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This study aimed to evaluate subjective and objective sleep parameters in de novo relapsing\u2013remitting multiple sclerosis patients compared to healthy controls and to explore correlations with cerebrospinal fluid cytokines. Twenty\u2010one patients underwent CSF cytokine analysis, overnight polysomnography and sleep quality assessments; 21 HCs also participated in sleep evaluations. We analysed sleep macrostructure and the cyclic alternating pattern. Compared to controls, patients exhibited increased sleep period time, time in bed, REM sleep latency, N3 sleep percentage and wakefulness after sleep onset, along with reduced sleep efficiency and REM sleep percentage. These alterations were more pronounced in patients who also had obstructive sleep apnoea. Cyclic alternating pattern analysis revealed increased CAP time and rate\u2014particularly higher A3 indices and duration of A phases\u2014suggesting enhanced sleep fragmentation. A significant association was found between IL\u20101\u03b2 and longer Phase B duration, and IL\u201015 showed a positive correlation with A3 mean duration in the cyclic alternating pattern, indicating inflammatory modulation of sleep architecture. Fatigue was negatively correlated with A1 mean duration and cycle mean duration. These findings demonstrate that de novo relapsing\u2013remitting multiple sclerosis is associated with significant sleep fragmentation, particularly in patients with obstructive sleep apnoea and suggest that pro\u2010inflammatory cytokines might influence sleep homeostasis through adaptive mechanisms. This underscores the importance of addressing sleep quality in multiple sclerosis management.<\/jats:p>","DOI":"10.1111\/jsr.70248","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T11:09:13Z","timestamp":1764846553000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sleep Macrostructure, Cyclic Alternating Pattern and\n                    <scp>CSF<\/scp>\n                    Cytokines in De Novo Relapsing\u2013Remitting Multiple Sclerosis: A Controlled Polysomnographic Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4505-2600","authenticated-orcid":false,"given":"A.","family":"Romigi","sequence":"first","affiliation":[{"name":"IRCCS Neuromed Istituto Neurologico Mediterraneo  Pozzilli Italy"},{"name":"Unicamillus\u2010Saint Camillus International University of Health Sciences  Rome 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