Multiple Sclerosis is an autoimmune disease where there is the destruction of myelin in the nerve cells. It affects 2.3 million people across the globe. The patients’ experience a wide range of symptoms such as vision, pains and spasms, balance, dizziness, bladder, tingling and numbness, sexual dysfunction and cognitive impairment. Fatigue is the most common symptom of multiple sclerosis. There are many factors responsible for multiple sclerosis such as epidemiology, genetics, immunity and infectious agents. There are a number of trigger factors for multiple sclerosis such as stress, fatigue, infection, and heat.
Can Lack Of Sleep Cause Multiple Sclerosis?
Multiple sclerosis as such does not cause insomnia, but the MS-related symptoms make it difficult to fall asleep and maintain good sleep quality. Here we present the factors which makes it difficult to sleep. (1)
- Muscle spasms
- Neuropathic or musculoskeletal pain
- RLS (restless legs syndrome)
- Night urination
- Sleep apnea
- The side-effect of medicines, disease-modifying drugs and drugs for treating multiple sclerosis can alter sleep pattern
- Sedentary lifestyle
- Tension and worries
- Lack of exposure to daylight
- Lesions in the brain can affect sleep pattern
Lack of sleep can result in fatigue, depression and increases the intensity of pain, adding to the ongoing crisis of disability and decreasing quality of life. Insomnia associated with multiple sclerosis can be treated, or the medicines which are affecting sleep should be withdrawn. Change the treatment schedule and the tome on which medicines are taken.
Gabapentin is one such medicine which decreased pain and also promotes good night sleep.
Disease-modifying drugs such as Rebif, Avonex, Betaferon, and Extavia can affect sleep at the start of the treatment. So these medicines are advised to be taken in the evening so, the side-effects associated with these medications can be skipped in sleep. The time of medicine depends on the tolerance level of the side-effect, is the side effects can be well managed, then it is advised to take it in the evening.
Certain disease-modifying drugs such as natalizumab (Tysabri) and Cannabis and associated products have improved sleep pattern, reduced sleep disturbance and decreased fatigue. Cannabinoids reduce spasticity and pain.
Tips To Improve The Quality Of Sleep In People With Multiple Sclerosis
- Sleep quality can be improved by maintaining biological rhythm and good ‘sleep hygiene’
- Do physical activity throughout the day, but don’t get so tired that you retire before the set time
- Take some early morning sunlight for sufficient Vitamin D and avoid sunburn
- Avoid taking CNS stimulants such as caffeine and chocolate in the evening which can disturb sleep.
- Relax before going to bed with warm ‘milky’ drink
- Do not use the bedroom to watch TV, at night concentrate only to sleep.
Follow the same routine daily to develop the definite wake-sleep pattern.
People suffering from multiple sclerosis experience up to 3 times more sleep disturbances and decreased sleep quality. Some symptoms which indicate sleep deprivation include fewer than 7 hours of sleep, feeling tired even after 8 hours, sleepy or grumpy all day long, etc. There can be many reasons for sleep deprivation such as
Body’s physiological processes get affected which can result in hypersomnia and narcolepsy, the disturbance is the sleep-wake cycle. There can be difficulty in breathing which causes sleep apnea and sleeps behavior disorders. Hormones such as hypocretin, dopamine, noradrenaline, and melatonin are responsible for it.
- Nutrient deficiencies
- Side effects of certain medications (disease-modifying therapies, corticosteroids, and stimulant)
- Decreased physical activity due to disability
- Emotional changes including stress, anxiety or depression
Multiple sclerosis is an autoimmune disease; lack of sleep is not responsible for it. Multiple sclerosis itself can cause sleep deprivation, insomnia, and narcolepsy. Spasms, side effects from medications, stress and depression results in difficulty in sleeping. Improve your sleep quality and duration for up to 8 hours to prevent fatigue and daytime tiredness.
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