b'Medicine & Researchcycles from 65 individuals for analysis. Treat- apnea, sleepiness, and insomnia in 2013 were ments included controlled ovarian stimula- higher for nurses with MS. Nurses with MS tion followed by fresh embryo transfer, COSwere more likely to report cognitive difficulties alone, embryo transfer alone, and oral ovu- in 2017. Insomnia was reported to make lationinduction. Themeanage was36.3.following instructions, conversations, plots, Most patients were White, 13 percent wereand memory impairment difficult for 5-15 Black, 7 percent were Asian, and 2 percentpercent of nurses with MS, while sleepiness wereHispanic.Allpatientshadrelapsingplayed a part in 8-12 percent of these outcomes. onsetMSorclinicallyisolatedsyndrome.OSA signicantly accounted for 34 percent of Across 80 cycles with COS, only ve relapsesthe total effect between MS and following occurred among four patients within threeinstructions. The study was published in the months of treatment. No cycles with thera- journal Multiple Sclerosis. peutic disease-modifying therapies duringThrower -Fatigue and cognitive dysfunction COS had three months relapse. Relapse ratesareamongthemostcommonsymptoms did not vary by COS protocol. The ndingsseen with MS. They are the leading causes of werepublishedinthejournalNeurologyvocational disability in the MS community. I Neuroimmunology and Neuroinammation.frequentlyusetheanalogyofastoolwith Thrower -Many of the women living with MSthree legs when discussing fatigue. The three are of child-bearing age. Issues surroundinglegs are fatigue, cognitive dysfunction, and pregnancy, fertility, breastfeeding, and the safetymood disorders. When one of these symptoms of various medications during pregnancy arechanges, theres a good chance of the other two of great interest. This study examined thechanging as well, for better or worse. Perhaps potential effects of fertility treatments on MS.we need to add a fourth leg to that stoolIts important to note that MS does not reducesleep disorders. We know that sleep can be fertility in either women or men living withdisrupted in many ways in MS. Spasms and MS. The good news is that fertility drugs didurinaryfrequencycanpotentiallydisrupt not increase the risk of an MS relapse.sleep. The incidence of sleep disorders such Researchers nd link between MS,as obstructive sleep apnea are more common cognition, and sleep disordersintheMScommunity.Regardlessofthe cause, poor sleep will result in more daytime This study was conducted by the Universityfatigue and it will make cognitive symptoms of Michigans Division of MS and Clinicalmore obvious. Neuroimmunology in conjunction with theThis correlation between disrupted sleep Division of Sleep Medicine based on a surveyand cognitive dysfunction was illustrated in completed in 2013 and 2017 of female registeredthis study of North American nurses. Female nurses. Researchers sought to determine directnurses with MS were found to have memory and indirect links between sleep disorders andimpairments, difficulty following conversations, perceived cognitive dysfunction in women withand difficulty following instructions that MS. The diagnosis of MS was self-reported bycorrelatedwithinsomniaandobstructive 524 of the 63,866 respondents. Prevalencesleep apnea. If your sleep is inadequate, be of diagnosed and suspected obstructive sleepsure to discuss it with your healthcare team. msfocusmagazine.org 48'