If you're constantly having sleep problems, your Multiple Sclerosis (MS), could very well be causing them.
Many studies have shown that sleep disturbances, in folks with MS, are 3 times more common than in the general population. In fact, MSers are about two times more likely to have a reduced quality of sleep.
In order to understand the magnitude of the sleep problems that many of us (MSers) have to deal with, it would be helpful to quickly review a few things about the regular sleep cycle of any person.
Keep in mind that the complete sleep cycle takes an average of 90 (1 hour and a half) to 110 minutes (almost 2 hours).
Stage 1 is light sleep. Here you drift in and out of sleep and can be awakened easily. In this stage there is very slow movement in the eyes and muscle activity slows. This is the stage where you might have experience sudden muscle contractions preceded by a sensation of falling.
Stage 2 eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.
Stage 3 the brain produces exceptionally slow brain waves better known as delta waves. These are mix together with smaller and faster brain waves.
Stage 4 the brain start producing delta waves almost exclusively.
Here is an interesting piece of trivia: What we normally refer to as deep sleep takes place right at stages 3 and 4. This is when some children experience bedwetting, sleepwalking or have nightmares.
Stage 5REM or Rapid Eye Movement is where the brain waves increase to levels normally experienced when a person is completely awake.
At REM your breathing becomes more rapid, shallow and irregular. Your eyes jerk quickly – hence the REM initials – and muscles in the arms and/or legs become momentarily paralyzed.
Most people should experience between three and five periods of REM sleep every night.
I'm sure you have heard that a minimum of 8 hours of ZZZ's every night are recommended. OK true but when it comes to MSers, many sleep problems are not caused so much by the number of hours but, as Gail Hartley, an MS-certified nurse with Neurology Consultants explained, going through all 5 stages of the sleep cycle at least two or three times a night is the main thing.
Nurse Hartley said: "People with sleep disorders wake up feeling tired because they haven't gone through those sleep cycles; they've not gone through those restorative levels of sleep".
At least in my case, as I'm sure probably in many of you too, when I don't get enough sleep or have sleep problems the night before or even when I don't take my afternoon nap, my cognitive symptoms worsen: I find it hard to think and concentrate in whatever I'm doing.
The answer to this question is not as simple as we would like to think. Even if you, like I, have to fight MS fatigue every day, having sleep problems every night or experiencing tiredness all the time, should be looked at more closely with your doctor.
There are several conditions that MSers might experience which interfere with getting enough sleep:
Obstructive sleep apnea (OSA): is very common amongst MSers with sleep problems. Usually OSA is accompanied by heavy snoring and the resulting bad oxygenation and interrupted sleep may in turn make other health conditions harder to treat.
Bladder problems: also known as nocturia are part of the sleep problems caused by getting out of bed several times every evening. If you think about it, all that interrupted sleep adds up sooner or later resulting in the tiredness experienced by must MSers.
RESTLESS LEG SYNDROME: the spasms, cramping and pain associated with this sporadic limb movement can easily prevent you from getting any good sleep. They are often the cause for insomnia or non-refreshing sleep by partially arousing you.
DEPRESSION AND ANXIETY: is often the reason behind many sleep problems. Also many of the drugs currently used to treat ms depression, spasticity and ms fatigue can hamper with sleep. Something you can do when talking with you neurologist is regulate the dosage and the time during the day that the drug is taken.
As you can see, there are many obstacles to you getting a really good night of ZZZZ's. There are also quite a few changes you can implement to improve your sleep odds:
The following suggestion, which I really love to pass on to you, I got it from an article written by Chris Blosse and Angela Maas for the publication "Momentum". They suggest to:
Other suggestions, like keeping cell phones, PDA's, BlackBerries, IPhones, computers and TV's out of the bedroom are out there for folks to decide.
Personally, I find it extremely difficult (if not impossible) to follow this one. Shutting off any and all of these modern comforts at a fix time every evening is something I think is easier to agree too.
