If you have multiple sclerosis and you're having trouble sleeping, you're not alone. More than 50% of people with MS report problems getting needed rest. MS symptoms like pain and muscle spasms are some obvious challenges to shut-eye. But MS has also been linked to several types of sleep disorders, so there may be something about MS itself that changes the way your brain regulates your sleep-wake cycle.
How MS Affects Sleep
In addition to pain and spasticity, the possible MS symptoms of depression and anxiety and the frequent need to go to the bathroom can interfere with your sleep. Exercise promotes good sleep, so if you aren't getting enough exercise because of MS fatigue or poor coordination, that could be another factor. Your MS medications might be interfering with sleep, too.
Specific sleep disorders linked to MS include:
Insomnia, which is trouble falling or staying asleep
Sleep apnea, which is sleep that's repeatedly interrupted by brief periods of not breathing
Narcolepsy, which is falling asleep during the day
Restless legs syndrome, which is the need to move your legs, especially at night
Periodic limb movement disorder, which is involuntary arm and leg movement during sleep
How Poor Sleep Affects MS
According to a study in The Journal of Neuroscience, brain cells responsible for maintaining the protective covering of nerve fibers do most of their work during periods of deep sleep. This covering, called myelin, is one of the primary areas of the central nervous system affected by MS. Loss of myelin is one of the main causes of MS symptoms.
MS symptoms that can be made worse by poor sleep include:
Tips for Better Sleep With MS
Start by working with your MS treatment team to get your MS symptoms under control. Talk with your doctor about any medications that might be interfering with your sleep.
It's also important to develop good sleep habits – and to stick to them. For example:
Go to bed and get up at the same time, even on weekends. Having regular hours of sleep helps you keep your sleep-wake cycle regular.
Get fresh air and sunshine every day to set your biological clock.
Exercise every day, but avoid heavy exercise for several hours before bed.
Avoid long naps and long periods of inactivity during the day.
Avoid stimulants like sugar, caffeine, and nicotine, especially later in the day.
Don't eat heavy meals in the hours before bedtime.
Use the hour before bed to clear your mind and start your bedtime routine. Don’t use a computer or watch TV for at least an hour before you want to sleep.
Don’t drink alcohol to fall asleep. If you do, you'll be likely to wake up after a few hours.
Use your bedroom for sex and sleep only.
Avoid drinking lots of fluids before bed, and go to the bathroom just before going to sleep.
Keep your bedroom quiet, dark, and comfortable.
Don’t lie awake at night. If you can't fall asleep, get up and do something relaxing for a while, and then return to bed.
If you've talked with your MS treatment team about medications and MS symptoms control and have been following good sleep habits but you still aren't sleeping well, you might ask to see a sleep specialist. Poor sleep not only makes MS worse but also increases your risk for diabetes, obesity, and heart disease. So take steps to get the rest your body needs.
It's common to have trouble sleeping when you have MS.
Both MS symptoms and MS medications may contribute to poor sleep, and poor sleep can make your MS symptoms worse.
MS may increase your risk for several sleep disorders, including sleep apnea and restless legs syndrome.
Develop good sleep habits to overcome your sleep problems.
Consider changes in medication or a referral to a sleep specialist if other steps don't help.