MS symptoms, such as fatigue and muscle stiffness, can fluctuate throughout the day. They can also fluctuate for days or weeks in a relapse. But how the symptoms change can vary greatly among individuals.

MS is a progressive, immune-mediated disease. It can damage or attack several areas of the brain and spinal cord, leading to unpredictable and varied symptoms.

Some MS symptoms can vary in severity throughout the day. Keep in mind that what you experience may differ from what others experience.

If you feel like your MS symptoms get better or worse throughout the day, you’re not alone. MS symptoms can change in severity throughout the day.

Often, experts and researchers focus on large trends of symptoms over the course of months or years. However, some studies have focused on some symptoms throughout the day or shorter periods of time.

In a 2017 study, researchers found evidence supporting the idea that MS fatigue can fluctuate in people living with relapsing-remitting MS for the same reasons that fatigue fluctuates in people who don’t have MS.

Reasons for fluctuations can include stress, mood, lack of sleep, temperature, and other causes.

Physical activity has different effects on MS fatigue. Sometimes physical activity can trigger or cause fatigue, but regular moderate exercise can help improve endurance, strength, and energy.

An estimated 80% of people living with MS will experience spasticity. Spasticity is characterized by muscle stiffness that can lead to spasms, pain, and reduced mobility. Spasticity is generally worse or more noticeable with movement.

It may also trigger or worsen the severity of other symptoms, such as fatigue, sleep disorders, and bladder dysfunction. You may find that some of your MS symptoms tend to worsen in the evening or overnight when you lay down to go to sleep.

Keep in mind that MS is a highly diverse condition that causes different symptoms and severities in everyone. You may find that your symptoms worsen in the morning or midafternoon and improve at night.

Fatigue affects between 65–80% of people living with MS. Fatigue associated with MS tends to worsen following activity and physical exercise. This means it often occurs during the daytime for people living with MS.

It may also increase due to normal, day-to-day fluctuations in stress and mood levels. Taking steps to help reduce stress at work, school, or home may help keep fatigue to a minimum during daytime hours.

Other symptoms may also worsen during the day. Common MS symptoms that you may find get worse or more noticeable during the day can include:

  • bladder and bowel problems
  • numbness and tingling
  • trouble with memory and thinking
  • muscle tightness, stiffness, spasticity, or spasms
  • loss of balance and dizziness
  • tremor
  • pain
  • vision issues

The severity of the symptoms will vary greatly among people, so you may or may not notice any of these symptoms during the day.

MS is associated either with slow progression of symptom development and severity or periods of disease activity (relapse) followed by periods of symptoms going away or mostly going away.

If you’re living with relapsing-remitting MS, you may notice that during a relapse, your symptoms may:

  • start abruptly within a few hours or days
  • reach a peak within a few days
  • slowly resolve over the course of days or weeks if the relapse is treated

Sometimes, symptoms might linger for 8 weeks or longer, even with treatment.

Several factors may trigger MS symptoms to occur. Influences on symptoms include:

  • age
  • gender
  • serum levels of Vitamin D (amount in the blood)
  • temperature — heat is known to worsen MS symptoms
  • infections
  • pregnancy

Stress, certain medications, smoking, and exposure to heat or cold may also trigger symptoms to occur. Once you remove the trigger, the symptoms may reduce.

MS symptoms can change in severity throughout the day. You may notice some come more often at night while others are more common during the day.

MS is a tricky condition to generalize. While many experience fatigue during the day and muscle spasticity at night, this may not occur for everyone. You may experience no changes in the severity of symptoms or notice changes occurring frequently throughout the day.