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Abstract Details

Can the Myasthenia Gravis Activities of Daily Life (MG-ADL) Score Predict Sleep Disturbance and Fatigue Among Patients with Myasthenia Gravis?
Neuromuscular and Clinical Neurophysiology (EMG)
P4 - Poster Session 4 (11:45 AM-12:45 PM)
Fatigue is associated with worse quality of life and greater disease severity in patients with MG. Patients with MG also have higher rates of disordered sleep than their non-MG counterparts, however the impact of sleep on fatigue and quality of life in MG is understudied. 
To examine the association between fatigue and sleep disturbances and MG-ADL among patients with generalized MG.
We examined cross-sectionally the relationship between MG symptoms as measured by the Myasthenia Gravis-Quality of Life 15 (MG-QOL 15) and sleep disturbance in a cohort of outpatients with ocular and generalized MG. All models were adjusted for age, sex, pre-existing obstructive sleep apnea (OSA), major depression, and use of corticosteroids.

70% of participants (7/10) enrolled were male with a mean age of  43.90 years (SD ± 15.98). 60% of participants (6/10) enrolled were currently using corticosteroids. Worse health-related quality life defined by MG-QoL 15 score was associated with worse sleep as measured by the Functional Outcomes of Sleep Questionnaire (FOSQ-10) (p=0.036) and Insomnia Severity Index (ISI) (p=0.005), but not the Neuro-QoL Sleep T-score, Epworth Sleepiness Scale (ESS), or Pittsburgh Sleep Quality Index (PSQI). Severity of disability defined by MG-ADL was associated with worse sleep as measured by the ESS (p=0.018), PQSI (p=0.017), and Neuro-QoL Sleep T-score (p=0.045), but not the ISI or FOSQ-10.

Higher MG-ADL scores predicted greater sleep disturbance and fatigue among individuals with generalized MG, even after adjusting for OSA. These findings emphasize the bidirectional relationship between quality of life and disordered sleep and fatigue in patients with MG, and the need for further research into the mechanisms driving this relationship.

No disclosure on file
Julia H. Greenberg, MD Dr. Greenberg has a non-compensated relationship as a Editorial Board Member with Neurology Resident and Fellow Section that is relevant to AAN interests or activities.
Sophia T. Tong Ms. Tong has nothing to disclose.
No disclosure on file
Kiril Kiprovski, MD (NYU-Langone Health) Dr. Kiprovski has nothing to disclose.
No disclosure on file
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine) An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia. Dr. Balcer has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for North American Neuro-Ophthalmology Society.
Sujata P. Thawani, MD (NYU Neurology Associates) Dr. Thawani has nothing to disclose.