Tracking daily fatigue fluctuations in multiple sclerosis: ecological momentary assessment provides unique insights

Daniel J. H. Powell (Corresponding Author), Christina Liossi, Wolff Schlotz, Rona Moss-Morris

Research output: Contribution to journalArticle

21 Citations (Scopus)
9 Downloads (Pure)

Abstract

Studies investigating the prevalence, cause, and consequence of multiple sclerosis (MS) fatigue typically use single measures that implicitly assume symptom-stability over time, neglecting information about if, when, and why severity fluctuates. We aimed to examine the extent of moment-to-moment and day-to-day variability in fatigue in relapsing-remitting MS and healthy individuals, and identify daily life determinants of fluctuations. Over 4 weekdays, 76 participants (38 relapsing-remitting MS; 38 controls) recruited from multiple sites provided real-time self-reports six times daily (n = 1661 observations analyzed) measuring fatigue severity, stressors, mood, and physical exertion, and daily self-reports of sleep quality. Fatigue fluctuations were evident in both groups. Fatigue was highest in relapsing-remitting MS, typically peaking in late-afternoon. In controls, fatigue started lower and increased steadily until bedtime. Real-time stressors and negative mood were associated with increased fatigue, and positive mood with decreased fatigue in both groups. Increased fatigue was related to physical exertion in relapsing-remitting MS, and poorer sleep quality in controls. In relapsing-remitting MS, fatigue fluctuates substantially over time. Many daily life determinants of fluctuations are similar in relapsing-remitting MS and healthy individuals (stressors, mood) but physical exertion seems more relevant in relapsing-remitting MS and sleep quality most relevant in healthy individuals.
Original languageEnglish
Pages (from-to)772-783
Number of pages12
JournalJournal of Behavioral Medicine
Volume40
Issue number5
Early online date9 Mar 2017
DOIs
Publication statusPublished - Oct 2017

Keywords

  • multiple sclerosis
  • fatigue
  • ecological momentary assessment
  • ambulatory assessment
  • psychological stress
  • affect

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