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Apnea and Other Sleep Problems Associated with Multiple Sclerosis

What keeps you from sleeping?

Key points

  1. Fatigue affects 75 to 95 percent of people with MS.
  2. There isn’t an across-the-board cause for sleep problems in people with MS.
  3. Potential MS-related sleep problems include sleep apnea, nocturia, and narcolepsy.

Multiple sclerosis (MS) causes many symptoms that can disrupt your quality of life. MS is known in part for the physical fatigue it causes. But the sleep problems associated with MS aren’t as widely known.

This neuroinflammatory disease can prevent you from getting a good night’s rest. The causes of MS-related sleep problems are more than just physical discomfort for many patients. Talk to your doctor about one or more of the following possible causes if you have MS and have trouble sleeping.

Sleep apnea

Sleep apnea is a serious medical condition. It’s characterized by frequent pauses in breathing while you sleep. Your lungs catch up after these breathing pauses by taking deep gasps of air. This condition may cause you to snore violently. You can even choke from oxygen deprivation. It can also cause you to feel excessively tired during the day.

Nerve spasms associated with MS can cause related sleep apnea. Apnea should be addressed by a sleep specialist immediately to prevent long-term damage to the body.

Nocturia

Nocturia is a sleep problem experienced by many patients with MS. Having nocturia means you wake up frequently in the middle of the night with strong urges to urinate. You may not release very much urine most of the time but find yourself waking up anyway.

Overactive bladder medications can help treat nocturia. These medications can calm down the bladder muscles and decrease your urinary frequency caused by bladder spasms.

Periodic limb movements in sleep

Periodic limb movements in sleep (PLMS) is characterized by involuntary movements during periods of rest. These can be as small as toe movements, or as significant as leg bends at the knee. Large PLMS movements are likely to wake you up in the middle of the night.

MS medications unfortunately can’t relieve PLMS. A sleep specialist, however, might be able to help treat PLMS.

Hypersomnia

Hypersomnia causes you to feel excessively tired during the day. What sets hypersomnia apart is that the tiredness isn’t related to interrupted sleep at night. MS patients who have hypersomnia may take frequent naps during the day, no matter how much shut-eye they get at night. These naps can come at inappropriate times, such as during work, and can lure you into deep sleeping spells. Hypersomnia can also cause irritability and anxiety.

Narcolepsy

Narcolepsy is a disorder that disturbs sleep-wake cycles. A “sleep attack” causes uncontrollable drowsiness, and may come at any time. An autoimmune reaction within the brain may cause narcolepsy.

Most narcolepsy occurs due to low levels of a neurotransmitter called hypocretin, which is produced by the hypothalamus. A 2012 study stated that brainstem and hypothalamic lesions resulting from MS can bring about symptomatic narcolepsy.

Stress and depression

Stress and depression are other symptoms of MS that can also keep you up at night. Anxiety may be a precursor to stress, which can make it difficult to fall asleep.

Fatigue and depression often go hand-in-hand, so relaxation before bed is key. A relaxation routine can help you cope with stress and depression so you can sleep more soundly with few disruptions. Antidepressants can also help treat insomnia and fatigue related to MS.

Ruling out other causes

It’s important to have your sleep problems evaluated by a doctor. Sleep apnea, overactive bladder, and hypersomnia may be stand-alone conditions not necessarily caused by MS. Other possible causes include underactive thyroid (hypothyroidism), obesity, and bladder infections. Making this determination is important for finding the right treatments and medications.

Never self-medicate for any sleep problem. Doing so can interfere with your MS treatment plan and your overall health.

Achieving a good night’s sleep

Fatigue affects 75 to 95 percent of people with MS. But this common symptom doesn’t have the same across-the-board-causes for people with MS. Be sure to talk to your doctor about your symptoms, as well as medications that can help address the specific sleep problems you’re experiencing. A better night’s sleep can help you fight MS-related fatigue, as well as battle the physical toll the condition takes on your body.

Consistency is one of the best measures to take for addressing sleep problems. You should make an effort to go to bed at the same time every evening with no distractions. Reserve your bed for sleep alone. Reading, using your computer or phone, or watching TV in bed may make it more difficult for you to fall asleep. When you get in the bed, you should make sure your environment is quiet, dark, and relaxing. Also, try to wake up around the same time every morning.

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Multiple Sclerosis (MS) Complications
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