Is your MS fatigue caused or made worse by a sleeping disorder?
There are about 80 different types of sleep disorders, and about 25% of people (that’s 70 million Americans) suffer from them. The inability to fall asleep or to stay asleep, called insomnia, is the most common. Multiple Sclerosis (MS) is well represented in the Sleep Disorders department. ” On her “good” nights, she awoke as frequently as every hour; on the worst ones she lay awake until breakfast.”
Sleep problems are common in MS, but are somewhat under recognised. In a study from the UK, as many as half of the patients with MS (of varying severity) studied had some sleep-related problem. The commonest was insomnia, usually related to spasm, pain, immobility, bladder problems, or medication. It has also been felt that periodic leg movements may be more common in MS. Besides these relatively common problems, there are more than a few case reports of some unusual or rare sleep disorders in MS.
MS patients have pain, depression and anxiety all of which can cause insomnia However, most Insomnia is Psychophysiological- that is related to a pattern of sleep difficulties that is not specifically due to a physical trigger or a recurrent identifiable cause. This is true in MS too.
Sleep disorders are twice as prevalent among MSers than non-MSers. These disorders can be sleep-related movement disorder, nocturia (frequent visits to the bathroom), tinnitus (ringing in the ears), obstructive sleep apnea or OSA (tissues of the throat interfere with breathing), central sleep apnea or CSA (brain slows down regulation of breathing), REM sleep behavioural disorder (person acts out dreams during sleep), and narcolepsy (falling asleep unexpectedly and at inappropriate time). Throw in the usual MS symptoms, such as numbness, tingling, spasms, pain, and it’s no wonder that sleep becomes an issue for many of us.
Sometimes, unco-ordination in breathing, which is more common in MS than in those without it, can worsen the upper airway obstruction which is the major cause of OSA. In MS, the central control of breathing can be impaired due to plaques in the brain stem. This can cause Central Sleep Apnea. MS patients, like many others can have combinations of OSA and CSA when tested in an overnight Polysomnogram (PSG).
All of these can be operative in Multiple Sclerosis, the most common being OSA which is the leading cause of Excessive Daytime Sleepiness in the vast majority of people with or without a concurrent disease.
Improving your sleep
Is there anything we can do to make these sleep problems better? Try some of the following tips.
- Do not nap during the day.
- Do not consume caffeine within 4-6 hours of bedtime
- Do not smoke or use nicotine products close to bedtime or during the night.
- Do not drink alcoholic beverages within 4-6 hours of bedtime.
- If the need to use the bathroom is keeping you up at night, reduce fluid intake in the evening. It is still important to drink the recommended amount of fluids during the day. Also go to the bathroom immediately before you go to bed.
- Do not go to bed hungry or soon after a heavy meal. If you are hungry, eat a light snack or drink a glass of warm milk.
- Exercise regularly, preferably during the day. Avoid vigorous exercise 3 hours before bedtime.
- Set your alarm to wake up at the same time every day, even on days when you’re off work and on the weekends.
- If you have sleepless nights and lie in bed until it seems like the sun is coming up get back up if you have not fallen asleep after 10 to 15 minutes. Find something to do that is relaxing to you, such as putting together a puzzle, reading, or writing a letter to a friend.
- Rather than watching TV, which is a passive activity, do something active so that natural tiredness can build up–although you should avoid physical activity when trying to become sleepy.
- I’ve been told “Remember that your bed is only for sleeping. Any of the above activities should be done in another room, not your bedroom. Return to the bedroom only when you feel tired.” But personally I much prefer to stay warm in bed as I try things to tire me out.
Finally these relaxation techniques can help you fall asleep or improve your sleeping patterns:
- Repetitive mental exercises. Close your eyes, and silently repeat a word or short phrase. Let your breathing become slow and steady. Repeat the phrase for 10 minutes until you feel more relaxed.
- Visualization. Imagine that you are in a peaceful environment, such as lying on a beautiful beach, relaxing and taking in the rays.