An excellent tip to reduce sleep problems is to create what I like to call a pre-sleeping routine. By this I mean having a set of steps that are performed each and every night before finally getting in bed to go to sleep.
The purpose is to start "educating" your body. By following a routine like putting your pajama, brushing your teeth, preparing what you're going to wear the next morning, read a book for 20 to 30 minutes and finally shutting off the night table's light every night, you're communicating to your brain and rest of your body that you're fixing to retire (go to sleep) for the day.
Another tip for you is to try to avoid eating a huge meal or having caffeine just before bed or very late in the day. You can also try one of the STRESS MANAGEMENT TECHNIQUES presented for you and explained in my website.
I can tell you that amongst all the tips and strategies for dealing with sleep problems that I have try, the most useful one has been to learn to tune in to my body and understand my daily rhythm.
By learning to do that you'll be able to program and choose your activities accordingly. I, for example, plan all my errands and meetings for the mornings and before lunch. Normally I would take a one hour nap after lunch and try not doing any strenuous activity the rest of the day.
You could try taking sleeping pills but most doctors and experts recommend them only as a last resource to deal with any sleep problems. You must remember that their use involve the risk of becoming dependant on them.
There are also various herbal supplements to help you sleep. The most important thing here that you should always remember is that they may interact with other medications or they may stimulate the immune system so the number one rule of always consulting your doctor before deciding applies here.
There are times when professional help is required. A visit to an urologist might be needed if constant waking during the night is provoking your being tired all the time.
It is a good idea that before you see your doctor you keep a sleep diary and track your habits. Here you simply keep track of things like:
Simple practices like this one will allow your doctor to get a clearer picture of your sleeping habits which in turn will help him/her decipher what's happening.
Many studies have shown that sleep disturbances, in folks with MS, are 3 times more common than in the general population. In fact, MSers are about two times more likely to have a reduced quality of sleep.
In order to understand the magnitude of the sleep problems that many of us (MSers) have to deal with, it would be helpful to quickly review a few things about the regular sleep cycle of any person.
Keep in mind that the complete sleep cycle takes an average of 90 (1 hour and a half) to 110 minutes (almost 2 hours).
THE REGULAR SLEEP CYCLE
Stage 1 is light sleep. Here you drift in and out of sleep and can be awakened easily. In this stage there is very slow movement in the eyes and muscle activity slows. This is the stage where you might have experience sudden muscle contractions preceded by a sensation of falling.
Stage 2 eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.
Stage 3 the brain produces exceptionally slow brain waves better known as delta waves. These are mix together with smaller and faster brain waves.
Stage 4 the brain start producing delta waves almost exclusively.
Here is an interesting piece of trivia: What we normally refer to as deep sleep takes place right at stages 3 and 4. This is when some children experience bedwetting, sleepwalking or have nightmares.
Stage 5REM or Rapid Eye Movement is where the brain waves increase to levels normally experienced when a person is completely awake.
At REM your breathing becomes more rapid, shallow and irregular. Your eyes jerk quickly – hence the REM initials – and muscles in the arms and/or legs become momentarily paralyzed.
Most people should experience between three and five periods of REM sleep every night.
I'm sure you have heard that a minimum of 8 hours of ZZZ's every night are recommended. OK true but when it comes to MSers, many sleep problems are not caused so much by the number of hours but, as Gail Hartley, an MS-certified nurse with Neurology Consultants explained, going through all 5 stages of the sleep cycle at least two or three times a night is the main thing.
Nurse Hartley said: "People with sleep disorders wake up feeling tired because they haven't gone through those sleep cycles; they've not gone through those restorative levels of sleep".
At least in my case, as I'm sure probably in many of you too, when I don't get enough sleep or have sleep problems the night before or even when I don't take my afternoon nap, my cognitive symptoms worsen: I find it hard to think and concentrate in whatever I'm doing.
HOW DO YOU KNOW IF YOU HAVE SLEEP PROBLEMS?
