Sleep & MS – 2/18

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Quality sleep is important to maintaining good health, but getting good sleep can be complicated. Issues ranging from insomnia to sleep apnea and from restless legs syndrome to narcolepsy can affect your ability to get adequate, quality sleep.

Lack of restful sleep can cause daytime sleepiness and — in MS — have serious consequences for cognition, fatigue, mood swings, and physical symptoms such as balance, spasticity and pain. Studies suggest that people with MS may be up to 3 times more likely to experience sleep disturbances than the general population, and about 2 times as likely to experience a reduced quality of sleep.

Sleep disturbance is a general term for a wide range of sleep-related symptoms and disorders, and can include:

– Difficulty with initiating or maintaining sleep, also known as insomnia
– Difficulty with too much sleep, also known as hypersomnia or hypersomnolence
– Uncontrollable lapses into sleep, also known as narcolepsy
– Sleep related breathing difficulty, including sleep apnea
– Abnormal movements during sleep, including restless legs/body syndrome
– Abnormal behaviors during sleep including acting out dreams
– Daytime dysfunction, including excessive daytime sleepiness
– Are you sleep-deprived?

If you answer yes to any of the following questions, you may not be getting enough good quality sleep.

– Do you feel sleepy, grumpy or “down” during much of the day?
– Do you fall asleep as soon as your head hits the pillow?
– Do you sleep fewer than 7 hours most nights?
– Do you still feel tired even after having 8 hours of sleep or more?
– Causes of sleep disturbances in MS

Research over the past decade has aimed to better understand the causes of sleep disturbance in MS. MS can impact sleep in a number of ways including:

-Interruption of the body’s essential hormones and physiological processes (e.g., hunger/thirst, temperature regulation, stress response) can cause hypersomnia and narcolepsy, and make it difficult to maintain a consistent sleep-wake cycle. This can disrupt breathing — resulting in sleep apnea and sleep behavior disorders.

– Disruption of key neurotransmitters involved in sleep like hypocretin, dopamine, norepinephrine and melatonin can result in narcolepsy, fatigue and poor sleep efficiency.

– Deficiencies in Vitamin D and other nutrients that may help regulate sleep
Side effects of MS medications including the disease-modifying therapies, corticosteroids and stimulant medications for fatigue

– Increased napping during the day due to fatigue
– Reduced physical activity due to fatigue and MS-related disability
– Emotional changes including stress, anxiety or depression.
– Other MS symptoms including restless legs, pain, urinary or bowel symptoms, and temperature dysregulation

I have to admit that fatigue is one of my most debilitating MS symptoms on a daily basis. I don’t sleep well at night anymore. I lay in bed at night thinking about nothing or watching T.V.

After a night of laying in bed I wake up in the mornings still tired and sleepy. I’m retired so it doesn’t affect a job performance however my daily activities can also just exhaust me.

My daily activities are normal things like showering, a light work out, eating, writing my blog and typing on my computer. Not too strenuous, is it? Usually, by 3pm I’m tired enough to lay down and sleep for 30-60 minutes.

When I get up after my afternoon nap I seem to be recharged for more inactivity! lol Nowadays, I’m on my couch by 6pm eating supper, watching TV and dozing on and off. I do that until I finally lay down in bed at 11pm.

Information above from the National Multiple Sclerosis Society



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