One of the lesser talked about symptoms of MS are the various sleep issues that can be present. Of course, we all know about the fatigue that may or may not be a result of said sleep issues. But the sleep issues that accompany the disease as well are lesser known.
Fatigue can be caused by the sleep issues that I’ll discuss below, or it can be its own issue altogether that is completely separate. I realized when researching for this article that sleep and fatigue need to be separate articles, since there is such a breadth of information on both topics.
There are several sleep issues that are common in the MS community that can keep us from getting the sleep and rest we need. Which can lead to even more fatigue than is already present.
Usually not thought of first when you think of sleep issues with MS, but nerve spasms can cause sleep apnea in individuals with MS. Sleep apnea is defined as a condition that creates frequent pauses in breathing during sleep. You eventually catch up after those pauses by taking large gasps of air. You also might snore very loudly and violently. You might also be very tired during the day and fall asleep often, like on the couch or during work. Most often, people with sleep apnea don’t realize they have the condition. They are only alerted when a spouse or partner tells them they snore or gasp for air while sleeping.
Insomnia is when an individual struggles with getting to sleep. Individuals with MS often struggle to get to sleep usually due to physical discomfort, pain, depression or anxiety. Or it could be caused by other factors all together. Sleep maintenance insomnia is fragmented sleep, that is caused by awakening for various reasons, muscle spasms, or pain for example.
As you may have guessed, hypersomnia is the exact opposite of insomnia, where an individual sleeps too much or for extended periods of time. It causes you to feel extremely tired during the day but isn’t related to quality of sleep at night. Frequent naps are associated with hypersomnia and can those naps can become quite deep sleep.
Periodic Limb Movements in Sleep (PLMS/PLMD)
Periodic limb movement disorder are repetitive limb movements while sleeping or at rest that can often cause sleep disruption. The movements often involve the lower extremities, most often the extension of the big toe and flexion of the ankle, knee and hip. The movements most often occur at night in non-REM, light sleep and are separated by regular intervals.
Restless Leg Syndrome
Similar to PLMS, but a bit different, is restless leg syndrome. The similarity is characterized by leg movements, but these movements are voluntary. More specifically, a strong urge is felt to move the lower limbs (as opposed to the movements being involuntary in PLMS). Discomfort, pain and a pins and needles sensation can also be present in restless leg as well. Symptoms worsen at night or at rest when lying down. Moving and stretching can be helpful.
This is a common sleep disturbance for MSers. Nocturia is waking up frequently in the middle of the night with the urge to urinate, regardless of whether or not you actually need to when you arrive at the bathroom. How annoying is that.
If you’re struggling with any of these sleep issues, getting to the root cause will be beneficial for resolving it. If you’re interested in hearing about how your gut can play a role in sleep, sign up for my Masterclass happening this Thursday, July 25th at 7pm. We’ll be discussing the gut’s role in sleep, as well as acid reflux and GERD. I hope to see you there!