The answer to this question is not as simple as we would like to think. Even if you, like I, have to fight MS fatigue every day, having sleep problems every night or experiencing tiredness all the time, should be looked at more closely with your doctor.
There are several conditions that MSers might experience which interfere with getting enough sleep:
Obstructive sleep apnea (OSA): is very common amongst MSers with sleep problems. Usually OSA is accompanied by heavy snoring and the resulting bad oxygenation and interrupted sleep may in turn make other health conditions harder to treat.
Bladder problems: also known as nocturia are part of the sleep problems caused by getting out of bed several times every evening. If you think about it, all that interrupted sleep adds up sooner or later resulting in the tiredness experienced by must MSers.
RESTLESS LEG SYNDROME: the spasms, cramping and pain associated with this sporadic limb movement can easily prevent you from getting any good sleep. They are often the cause for insomnia or non-refreshing sleep by partially arousing you.
DEPRESSION AND ANXIETY: is often the reason behind many sleep problems. Also many of the drugs currently used to treat ms depression, spasticity and ms fatigue can hamper with sleep. Something you can do when talking with you neurologist is regulate the dosage and the time during the day that the drug is taken.
As you can see, there are many obstacles to you getting a really good night of ZZZZ's. There are also quite a few changes you can implement to improve your sleep odds:
- Create a comfortable sleeping environment that promotes good sleep.
- Make sure your bedroom is dark, quiet and cool.
- Make sure your bed, pillow and bed covers are comfortable.
The following suggestion, which I really love to pass on to you, I got it from an article written by Chris Blosse and Angela Maas for the publication "Momentum". They suggest to:
- "Use the bedroom for sleep and SEX ONLY". Is this a pearl or what?
Other suggestions, like keeping cell phones, PDA's, BlackBerries, IPhones, computers and TV's out of the bedroom are out there for folks to decide.
Personally, I find it extremely difficult (if not impossible) to follow this one. Shutting off any and all of these modern comforts at a fix time every evening is something I think is easier to agree too.
An excellent tip to reduce sleep problems is to create what I like to call a pre-sleeping routine. By this I mean having a set of steps that are performed each and every night before finally getting in bed to go to sleep.
The purpose is to start "educating" your body. By following a routine like putting your pajama, brushing your teeth, preparing what you're going to wear the next morning, read a book for 20 to 30 minutes and finally shutting off the night table's light every night, you're communicating to your brain and rest of your body that you're fixing to retire (go to sleep) for the day.
Another tip for you is to try to avoid eating a huge meal or having caffeine just before bed or very late in the day. You can also try one of the STRESS MANAGEMENT TECHNIQUES presented for you and explained in my website.
I can tell you that amongst all the tips and strategies for dealing with sleep problems that I have try, the most useful one has been to learn to tune in to my body and understand my daily rhythm.
By learning to do that you'll be able to program and choose your activities accordingly. I, for example, plan all my errands and meetings for the mornings and before lunch. Normally I would take a one hour nap after lunch and try not doing any strenuous activity the rest of the day.
SLEEPING MEDICATIONS AND OTHERS
You could try taking sleeping pills but most doctors and experts recommend them only as a last resource to deal with any sleep problems. You must remember that their use involve the risk of becoming dependant on them.
There are also various herbal supplements to help you sleep. The most important thing here that you should always remember is that they may interact with other medications or they may stimulate the immune system so the number one rule of always consulting your doctor before deciding applies here.
There are times when professional help is required. A visit to an urologist might be needed if constant waking during the night is provoking your being tired all the time.
It is a good idea that before you see your doctor you keep a sleep diary and track your habits. Here you simply keep track of things like:
- What time did you go to bed?
- What time do you think you fell asleep?
- Do you remember waking up during the night?
- How many times?
- How many hours were you in bed before you got up?
- Did you feel refreshed when you got up?
Simple practices like this one will allow your doctor to get a clearer picture of your sleeping habits which in turn will help him/her decipher what's happening.