Perceived Stress, Sleep Quality Can Mediate Depression in MS Patients


Treating patients’ stress and poor sleep may help reduce the risk of depression in multiple sclerosis.

Patients’ perceptions of stress and sleep quality are tied to perceived cognitive impairments and depression in multiple sclerosis (MS), according to a new study. The study, published in Multiple Sclerosis and Related Disorders, highlights stress and sleep quality as underlying factors that contribute to higher levels of depressive symptoms in patients, which may serve as potential targets for treatment.

Focusing on patients’ perceptions can help providers identify and treat depressive symptoms, according to the study authors. The researchers explored the association of perceived stress and sleep quality with patients’ conceptions of their cognitive health and depressive symptoms.

The researchers recruited a sample of 77 patients with MS from an outpatient, university-based MS clinic in the United States. Study participants ranged in age between 30 and 75 years old. The participants completed questionnaires and rated their perceived sleep quality, cognitive difficulties, stress, and depression.

The researchers found that higher levels of perceived cognitive deficits were associated with poorer sleep quality and greater perceived stress, both of which relate to higher levels of depressive symptoms. Additionally, both perceived stress and sleep quality served as a significant mediator in the perceived linkage between cognitive impairments and depressive symptoms, the researchers noted.

Patients with MS beginning to experience cognitive difficulties are more likely to have an increased perception of stress and poorer sleep quality, which in turn can affect the development of depressive symptoms, the researchers noted.

“Perceived stress and sleep quality are potentially modifiable factors, perhaps serving as a target for future treatment, to buffer risk of MS patients developing depression,” the authors concluded.


Lamis DA, Hirsch JK, Pugh KC, et al. Perceived cognitive deficits and depressive symptoms in patients with multiple sclerosis: Perceived stress and sleep quality as mediators. Multiple Sclerosis and Related Disorders. 2018.

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