{
  "abstract": "Background Fatigue is a common symptom of multiple sclerosis (MS) and impacts quality of life, yet the role of chrononutrition and sleep in MS management remains underexplored. We aimed to investigate the cross-sectional associations of meal and sleep timing with fatigue in persons with MS (pwMS).Methods We implemented a chrononutrition questionnaire within the Swiss MS Registry to quantify the relationships between meal timing, sleep patterns and fatigue among pwMS.Results In unadjusted analyses of 958 participants (median age 49 years, 73% women), a longer interval between the first and last meals (eating window) was associated with less fatigue (OR per 1 SD change in predictor=0.84, 95% CI 0.75 to 0.94), while later wake-up (OR 1.26, 95% CI 1.12 to 1.43) and first meal (OR 1.28, 95% CI 1.14 to 1.44) were associated with more fatigue. Later weekend versus weekday patterns (‘social jetlag’) across meal and sleep timing were associated with less fatigue.Adjustment for lifestyle factors attenuated most of the relationships, with employment status being the most influential. After adjustment, a larger ‘social jetlag’ in first meal (OR 0.86, 95% CI 0.76 to 0.97) and going to bed later (OR 0.86, 95% CI 0.76 to 0.97) remained associated with less fatigue, while a longer time in bed (OR 1.28, 95% CI 1.12 to 1.46) remained associated with more fatigue.Conclusions Associations of meal and sleep timing with fatigue in pwMS were influenced by lifestyle factors, particularly employment status. After adjustment, eating the first meal later during weekends compared with weekdays, going to bed later and a shorter time in bed were associated with less reported fatigue. The apparent benefits of ‘social jetlag’ on first meal times require confirmation from prospective and interventional studies.",
  "authors": [
    {
      "affiliations": [
        "Service of Endocrinology, Diabetology and Metabolism, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland",
        "Laboratories of Neuroimmunology, Center for Research in Neuroscience and Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland",
        "The Thoracic and Endocrine Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland",
        "Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Nicholas E Phillips"
    },
    {
      "affiliations": [
        "Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Vladeta Ajdacic-Gross"
    },
    {
      "affiliations": [
        "Laboratories of Neuroimmunology, Center for Research in Neuroscience and Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"
      ],
      "name": "Jessica Rebeaud"
    },
    {
      "affiliations": [
        "Laboratories of Neuroimmunology, Center for Research in Neuroscience and Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"
      ],
      "name": "Guillaume Thévoz"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland"
      ],
      "name": "Stefania Iaquinto"
    },
    {
      "affiliations": [
        "Neurology, Rehabilitation Hospital Zihlschlacht, Zihlschlacht-Sitterdorf, Switzerland"
      ],
      "name": "Claudia Baum"
    },
    {
      "affiliations": [
        "Neurology and Neurorehabilitation Center, Lucerne Cantonal Hospital, Lucerne, Switzerland",
        "Department of Neurology, Bern University Hospital (Inselspital) and University of Bern, Bern, Switzerland"
      ],
      "name": "Christian P Kamm"
    },
    {
      "affiliations": [
        "Departments of Biomedicine and Clinical Research, Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland"
      ],
      "name": "Jens Kuhle"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland"
      ],
      "name": "Irene Rapold"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospital Zürich and University of Zürich, Zürich, Switzerland"
      ],
      "name": "Patrick Roth"
    },
    {
      "affiliations": [
        "Department of Neurology, Neurocenter of Southern Switzerland, Lugano Regional Hospital, Lugano, Switzerland",
        "Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland"
      ],
      "name": "Chiara Zecca"
    },
    {
      "affiliations": [
        "Department of Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland"
      ],
      "name": "Viktor von Wyl"
    },
    {
      "affiliations": [
        "Department of Epidemiology",
        "Cardiovascular Research Institute Maastricht (CARIM)",
        "and Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Netherlands"
      ],
      "name": "Simone JPM Eussen"
    },
    {
      "affiliations": [
        "Swiss MS Registry, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland"
      ],
      "name": "Nina Steinemann"
    },
    {
      "affiliations": [
        "Laboratories of Neuroimmunology, Center for Research in Neuroscience and Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland"
      ],
      "name": "Caroline Pot"
    },
    {
      "affiliations": [
        "Service of Endocrinology, Diabetology and Metabolism, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland",
        "Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Tinh-Hai Collet"
    }
  ],
  "title": "Associations of chrononutrition and sleep with fatigue in multiple sclerosis: an analysis of the Swiss Multiple Sclerosis Registry",
  "uid": "c6d6bf7c-96f9-5d30-b3b5-94a514325058"
}