Sleep and MS
Lots of people with MS have sleep problems at some time, and the effects of MS can disturb sleep or make any difficulties worse. But there are ways to get a better night’s rest - from treating MS symptoms and other conditions, to making lifestyle changes that improve our ‘sleep hygiene’.
Does MS cause sleep problems?
MS can cause sleep problems because of MS symptoms, and from the effects of living with MS. But sleep can also be disturbed by other conditions and our day to day lifestyle.
MS symptoms
MS symptoms that can disrupt sleep include:
- muscle spasms
- pain or unusual sensations
- bladder problems (needing to pee at night a lot is called ‘nocturia’)
Living with MS
Some of the impact of living with MS can also affect sleep, like:
- stress and anxiety
- depression
- being less active
- dealing with lots of fatigue during the day
- side effects from some MS disease modifying therapies
Other conditions
MS might not be the only reason sleep is disturbed. People with MS can have problems sleeping well because of other conditions, including:
- restless legs syndrome
- sleep apnoea, which affects people’s breathing while they sleep
- rapid eye movement (REM) sleep behaviour disorder, when you make movements and sounds to act out your dreams
Lifestyle
Anyone’s sleep can be upset by certain lifestyle things, like:
- noise
- not finding the time to sleep
- shift patterns
- too much caffeine
Restless legs syndrome (RLS)
Restless legs syndrome (RLS) is quite a common reason for people with MS to have disrupted sleep. It’s called restless legs because it causes unpleasant or uncomfortable feelings in your legs, and a constant urge to move them. It’s most noticeable when you’re sitting or lying down, especially at night.
RLS isn’t a symptom directly caused by MS, but it might be more common for people with MS. Some of the symptoms of restless legs can be similar to MS muscle spasms or ‘spasticity’. So your MS team or GP will need to consider both to help you find the best treatments.
Does poor sleep make MS worse?
Poor sleep might make some of your MS symptoms feel worse, including fatigue, pain and memory and thinking. Finding ways to sleep better could help you manage these symptoms.
In the long term, if we don’t get enough sleep it can make us more likely to have problems later in life with ‘cognitive decline’ - memory and thinking issues. That’s true for people with or without MS.
Why does sleep matter?
Sleep is part of staying as healthy as possible. Lots of things go on in our body while we sleep to keep things working well when we’re awake. That includes helping our mood and our memory.
Some of us need more sleep than others. To be at our best, most adults need between seven and nine hours a night. But some people are fine on less. We have to listen to our bodies to gauge if we’re getting enough sleep. And health care professionals can help us look for signs we might not be.
Am I getting a good night’s sleep?
You might know your sleep is disturbed because it’s shorter than you’d like. Or if you wake up during the night. But sometimes sleep problems aren’t so obvious.
For example, the breathing changes caused by sleep apnoea might disturb your sleep cycle or briefly wake you many times – but you might not be aware of waking up. If you share a bed, the other person might notice sounds or movements that show your sleep is disturbed. Or the signs might be there during the day, like:
- always feeling tired
- feeing irritable
- finding it hard to concentrate
Of course sometimes it can be hard to tell if these are the effects of bad sleep. Fatigue, for example, is a very common MS symptom. That’s why it’s really important to manage things ‘holistically’ – getting care support as a whole person, not just seeing one symptom separated out.
Tips for better sleep if you’ve got MS
Lifestyle changes – ‘sleep hygiene’
We can get better quality sleep by having regular sleep habits. This is sometimes called ‘sleep hygiene’ - it’s like we’re keeping our sleeping time clean and tidy.
In the late afternoon and evening
- avoid stress where you can
- don’t have stimulants like caffeine, chocolate or alcohol
- try to find time to wind down and relax
- don’t exercise too close to bedtime
- avoid big heavy meals
Physical activity
- through the day, try to be physically active if you can (but not so much close to bedtime)
- avoid getting overtired with too much activity
Natural sunlight
- aim to see some natural sunlight every day, whether indoors or outside (even on a cloudy day)
- it might also help to avoid bright lights in the evening
Establish a routine
- keep the same habits every night before bed
- the routine could be, for example, relaxing, having a drink of warm milk, having a bath
- aim to get up the same time every day
Instead of lying awake
- if you can, get up and do something calming or even boring
- if getting up isn’t possible, relaxation techniques could help
As comfortable as possible
- think about what’s a good temperature for you – too hot or too cold can make a difference to how well you sleep
- does your bed support your body as comfortably as possible?
- if noise is an issue, can you change or manage that, even if only with earplugs?
- if it’s hard to turn and stay comfortable in bed, a physiotherapist or occupational therapist might suggest things to help – for instance, handles on the side of the bed
Managing MS symptoms
There are treatments for lots of the MS symptoms that can cause sleep problems, including muscle spasms and stiffness, pain and bladder problems. So speak to your MS team about any symptoms you have so they can help find ways to manage them.
Dealing with treatment side effects
Some treatments for MS can cause side effects that affect sleep. To help with this, your MS team or GP might be able to offer alternative treatments. Or they could suggest changing the time you take the treatment.
Sometimes you might need to balance different side effects to find what’s best for you. For example, lots of people take beta interferons in the evening so they sleep through side effects. But if you find you’re not sleeping well you might prefer to take them in the morning.
Speak to your MS team or GP before you make changes to how you take a drug treatment.
Treating other conditions
If other conditions affect your sleep, it’s important they’re treated alongside your MS. It could help you manage your MS symptoms as well as the general benefits of good sleep.
Health care professionals can diagnose conditions like restless legs syndrome and sleep apnoea. And then work with you to find ways to manage them. The NHS as more information about these and other causes of sleep problems.
Read about common causes of sleep problems on the NHS website
Read about treating restless legs syndrome on the NHS website
Managing any anxiety or worries
Stress, anxiety and depression can all affect how well we sleep. Health care professionals can help you with your mental health, so raise any concerns with your MS team or GP. But there’s a lot you might do yourself as well to help manage your mental health. One of the benefits could be better, more effective sleep.
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