- Progressive muscle relaxation. You can mentally put each part of your body to sleep by tensing and relaxing your muscles. People with spasticity should be careful because this exercise could trigger muscle spasms.
Tags:ms symptoms,periodic leg movements,sleep apnea,sleep difficulties,sleep problems,types of sleep disorders,upper airway obstruction
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This can be such an issue – especially with the changing seasons. Thank you for the valuable information.
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It was very helpfull thank you so much for communion. I will share it with my friends. Thanks….
Helpful pointers right here, I included your website with the best, hence stop by once again.
Kath I have been reading several of your articles and it seems you have written very few of these articles yourself and yet you take credit for them all. At the very least you have skimmed from others,in some cases you have been blatant and in others you have made a few subtle changes but in all reality you are a rampant plagiarist! I will be enjoying passing onto the the authors whose articles you have skimmed and seeing how they react to the questionable use of their articles!!
http://www.fortnet.org/NCMSN/0305.html
http://www.msnz.org.nz/Page.aspx?pid=266
http://www.msif.org/en/about_m.....index.html
http://www.auctiondaum.com/aus.....de=1256774
http://www.msnz.org.nz/Page.aspx?pid=272
Sorry you don’t give your real name so I cannot use it. ( I’m sure you’re not called Grovy)
Yes you are right about some of my sources but some of these I have never seen so somebody else is sharing information.
I never make any claim that my publications are “ORIGINAL RESEARCH” How could I, I am not working in clinical research. They are a collection of other publications which I stick together and often phrase in different ways.
Often I state the sources eg
This article has been largely Adapted from Intimacy and Sexuality, issue six of the MSIF’s ‘MS in focus’ The content has been split over 3 articles.
when I do not it is more because a small article would be swamped by reams of acknowledgements.
Most information around is not new but that doesn’t mean that everyone has assimilated it.
My role is to disseminate information not originate it. The originators will be pleased that more people hear their message. I am not making money out of doing this and do it only as a service to other people with MS. This is a devastating disease and the more we know and understand about it the better.
I posted a question on my fan page as to whether this accusation of plagiarism was appropriate. In return I got numerous responses asking me to continue passing the information to them.
Thank you for pointing this out as I’d hate people to think I was the font of all knowledge about MS.
Kath sorry it has taken me so long to get back to your post I received no notification of your reply.I know that people have spoken to you in the past about this subject and I will be honest on the day I posted I was angry and frustrated because there are so many people that seem to think it is okay to take articles from the internet without crediting the Authors or website it has been taken from.There are publishing and copy right issues that are there to protect Authors and this seems to be blatantly ignored.
It might well be that you don’t earn any money from any of this and it might be that you do this with good heart and honest intentions.But it is important and is a known copyright issue that you DO name the the Authors and credit those people who’s words and thoughts you are using and to make sure that you have permission in some cases to use the articles at all,not all writers or websites are happy with the copy and pasting of their articles and especially not without acknowledgement.
As an MS patient you are very knowledgeable and have personal experience which is valuable to the community and getting information to the MS community is an honourable thing to do,but it does have to be done within the copyrighting laws.I respect your efforts to want to help people.
I think a disclaimer and a list of sources is the least that should be made.
I was angry when I wrote because I know this has been bought up in the past and still no effort has been made to name sources.If for no other reason than to protect yourself from legal battles,it really is advisable to do.
I apologize for my tone,it was not called for, however I feel very strongly about copyright issues and feel we all have a duty to respect them,especially on internet,so that we can all be given credit for our thoughts and words.
I wish you the best.
OK, I note your concern. I have changed the front page of my blog to say that I am often not the originator and I have suggested that people ask for sources if I have not mentioned them.
I am also now being very careful to mention all sources in every article. Sadly this often make the article cumbersome with more accreditations than content.
It will take me a while to go back and update the earlier articles. and I may even chose to delete them rather than spend the time. After being hacked my whole set of articles were lost and many have to be rebuilt anyway so will deal with them as I come to them.