Poor sleep is common in people with Multiple Sclerosis (MS), with about 50% of people with MS reported to experience some form of sleep disturbance.1 However, sleep disorders are still under-diagnosed in people with MS. Poor sleep quality affects everyone’s health, but getting a good sleep is much more important for those with MS as a bad sleep could make MS symptoms worse.

What Is Multiple Sclerosis?

Multiple Sclerosis (MS) is a disorder in which the body’s immune system attacks and destroys myelin, a membrane that covers axons in the brain and spinal cord. Myelin protects axons and speeds up the conduction of electrical impulses along nerve fibres. The destruction of myelin results in the scarring and loss of nerve cells.2 This can lead to many symptoms of MS, including:

  • Fatigue
  • Difficulty walking
  • Vision problems, such as blurred vision
  • Problems controlling the bladder
  • Numbness or tingling in different parts of the body
  • Muscle stiffness and spasms
  • Problems with balance and co-ordination
  • Difficulty thinking, learning, and planning
  • Paralysis
  • Depression
  • Loss of memory
  • Poor bowel control

However, MS is a disease that progresses slowly. It can be mild for some patients or can sometimes cause serious disability.3

MS is most commonly diagnosed in people in their twenties and thirties, but it can develop at any age. It’s also about 2 – 3 times more common in women than in men. The cause of MS is still not clear, but environmental and genetic causes may play a role.4

Why Does Multiple Sclerosis Affect Your Sleep?

There can be many reasons why getting a good sleep is difficult for people with MS. Some of the symptoms of MS can make sleeping difficult, such as depression or muscle spasms. Depression can make it hard to fall asleep at night, as it can be difficult to quiet any troubling thoughts. Depression is also linked to anxiety and stress, which can trigger insomnia. Insomnia is a sleeping disorder that makes it hard to fall asleep, stay asleep, or even to get up in the morning. You can read more about depression in our article, ‘Sleeping with Depression’, or find out more about insomnia here.

Daytime Fatigue

High levels of daytime fatigue could also make it harder to fall asleep as night, as you lack the stimulation during the day to make you tired when the sun goes down. Plus, being less active during the day can harm your sleep pattern, or circadian rhythm. The circadian rhythm is your inner body clock that decides when it’s time for you to be awake or asleep. It’s also influenced by daylight, which is why you’re up when the sun is up. Being less active during the day could mean that you’re not being exposed to enough light, disrupting the circadian rhythm. If this clock is disrupted, your sleeping pattern is a bit skew-whiff. If this happens, your body and brain don’t know when to settle for sleep, making it hard to get to sleep at night-time. Read more about circadian rhythm here.

Restless Leg Syndrome & Sleep Apnoea

People with Multiple Sclerosis may also have Restless Leg Syndrome (RLS), a neurological disorder characterised by the irresistible urge to move or stop uncomfortable and odd sensations. This disorder can keep you from getting a restful sleep, and you can read more about it here.

Sleep Apnoea could be another reason as to why people with MS have trouble getting a good sleep. Sleep Apnoea is when someone’s breathing pauses for a brief moment, waking the sleeper up. Their breathing returns to normal and the sleeper goes back to sleep. Although they won’t remember this moment of waking up, someone’s breathing could be interrupted many times throughout the night. This constant disturbance to your sleep results in a poor sleep quality, which can make the symptoms of MS harder to cope with. Find out more about Sleep Apnoea here.

There could also be side effects of certain medications that could be keeping you awake at night or disturbing your sleep. Talk to your doctor about any medication that they’ve prescribed and try alternatives if you think this is keeping you from getting a good sleep.

How Can You Get A Good Night’s Sleep?

Have a regular sleep schedule

Go to bed and get up at the same time every day, including weekends. This regularity will help your circadian rhythm get back on track. Exposing yourself to sunlight during the day will also help your circadian rhythm, and you’ll start to feel tired enough to sleep when you go to bed.

Clear your mind before going to sleep

If you replay the day’s problems in your head, or worry about what tomorrow brings, when you’re in bed, sleeping will not be easy. Quieting your thoughts can seem impossible, but there are ways to do it. You could write a to-do list for the next day, which will help you get a better idea of what you need to do. These lists can also help you see that you don’t have as much to do as you thought. Consider writing a diary, too, as writing thoughts and worries down can help relieve the burden of them. The action of writing itself can be calming, too. You could also try meditating, which involves breathing exercises that relax your mind – read more about meditation here. Mindfulness is another great way to calm your thoughts, as it forces you to focus on the moment. Find out more about mindfulness and its benefits here.

Exercise

If you can, try exercising during the day – ideally in the morning. It doesn’t have to a vigorous exercise – a gentle walk can be enough to stimulate you for the day. However, make sure you don’t exercise within four – six hours of your bedtime, as this could actually keep you more alert. You can read more about how exercise helps improve your sleep in our article, ‘Five Ways Exercise Helps You Sleep’.

Limit your caffeine

While the first cup of coffee can help you feel more alert in the morning, drinking caffeine during the day will keep you alert when you want to feel sleepy in the evenings.

Limit alcohol intake

Alcohol can disrupt your sleep patterns, and it’ll prevent you from drifting off into a deep, restful sleep. You can read more about the affects of alcohol on sleep here.

Have a relaxing bedtime routine

If you have a routine each night, you’ll send signals to your brain and body to settle and get ready to sleep. Have a relaxing bath, put your pyjamas on, listen to soothing music or read a book for about an hour before going to sleep. It’s important that you’re consistent with this, as your mind and body need to learn the routine to recognise its meaning.

Have a healthy sleeping environment

Make sure your bedroom is cool, quiet, and dark. You should also make sure that you don’t do any hobbies or work in bed, as your brain needs to associate your bed with sleep. Don’t watch TV, use your phone, tablet, or laptop in bed. If you are still awake after twenty minutes of going to bed, get up. Go into another room and do something relaxing, like reading. If you stay in bed, your brain will associate your bed with restlessness, making it even harder to fall asleep. Only go back to bed when you feel sleepy.

While these are ideas for how you can help improve the quality of your sleep, the best way to help yourself is to see a doctor. Your doctor will be able to link any symptoms of Multiple Sclerosis with sleeping problems or can determine if there’s an underlying cause. They’ll also be able to prescribe medication, but remember to check side effects if you’re still struggling with sleep.

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Footnotes

  1. https://www.mstrust.org.uk/life-ms/wellbeing/sleep
  2. https://www.sleepfoundation.org/articles/multiple-sclerosis-and-sleep
  3. https://www.nhs.uk/conditions/multiple-sclerosis/
  4. https://www.nhs.uk/conditions/multiple-sclerosis/
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