The relationship between melatonin level, oxidative stress, fatigue and sleep disorders in multiple sclerosis patients

Abstract

Aims: Our study aimed to investigate the relationship between oxidative stress and melatonin levels, sleep disturbances and fatigue in persons with MS (pwMS). Methods: The study included 50 pwMS and 30 healthy controls. Levels of serum melatonin, glutathione peroxidase (GPx), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured in both groups. Persons with MS (pwMS) were evaluated using the extended disability status scale (EDDS) while Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale, insomnia severity index, fatigue severity scale and Beck depression scale were used for both groups. Results: Persons with MS (pwMS) exhibited significantly higher sleep disturbances (p<0,001), PSQI score (p<0,001), sleep latency (p=0,014), insomnia severity (p=0,001), fatigue (0,001) and fatigue severity (p<0,001), and Beck depression scale scores (p<0,001) and SOD levels (p<0,001) compared to the control group, while exhibiting significantly lower levels of melatonin(p=0,004). In pwMS, patients who experienced difficulty sleeping had significantly lower melatonin levels compared to those who did not (p=0,049). In pwMS, the melatonin level showed a negative correlation with age (r=-0,341; p=0,015) and EDSS (r=-0,386; p=0,006). Persons with MS (pwMS) with fatigue had significantly higher EDSS (p=0,003), PUQI (p=0,001), Epworth sleepiness score (p=0,028) and insomnia scores (p=0,002), compared to those who didn’t. Conclusion: Our results showed that the melatonin levels were lower, presence of fatigue, and fatigue severity were higher in pwMS with sleep disorders than in those without sleep disorders. The frequent occurrence of fatigue(indirectly) and sleep disturbances in pwMS can be attributed to low melatonin levels.

Keywords

• Multiple sclerosis
• melatonin
• sleep disturbances
• oxidative stress
• fatigue

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