Fatigue in multiple sclerosis is closely related to sleep disorders: a polysomnographic cross-sectional study.

BACKGROUND: Sleep disorders can cause tiredness. The relationship between sleep disorders and fatigue in patients with multiple sclerosis (MS) has not yet been investigated systematically. OBJECTIVE: To investigate the relationship between fatigue and sleep disorders in patients with MS. METHODS: Some 66 MS patients 20 to 66 years old were studied by overnight polysomnography. Using a cut-off point of 45 in the Modified Fatigue Impact Scale (MFIS), the entire cohort was stratified into a fatigued MS subgroup (n=26) and a non-fatigued MS subgroup (n=40). RESULTS: Of the fatigued MS patients, 96% (n=25) were suffering from a relevant sleep disorder, along with 60% of the non-fatigued MS patients (n=24) (p=0.001). Sleep-related breathing disorders were more frequent in the fatigued MS patients (27%) than in the non-fatigued MS patients (2.5%). Significantly higher MFIS values were detected in all (fatigued and non-fatigued) patients with relevant sleep disorders (mean MFIS 42.8; SD 18.3) than in patients without relevant sleep disorders (mean MFIS 20.5; SD 17.0) (p<0.001). Suffering from a sleep disorder was associated with an increased risk of fatigue in MS (odds ratio: 18.5; 95% CI 1.6-208; p=0.018). CONCLUSION: Our results demonstrate a clear and significant relationship between fatigue and sleep disorders.

Graduate follow-up in the US Air Force family practice residency programs.

Between June 30, 1973, and June 30, 1982, 216 family physicians completed residency training in family practice residencies sponsored by the US Air Force. The primary purpose of this study was to measure the adequacy of the graduates' residency training program. One hundred seventy-nine (83 percent) of the graduates responded to an extensive eight-page survey. The study assessed all Air Force program graduates as a whole as well as each program separately. Seventy-four percent of the respondents are still in the Air Force. All but one are board certified, and 19 have been recertified. Of the 179 respondents, 37.0 percent are involved in teaching medical students of family practice residents, only 5.0 percent are dissatisfied with their present hospital privileges, 43.5 percent felt that their residency training was superior to that provided by civilian family practice residency, 53.7 percent felt the training was equal, and 2.8 percent felt the training was inferior. Practice satisfaction and continuing medical education needs were also addressed in the study.