Study shows social support is key to quality sleep for people with multiple sclerosis

Tangible, emotional support most effective in predicting good sleep during a pandemic; can help holistic approach to health, researchers say

Is there a certain sleep cycle we should all adhere to?

The COVID-19 pandemic caused many people to lose sleep, not to mention the loss of in-person activities and social interactions. A new study from the University of Kansas shows that for people with multiple sclerosis, who often deal with sleep difficulty, having social support was key to predicting sleep quality, which in turn is vital to health and quality of life.

Researchers at KU and the KU Medical Center’s Multiple Sclerosis Clinic regularly work with people with MS. They’ve long seen how the neurological condition can result in poor sleep. They also work with individuals to better understand the full scope of their health and how factors like social support and sleep influence their overall well-being. The research team surveyed 163 adults with multiple sclerosis from February to May 2021 about their sleep quality and social supports during the pandemic.

“We noticed a good portion of participants were not the best sleepers. We were really interested in looking at socially, how things changed for them during the pandemic,” said Taylor Harris, doctoral student in counseling psychology and the study’s lead author. “People with MS have additional needs, and the pandemic affected social life for all of us. We were curious to assess if their social interactions had an impact on their sleep.”

Results showed that individuals who reported having social support routinely reported higher sleep quality. When adjusting for types of support, results showed that emotional/informational support, tangible support such as help with daily tasks, and positive social interaction support significantly predicted sleep quality. When controlling for age, education and disability status, sleep quality was predicted by tangible support and positive social interaction support, but not by affectionate or emotional/informational support only.

The study was published in the journal Multiple Sclerosis and Related Disorders, and written with co-authors Lauren Zaeske of the School of Education & Human Sciences at KU; Rebecca Ludwig, Sara Baker, Sharon Lynch, Amanda Thuringer and Catherine Siengsukon of KU Medical Center; and Jared Bruce of the University of Missouri-Kansas City.

The findings show the importance of social support and maintenance of social connections for people with MS, especially during a global pandemic. Poor sleep has long been linked to worse cognitive functioning and physical health. The results also examined anxiety and depression and found they were not predictors of sleep quality in context of social support and its role in sleep.

“That shows social support can really serve as that protective factor and the importance of what types of support we can form socially,” Harris said. “The pandemic has changed, and we don’t know what will happen in the future, but we can say, ‘Whatever happens, the impact of social support to our sleep is important. Everyone sleeps.”

From a medical and academic standpoint, the study also lends support to the importance of psychosocial constructs, such as everyday social interactions, and how they should be considered as part of holistic treatment for everyone. Taylor, who has conducted sleep quality research in other settings, including with nurses and parents, said she hopes to assess social supports and sleep quality in people with other chronic illnesses in the future as part of a larger body of research in the connections among psychosocial factors, sleep and health.

“I think this study shows that we really need to make more time and space for social interactions, because they have such an impact on our sleep quality,” Harris said. “This is especially true for people with MS who may face additional hurdles for social interactions amid a global pandemic. It can be as simple as scheduling more time with friends. In a world where social settings have to be limited, how can we address that and make sure people have the supports they need, beyond just appointments and treatments?”

Virtual reality technology could strengthen the effects of traditional rehabilitation for multiple sclerosis

Exercise training with virtual reality


Dr. Carly Wender supervises a research participant in a VR exercise training study at Kessler Foundation. CREDIT Kessler Foundation/Jody Banks

In a recent article, Kessler Foundation scientists advocated for the incorporation of virtual reality (VR) technology in cognitive rehabilitation research in multiple sclerosis (MS). They presented a conceptual framework supporting VR as an adjuvant to traditional cognitive rehabilitation and exercise training for MS, theorizing that VR could strengthen the effects of traditional rehabilitative therapies by increasing sensory input and promoting multisensory integration and processing.

MS and exercise researchers Carly L.A. Wender, PhD, John DeLuca, PhD, and Brian M. Sandroff, PhD, authored the review, “Developing the rationale for including virtual reality in cognitive rehabilitation and exercise training approaches for managing cognitive dysfunction in MS,” which was published open access on April 3, 2022 by NeuroSci as part of the Special Issue Cognitive Impairment and Neuropsychiatric Dysfunctions in Multiple Sclerosis

Article link:  https://doi.org/10.3390/neurosci3020015

Current pharmacological therapies for MS are not effective for cognitive dysfunction, a common consequence of MS that affects the daily lives of many individuals. This lack of efficacy underscores the need to consider other approaches to managing these disabling cognitive deficits.

The inclusion of VR technology in rehabilitation research and care for MS has the potential not only to improve cognition but to facilitate the transfer of those cognitive gains to improvements in everyday function, according to Brian Sandroff, PhD, senior research scientist in the Center for Neuropsychology and Neuroscience Research at Kessler Foundation. “With VR, we can substantially increase engagement and the volume of sensory input,” he foresees. “And by promoting multisensory integration and processing, VR can augment the effects of the two most promising nonpharmacological treatments – cognitive rehabilitation and exercise.”

Virtual environments are flexible and varied, enabling investigators to control the range and progression of cognitive challenges, with the potential for greater adaptations and stronger intervention effects. VR also allows for the incorporation of cognitive rehabilitation strategies into exercise training sessions, which may support a more direct approach to improving specific cognitive domains through exercise prescriptions.  The application of VR to stroke research has shown more improvement in motor outcomes compared with traditional therapy, as well as greater neural activation in the affected area of the brain, suggesting that greater gains may persist over time.

Dr. Sandroff emphasized the largely conceptual advantages for the use of VR to treat cognitive dysfunction in individuals with MS. “More clinical research is needed to explore the efficacy of combining VR with cognitive rehabilitation and/or exercise training, and the impact on everyday functioning on individual with MS,” Dr. Sandroff concluded. “The conceptual framework we outline includes examples of ways immersive and interactive VR can be incorporated into MS clinical trials that will form the basis for larger randomized clinical trials.”  

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