Are you or someone with you struggling with sleep due to multiple sclerosis? We can help! Read on to learn more about multiple sclerosis and sleep issues experienced by MS patients.
Multiple Sclerosis (MS) affects around 400,000 people in the US and 2.1 million people worldwide. It is a neurological disorder that affects the central nervous system (brain and spinal cord), and nerves that should communicate with the rest of the body. Because of that, there is a lack of information flowing through neurons, which makes it hard for a body to move.
The most frequent symptom of MS is fatigue. The problem with this is that it can mask some sleep disorders that fatigue can be attributed to, like insomnia, restless legs syndrome, parasomnia and sleep apnea. To make things even worse, poor sleep quality can lead to worsening of the MS symptoms, as quality sleep is needed for muscle restoration, sharp cognitive functioning, mood improvement, and many more.
Although people with MS experience some symptoms, it isn’t a deadly disease. However, it can lead to depression, lower quality of life and shortening of lifespan. There are many different treatments available that could help ease the symptoms a little bit and maybe even slow down the progression of the disease, but unfortunately, there is no cure.
MS is a neurological disorder that affects a person’s immune system. Because of not functioning the way it is supposed to, the immune system attacks myelin, a material that makes a layer around your neurons. Myelin serves as a protective layer of neuron’s bodies called axons, and it also contributes to the faster distribution of electrical impulses throughout the body. Myelination is a crucial feature of neurons in vertebrates that allowed them to conserve energy and space, and to increase conductivity by far. Due to MS, the myelin is broken down, causing nerve damage and scar tissue, which makes it difficult for signals to travel across the body and tell it to perform the needed functions.
Symptoms can vary between people, and not everyone is affected the same way. People who suffer from MS experience physical, mental, and emotional symptoms that can affect sleep. Also, a condition in some individuals may get worse with time, while others have periods of improvement and worsening. Most people experience:
A lot of people also experience some problems with their sleep. That can lead to a series of sleep disorders like:
It was estimated that the prevalence of MS in the United States in 2012 was around 15 in 10,000 people. While the cause of MS is still not known, some people are at a higher risk of developing it:
There is research being done in different fields to try and understand MS a little better. Immunology, epidemiology, and genetics are all studied to find a cure for MS, or maybe even prevent it in the first place.
Environmental factors also impact the development of MS. It is shown that people who live further from the equator are more likely to have it. To confirm that it is the environment that is responsible for that, it is recorded that people who migrate from the area of a higher risk to the place in the tropics before the age of 15, acquire the chance of MS of a new location.
There is growing evidence that vitamin D plays a role in MS as well. Low levels of vitamin D have been identified as a risk factor for MS. As exposure to sunlight is the biggest source of vitamin D, researchers believe that it fits with a narrative that people who live further of the equator are more prone to having MS. People in the tropics are exposed to more sunlight, and they naturally have higher levels of vitamin D produced.
People usually start to see the symptoms of MS between the age of 20 to 40. Because some of the signs are similar to some other disorders, medical professionals need a series of tests to determine whether you indeed have MS. The doctors will go through your medical history, a neurologist will need to examine you, and you’ll go through various tests including magnetic resonance imaging (MRI), spinal fluid analysis, and evoked potentials test that measures the activity in your brain. For a specialist to make a diagnosis, they need to find evidence of damage in at least two different areas of the central nervous system (CNS), to find evidence that this damage occurred at different times, and to rule out any other possible diagnoses.
Unfortunately, there is still no cure for MS. There are, however, different treatment options for easing the symptoms, including prescription drugs and therapy.
Lower levels of vitamin D have shown to increase the risk of MS, and moving to a sunnier place may help with the symptoms. The research with vitamin D supplements show different results, and while some showed some benefits, others didn’t find that link. There is more research needed to detect if vitamin D supplements do indeed help.
The primary goal of prescription drugs is to slow down the destruction of myelin and nerve damage, thus preventing the worsening of the symptoms.
Physical therapy has shown benefits in improving muscle strength and balance. It also improves coordination, so moving around and everyday life tasks can become a lot easier. Some patients find using a cane or a walker to help them move around very useful. Also, talking to a psychologist can help people who struggle from MS-related mental drainage and depression.
Many of the MS symptoms cause sleep disturbances, and problems with sleep can additionally increase the severity of MS symptoms. Patients with MS are three times more likely to suffer from fragmented sleep and are twice as likely to report inadequate sleep. The improvement is needed in the detection of sleep disturbances in people with MS, and also the education of patients to report sleep problems.
Most common sleep disorders in people with MS are:
Depression is another symptom of MS, and it can additionally worsen sleep problems. If you think that you are suffering from a sleep disorder, you should visit a doctor. They will most likely do an overnight sleep study called polysomnography, to determine if everything is okay with your sleep.
Fatigue is the most prevalent symptom of MS, and as much as 90% of people with MS report experiencing it at some point. They usually experience general tiredness throughout the day, or they can feel exhausted after some activity, such as walking.
There are a few theories about the case of MS-related fatigue. One is that the weakened immune system is responsible for it. Cytokines are molecules that are responsible for cell communication during the inflammation. People with MS have been observed to have higher levels of cytokine, which could be a potential cause of fatigue.
Other theories focus on the brain, and its inability to properly communicate with the rest of the body. Because of that, it needs to spend more energy, which could be at least a partial cause for general tiredness.
Obstructive sleep apnea (OSA) affects people with MS a lot more than healthy people. While the prevalence of OSA in the general population is estimated to be around 3%, it goes up to 20% in the MS patients.
One of the causes for that is higher obesity rate in people with MS. Because of the general tiredness, they are less likely to move and exercise, and that is one of the causes for adding extra weight. Extra fat can block the upper airway and cause OSA.
Even if people with MS are not overweight, they are still more prone to central sleep apnea. Because of the lack of brain communication, throat muscles may cause dysfunction, and that can lead to the cessation of airflow.
Snoring and waking up short of breath are the most common symptoms of sleep apnea, so people who are regularly experiencing them should consult their doctor.
RLS is characterized by the strong urge to move your legs during rest to relieve pain or discomfort that you feel inside them. It is much more prevalent in people with MS than in the general population, and women are more likely to develop it.
Some individuals with MS also experience periodic limb movement disorder, which is described as involuntary muscle twitching during sleep.
Improving your sleeping habits can help you ease some of the symptoms and get better quality sleep.