Symptom Awareness: Tips for a Better Night’s Sleep
Many individuals with MS experience trouble sleeping, which often leads to fatigue, a common and disabling symptom of MS. MS patients are not alone in having trouble sleeping. A 2005 survey of the general population found that 75 percent of adults had at least one sleep problem during the preceding year. With busy lifestyles and access to media 24-hours a day, Americans average less than seven hours of sleep per night – and some people get by with six or less hours a night. Research shows that at least seven-and-a-half or eight hours are needed each night for proper repair and restoration of the body and mind.
The benefits of a good night’s sleep include increased alertness, a quicker reaction time, and better performance with tasks at work and at home. One’s memory, concentration, and creativity are also improved. When well-rested, people are more motivated to get things done and they are more efficient at what they do. In general, a good night’s sleep helps someone to feel good throughout the day, and ultimately, sleep may improve one’s overall health.
Insomnia can occur for a number of reasons, including “over-activation,” where someone has too much on his or her mind to drift off to sleep. Specific or general worries, or an upsetting event, can often keep someone awake, and the worry of not falling asleep only worsens the problem. In addition to anxiety, depression can impact one’s ability to sleep as well. Naps can be helpful to re-energize people during the day, but too much napping will also contribute to nighttime insomnia.
Another issue is when a person’s biological clock and “circadian rhythm,” which normally promote sleepiness during the dark of evening and wakefulness during the light of day, are not working properly. These can get off balance by not staying on a schedule, or from late-night activities, including shift work. Sensory disruptions of noise or light during the night can interrupt one’s sleep schedule as well, and taking steps to minimize these disturbances during times of sleep can be of help. Examples of such steps include closing windows, installing shades or curtains that block outside light, turning down the phone, and dimming or blocking inside light. Some people sleep better with the constant sounds of “white noise,” from a room fan or a CD designed for that purpose.
Restless legs syndrome is a sleep disorder experienced by some individuals with MS. When relaxed in a chair or bed during the evening, people with this disorder will feel uncomfortable and have the constant urge to move their legs. For restless legs syndrome, experts advise staying away from alcohol, caffeine, and nicotine. Certain medications can also cause restless legs syndrome as a side effect, and individuals should check with their physician about the medicines they are taking. Other conditions, including anemia, diabetes, nutritional deficiencies, kidney disease, thyroid disease, and varicose veins could be involved, so individuals should be screened for these conditions.
Other helpful strategies for restless legs syndrome include stretching, taking warm or cool baths, whirlpool baths, applying hot or cold packs to the affected area, limb massage, or vibratory or electrical stimulation of the feet and toes before bedtime. (Individuals who are heat sensitive should not take a warm bath.) Exercise and relaxation techniques may be helpful, and drug therapies may also be prescribed.
Sleep apnea is a serious disorder which occurs when a person’s throat muscles relax too much and the airway is temporarily blocked. Overweight individuals are more prone to this disorder, and snoring can sometimes be a sign of the condition. While people with sleep apnea usually do not have trouble falling asleep, their breathing is affected once asleep, and the sudden inability to take a breath wakes them repeatedly throughout the night, sometimes as often as every 30 seconds.
Sleep apnea can be particularly dangerous since it affects breathing. For a proper diagnosis of a sleep condition, a sleep study at a sleep center is often prescribed. Some overweight individuals even lose weight once they are able to get adequate sleep. This is due to a decrease in the production of a hormone that promotes appetite.
Other sleep problems can include sleepwalking, sleep terrors and nightmares, acting out physically while dreaming, waking up confused, and even overeating while asleep. Medical conditions, including frequent nighttime trips to the bathroom (common with bladder problems in MS), also interfere with one’s quality of sleep and should be addressed. Grinding of teeth and/or snoring can have health implications and are disruptive to a partner’s sleep. Any underlying medical conditions which may affect sleep need to be investigated, diagnosed, and treated.
Some individuals need medication to help them get the sleep they need. Many sleep aids are available, but these have side effects, and most require a prescription. Individuals should always consult their physician about what medication might be the most appropriate for them.
To encourage a good sleep regimen, experts recommend practicing a healthy lifestyle, which includes daily exercise, a healthy diet, limiting one’s alcohol and caffeine intake, and not smoking. Staying on a good sleep and waking schedule is important, as is preparing for sleep. For the latter, time should be allowed to finish household chores or take care of any loose ends before going to bed. Writing down any concerns is a good way to put them aside until the next morning. And taking time to unwind and relax – by drinking herbal tea, taking a warm bath (if not heat sensitive), or reading a book, can assist with falling asleep more naturally. Some individuals may find relaxation techniques, such as guided imagery, meditation, or biofeedback, to be of great help.
Resources
WebMD at www.webmd.com and The Harvard Medical School Guide to: A Good Night’s Sleep, written by Lawrence J. Epstein, MD, (McGraw Hill, 2007). This book may be borrowed at no charge from MSAA’s Lending Library. Other books dealing with sleep disorders are also available from the Lending Library.
Please note: MSAA does not endorse or recommend any specific drug or treatment. Readers are strongly urged to consult a medical professional before making any changes to their medications, diet, or activities.