{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:53:42Z","timestamp":1781502822316,"version":"3.54.1"},"reference-count":35,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009086","name":"European Union-NextGenerationEU","doi-asserted-by":"publisher","award":["BG-RRP-2.004-0004-C01"],"award-info":[{"award-number":["BG-RRP-2.004-0004-C01"]}],"id":[{"id":"10.13039\/100009086","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Sleep disturbances in the multiple sclerosis (MS) population are increasingly recognized, but the factors driving this association remain understudied. This study aimed to determine the prevalence and associations of poor sleep quality in the relapsing\u2013remitting MS (RRMS) population receiving disease-modifying therapy (DMT). Methods: We conducted a cross-sectional study that enrolled 399 individuals diagnosed with RRMS on DMT. Data on patient demographics, clinical presentation, and treatment were systematically evaluated. Sleep-related outcomes were assessed using validated questionnaires\u2014the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), STOP-Bang questionnaire, and Hamilton Anxiety Rating Scale (HAM-A). Independent associations of poor sleep were examined using log-binomial regression to estimate risk ratios (RR). Results: Poor sleep was reported in 42% of the participants in our cohort. In multivariable analysis, only insomnia severity (RR = 1.07; 95% CI 1.05\u20131.09, p &lt; 0.001) and anxiety (RR = 1.02; 95% CI 1.01\u20131.04, p = 0.001) remained independently associated with poor sleep. Conclusions: Sleep disturbances are common among patients with RRMS. Insomnia severity and anxiety, rather than demographic or disease-related characteristics, showed independent associations with impaired sleep. Routine screening and targeted interventions addressing insomnia and anxiety may improve sleep quality and, consequently, overall quality of life in this population.<\/jats:p>","DOI":"10.3390\/jcm14217837","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:06:06Z","timestamp":1762362366000},"page":"7837","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Associations of Poor Sleep in Patients with Relapsing-Remitting Multiple Sclerosis on Disease-Modifying Therapy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0939-5382","authenticated-orcid":false,"given":"Dimitar","family":"Taskov","sequence":"first","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Ivanova","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay","family":"Topalov","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4766-7931","authenticated-orcid":false,"given":"Alexandra","family":"Barkalova-Atanasova","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2416-7040","authenticated-orcid":false,"given":"Nikolay","family":"Yordanov","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitko","family":"Yurukov","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Atanasova-Ivanova","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Ilieva-Nedeva","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Nikolova","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-9759","authenticated-orcid":false,"given":"Sonia","family":"Chipeva","sequence":"additional","affiliation":[{"name":"Department of Statistics and Econometrics, University of National and World Economy, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4522-4070","authenticated-orcid":false,"given":"Ivan","family":"Milanov","sequence":"additional","affiliation":[{"name":"Multiprofile Hospital for Treatment in Neurology and Psychiatry, St. Naum, 1113 Sofia, Bulgaria"},{"name":"Department of Neurology, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nikolova, A., Milanov, I., and Kmetska, K. 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