Fatigue is one of the most common symptoms of multiple sclerosis, leading many to require more time to rest and sleep than the general population. But when sleep is accompanied by other MS symptoms, sleeping will not provide the needed relief from fatigue.
Bladder dysfunction affects at least 80% of the MS population. There are different types of problems associated with the bladder, including incontinence (inability to hold urine) and inability to empty the bladder completely. The frequent need to urinate at night is called nocturia, which disrupts sleep when the person needs to get out of bed to urinate several times a night. When nocturia is accompanied by incontinence, it can cause a bedwetting incident, presenting a different problem completely. Avoiding drinking liquids close to bedtime, urinating to empty the bladder before going to bed, and/or using incontinence products (such as pads), are some ways to address this problem.
Nocturnal leg spasms are sudden tightness and/or pain in the calf, thigh, or foot. Similar to spasticity, these spasms occur when the person is lying down to fall asleep or about to wake up, making sleep uncomfortable. I find that straightening my leg, then bending my ankle to move my foot up and down, is helpful. Preventative measures include drinking plenty of fluids during the day, or taking a warm shower or bath before bed to relax the muscles.
Restless legs syndrome (RLS), as the name suggests, is also a problem affecting the legs at night. Symptoms are uncomfortable sensations that vary from itchiness to feeling like ants are crawling on the skin, causing the person to move their legs for relief. Depending on the severity of the symptoms, there are different ways to address them. Preventative measures include leg massages and warm showers or baths, and there are also prescription medications that can treat them, including pain relievers and anticonvulsants. Taking a quick shower at the onset of symptoms has been helpful for me.
Insomnia deprives a person of sleep, with symptoms including difficulty falling and/or staying asleep, and waking up during the night then having difficulty falling back asleep. The tiredness resulting from insomnia aggravates the fatigue already common with MS. A good sleep schedule is recommended as a preventative measure, and over-the-counter sleeping pills may also help.
There may also be underlying medical conditions, aside from MS, causing any of the above problems. It is important to inform your primary care doctor, in addition to your neurologist, so that other problems can be diagnosed and addressed, or ruled out.
Do you have any of these problems? Have you discovered any tips to help you sleep better?
Shortly after earning her MSW degree from Columbia University and starting a career in psychiatric social work, KM was diagnosed with multiple sclerosis. She stopped working in 2013 and became active in the MS community. She joined team Park Pedalers for Bike MS: Coast the Coast in 2014 and she will be riding with them again this year. She lives in New Jersey with her husband, two children, and her nursemaids—cat, Mali, and dog, Moby.