The Nature, Severity, and Treatment of Insomnia Disorder in Relapsing-Remitting Multiple Sclerosis

Objective. Examination and treatment of insomnia in those with multiple sclerosis (MS) is crucial, as insomnia may contribute to decreased quality of life and disease progression through increased inflammatory responses; however, few studies have adequately assessed for insomnia among individuals with MS. Similarly, few studies have examined the correlates of insomnia or implemented behavioral treatments for insomnia. This study aimed to characterize the nature of insomnia, to explore the symptom profiles of those with insomnia, and to conduct a pilot trial of Brief Behavioral Treatment for Insomnia (BBTI) among those with insomnia disorder and relapsing-remitting multiple sclerosis. Procedures. 31 participants attended an initial in-person session where they completed the Duke Structured Interview for Sleep Disorders and several self-report measures to characterize sleep, health, and mood. Subsequently, participants completed two weeks of sleep diaries. Four participants diagnosed with insomnia disorder during the initial session completed a trial of BBTI. Results. Findings indicated that 54.8% of the study sample met criteria for insomnia disorder. Insomnia severity was related to pain and physical health-related quality of life. Insomnia severity was also related to fatigue; however, when sleep aid use was controlled for, the association between insomnia and fatigue was no longer significant. Lastly, three individuals had clinically significant improvements in insomnia and decreased fatigue after BBTI. Discussion: Insomnia is prevalent among those with RRMS and is related to factors of MS that are known to be debilitating. BBTI may serve as an effective treatment to improve both insomnia and fatigue; however, larger studies to demonstrate efficacy are necessary.Ph.D., Psychology -- Drexel University, 201