Can poor sleep in teens increase MS risk?

By Alan Moses HealthDay Reporter

(Health Day)

WEDNESDAY Jan 25 2023 (HealthDay News) — Teens who regularly don’t get a good night’s sleep may be at a higher risk of developing multiple sclerosis (MS) as adults, new research suggests.

“We found that sleeping too little or experiencing poor sleep quality [as a teen] increased the risk of later developing MS by as much as 50%,” said study author Dr. Anna Karin Hedström, a senior research specialist in the Department of Clinical Neuroscience at the Karolinska Institute in Stockholm, Sweden.

MS is a disabling neurodegenerative disease that targets the body’s central nervous system, essentially short-circuiting communication between the body and the brain. According to the US-based National Multiple Sclerosis Society, the disease affects about 2 million Americans.

The MS Society notes that sleep problems – including insomnia, sleeping too much, narcolepsy and/or sleep apnea – are more common in people with MS, compared to healthy peers.

Difficulty sleeping, MS Society experts note, can be traced back to the physical limitations caused by MS. These may include increased fatigue and decreased ability to engage in physical activity, in addition to chronic symptoms such as restless legs, pain, body temperature fluctuations and urinary/bowel discomfort.

MS can also take an emotional toll that undermines sleep, due to an increase in stress or anxiety and an increased risk of depression.

But maybe also bad sleep precede the onset of MS, increasing long-term risk?

To investigate the possibility, the research team focused on nearly 2,100 adult MS patients and about 3,200 randomly selected healthy adult peers up to age 70.

Participants completed adolescent sleep questionnaires sometime between 2005 and 2018.

The questionnaires focused on sleep habits and quality when the participants were between the ages of 15 and 19, when none had been diagnosed with MS.

For example, they were all asked to remember how long they slept on work and/or school days versus how long they slept on weekends and days off. “Short sleep” was characterized as less than seven hours of sleep per night, while “sufficient sleep” was defined as seven to nine hours. Staying in bed for 10 hours or more was seen as ‘sleeping long’.

Allen was also asked to rate the quality of their sleep on a scale of 1 to 5 (5 being the best).

Among those who eventually developed MS, the average age at diagnosis was 35 years.

And after crunching the numbers, the team finally found that regularly experiencing “short sleep” was associated with a 40% higher risk of developing MS as an adult, compared to routinely getting “enough sleep.”

The finding held even after accounting for factors that can influence sleep habits, such as body mass index — a marker of obesity — and smoking.

In contrast, “sleeping long” was not linked to a higher risk of MS. Nor was it routine to stay up later on days off, as long as overall sleep duration and quality remained adequate.

On the other hand, those who said their teen sleep quality was generally poor were found to have a 50% higher risk of developing the disease.

But even if MS risk is higher in those whose teenage sleep habits were less than ideal, “the prevalence of MS [remains] very low, much less than 1 in 1,000,” said the study’s lead author, Torbjörn Åkerstedt.

“So one should avoid alarmism,” added Åkerstedt, former president of the European Sleep Research Society and professor of clinical neuroscience at the Karolinksa Institute.

So what’s going on? The research team pointed to previous research showing that lack of sleep and poor sleep quality are linked to systemic inflammation and impaired immune function. Over time, both can increase vulnerability to chronic health conditions and serious illness.

The upshot, Hedström said, is that “enough restorative sleep — which is necessary for adequate immune system function — is important.”

Kathy Zackowski, the MS Society’s vice president of research, cautioned that the research relied entirely on people’s memories of past sleep patterns, sometimes decades earlier. “We need more objective research to investigate this,” she said.

“At the same time, there’s really nothing, no research at all on sleep and MS in adolescents,” Zackowski acknowledged. “So this work really fills a need.”

She added that the findings make sense. “Not only the number of hours of sleep is important, but the quality of sleep is also important, especially in adolescents,” Zackowski said. “They go through a lot of emotional changes from hormones and tons of brain growth, as the brain doesn’t finish growing until they’re 25 or 26. That’s all pretty exhausting on the nervous system, building all that hardware that we have to get us through life. ”

“And sleep,” agreed Zackowski, “is known to be restorative.”

SOURCE: Anna Karin Hedström, MD, PhD, senior research specialist, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Torbjörn Åkerstedt, PhD, Professor, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden, and former President, European Sleep Research Society; Kathy Zackowski, PhD, OTR, associate vice president, research, National MS Society, New York City; Journal of Neurology Neurosurgery & Psychiatry, January 23, 2023

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Can poor sleep in teens increase MS risk?

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