and Activity Impairment MS version questionnaire was used to measure MS-related work productivity loss. Cragg hurdle regression was used to examine associations. RESULTS: The prevalence of any work productivity loss was higher among poor sleepers (59.7 %) compared to good sleepers (34.4 %). Worse sleep quality (β=2.9, 95 % CI [1.9,3.8]) and greater day time sleepiness (β=2.1, 95 % CI [1.4, 2.8]) were associated with total work productivity loss. Both sleep measures were associated with both presenteeism and absenteeism, with stronger associations seen for presenteeism. MS symptoms mediated these associations, with the cluster of 'fatigue and cognitive symptoms' being the strongest mediator. CONCLUSIONS: Poor sleep quality and high levels of daytime sleepiness are associated with work productivity loss, and mediated by MS symptoms. Targeted management, prioritising those with worse sleep quality and greater daytime sleepiness, may help improve work productivity, either directly or indirectly via improvements in MS symptoms.<p></p>