Impact of pharmacological and non-pharmacological approaches on the sleep quality of MS patients: A systematic review

Q2 Nursing

International Journal of Africa Nursing Sciences Pub Date : 2025-01-01 DOI:10.1016/j.ijans.2025.100882

Soheila Shamsikhani , Mohammad Reza Shamshiri , Mohammadsadegh Kamran , Mahsa Hosseini

{"title":"Impact of pharmacological and non-pharmacological approaches on the sleep quality of MS patients: A systematic review","authors":"Soheila Shamsikhani , Mohammad Reza Shamshiri , Mohammadsadegh Kamran , Mahsa Hosseini","doi":"10.1016/j.ijans.2025.100882","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, recognized by various symptoms, like fatigue, pain, cognitive impairment, and mood disorders, which can impact sleep and cause sleep disorders.</div></div><div><h3>Objective</h3><div>Due to the scattered nature of existing evidence and the significant clinical impact of sleep disturbances among patients with MS, this systematic review seeks to comprehensively integrate current pharmacological and non-pharmacological treatment approaches while identifying prevailing knowledge gaps and outlining directions for future investigations.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, and Scopus databases up to September 2024, following PRISMA guidelines. The research was guided by the question: “What therapeutic approaches are effective in improving sleep quality in MS patients?” The PICOS framework defined the inclusion criteria (P = MS patients, I = Any intervention, C = Compared to other interventions, O = Sleep quality, S = Randomized controlled trials). After removing duplicates, the remaining articles were screened based on predefined inclusion/exclusion criteria. A total of 24 full-text articles were evaluated, and 16 studies met the final inclusion criteria. Data were extracted on study characteristics, intervention details, and outcomes. The quality of included studies was assessed using the NIH quality assessment tool for controlled intervention studies.</div></div><div><h3>Results</h3><div>Sixteen randomized controlled trials (RCTs) were included. This study confirms the efficacy of melatonin and CBT-I as primary interventions while highlighting the potential of relaxation and mindfulness-based approaches. All studies referenced in this article were of acceptable quality, demonstrating either good or fair quality standards.</div></div><div><h3>Conclusion</h3><div>This review provides valuable insights into the management of sleep disturbances in individuals with MS. It confirms the efficacy of melatonin and CBT-I as primary interventions while highlighting the potential of relaxation and mindfulness-based approaches.While melatonin showed some benefits, other medications had limited or mixed effects. These findings underscore the need for methodological improvements and more targeted research. Addressing these gaps will help refine clinical practices, ensuring better sleep quality and overall well-being for individuals with MS.</div></div>","PeriodicalId":38091,"journal":{"name":"International Journal of Africa Nursing Sciences","volume":"23 ","pages":"Article 100882"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Africa Nursing Sciences","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214139125000691","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system, recognized by various symptoms, like fatigue, pain, cognitive impairment, and mood disorders, which can impact sleep and cause sleep disorders.

Objective

Due to the scattered nature of existing evidence and the significant clinical impact of sleep disturbances among patients with MS, this systematic review seeks to comprehensively integrate current pharmacological and non-pharmacological treatment approaches while identifying prevailing knowledge gaps and outlining directions for future investigations.

Methods

A systematic search was conducted in PubMed, Web of Science, and Scopus databases up to September 2024, following PRISMA guidelines. The research was guided by the question: “What therapeutic approaches are effective in improving sleep quality in MS patients?” The PICOS framework defined the inclusion criteria (P = MS patients, I = Any intervention, C = Compared to other interventions, O = Sleep quality, S = Randomized controlled trials). After removing duplicates, the remaining articles were screened based on predefined inclusion/exclusion criteria. A total of 24 full-text articles were evaluated, and 16 studies met the final inclusion criteria. Data were extracted on study characteristics, intervention details, and outcomes. The quality of included studies was assessed using the NIH quality assessment tool for controlled intervention studies.

Results

Sixteen randomized controlled trials (RCTs) were included. This study confirms the efficacy of melatonin and CBT-I as primary interventions while highlighting the potential of relaxation and mindfulness-based approaches. All studies referenced in this article were of acceptable quality, demonstrating either good or fair quality standards.

Conclusion

This review provides valuable insights into the management of sleep disturbances in individuals with MS. It confirms the efficacy of melatonin and CBT-I as primary interventions while highlighting the potential of relaxation and mindfulness-based approaches.While melatonin showed some benefits, other medications had limited or mixed effects. These findings underscore the need for methodological improvements and more targeted research. Addressing these gaps will help refine clinical practices, ensuring better sleep quality and overall well-being for individuals with MS.

查看原文本刊更多论文

药物和非药物方法对MS患者睡眠质量的影响：一项系统综述

多发性硬化症（MS）是一种中枢神经系统的自身免疫性疾病，有多种症状，如疲劳、疼痛、认知障碍和情绪障碍，这些症状会影响睡眠并导致睡眠障碍。由于现有证据的分散性和睡眠障碍对MS患者的重大临床影响，本系统综述旨在全面整合当前的药物和非药物治疗方法，同时确定普遍的知识差距并概述未来研究的方向。方法系统检索截至2024年9月的PubMed、Web of Science和Scopus数据库，按照PRISMA指南进行检索。这项研究的指导问题是：“什么样的治疗方法能有效改善多发性硬化症患者的睡眠质量？”PICOS框架定义了纳入标准（P = MS患者，I =任何干预措施，C =与其他干预措施相比，O =睡眠质量，S =随机对照试验）。删除重复条目后，根据预定义的纳入/排除标准筛选剩余条目。共评估了24篇全文文章，其中16篇研究符合最终纳入标准。提取有关研究特征、干预细节和结果的数据。采用NIH对照干预研究质量评估工具对纳入研究的质量进行评估。结果共纳入16项随机对照试验（RCTs）。这项研究证实了褪黑激素和CBT-I作为主要干预措施的有效性，同时强调了放松和正念方法的潜力。本文中引用的所有研究都具有可接受的质量，证明了良好或公平的质量标准。这篇综述为ms患者睡眠障碍的管理提供了有价值的见解。它证实了褪黑激素和CBT-I作为主要干预措施的有效性，同时强调了放松和正念为基础的方法的潜力。虽然褪黑素显示出一些益处，但其他药物的效果有限或好坏参半。这些发现强调需要改进方法和更有针对性的研究。解决这些差距将有助于完善临床实践，确保更好的睡眠质量和MS患者的整体健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Africa Nursing Sciences Nursing-Nursing (all)

CiteScore

2.40

自引率

0.00%

发文量

114

审稿时长

21 weeks

期刊介绍： International Journal of Africa Nursing Sciences (IJANS) is an international scientific journal published by Elsevier. The broad-based journal was founded on two key tenets, i.e. to publish the most exciting research with respect to the subjects of Nursing and Midwifery in Africa, and secondly, to advance the international understanding and development of nursing and midwifery in Africa, both as a profession and as an academic discipline. The fully refereed journal provides a forum for all aspects of nursing and midwifery sciences, especially new trends and advances. The journal call for original research papers, systematic and scholarly review articles, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing as related to nursing and midwifery in Africa, technical reports, and short communications, and which will meet the journal''s high academic and ethical standards. Manuscripts of nursing practice, education, management, and research are encouraged. The journal values critical scholarly debate on issues that have strategic significance for educators, practitioners, leaders and policy-makers of nursing and midwifery in Africa. The journal publishes the highest quality scholarly contributions reflecting the diversity of nursing, and is also inviting international scholars who are engaged with nursing and midwifery in Africa to contribute to the journal. We will only publish work that demonstrates the use of rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of nursing and midwifery as it relates to the Africa context.