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Emerging research has broadened our understanding about the relationship between comorbidities, general medical health maintenance, multiple sclerosis (MS) disease progression, and MS treatment modalities. The vaccinations beneficial for MS patients are vaccination during relapse, live-attenuated vaccines that include varicella, and inactivated vaccines that include hepatitis B, influenza and tetanus. MS occurs in greatest numbers among woman of child-bearing age. Patients with MS have an increased likelihood to have corticosteroid exposure, impaired vision, cognitive impairment, poor health, falls, and low physical activity, all of which are independent risk factors for bone loss and fracture. Patients with MS have the same prevalence of vascular comorbidities as the general population. Hypothyroidism accounts for the majority of thyroid disease in the MS population. The sleep disorders in MS patients are: insomnia, narcolepsy, sleep disordered breathing, rapid eye movement (REM) sleep behavior disorder, and restless legs syndrome.
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