Wellness involves a balance of emotional, social, spiritual, intellectual, leisure and physical activities.  Sleep, exercise, and nutrition are the three pillars that support physical health and well-being. Although all interact with and influence each other, many experts believe that sleep is the most critical and underpins the development of the other two.

What Makes Sleep So Important?

Sleep does not serve a single purpose. It’s necessary for the consolidation of learning and memory, proper immune functioning, general physiological housekeeping and maintenance, and emotional functioning.

Key metabolic activities happen when we sleep. We create a certain amount of jumble and disorder in our brains during a long and busy day and one of the activities that seems to occur when we sleep is that the brain has a chance to clean up the mess. For example, recent research suggests that during sleep the space between cells in the brain may expand slightly to allow greater flow of cerebral spinal fluid to flush out the debris.

Sleep is also important in learning and memory formation. We acquire information while we are awake, so people who are sleep-deprived generally have less ability to concentrate and learn.

But the actual process of sleeping also appears to be important for the consolidation of learning. Studies show that after exposure to a complex problem, those who were allowed to work on the problem and then get eight hours of sleep were 60 percent more likely to find a novel solution than those who did not get the eight hours of sleep.

Numerous research studies support the theory that sleep is essential to give the body a chance to repair and rejuvenate itself. In fact, it appears that many important processes like muscle growth, tissue repair, protein synthesis, and hormone release occur mostly, and sometimes only, when we sleep.

That’s a good question. Sleep is a very complex process. Chronic sleep disturbances, especially in combination with a chronic disease like multiple sclerosis, are usually complicated problems to manage. They seldom have quick and easy solutions. The first step to managing them is to recognize that good sleep is essential to our health. Figuring out how to get good sleep needs to be at the top of our list of problems to solve. Frequently it’s just an afterthought.

Strategies for Getting Better Sleep

GOOD SLEEP HYGIENE

  • Go to sleep and wake up at the same time each day. Good sleep begins with having good routine sleep times. Certainly, this is not always possible, but to the extent that it is possible, try going to bed at the same time every night and, even more importantly, waking up at the same time every day.
  • Create a comfortable sleep environment. Make sure that your sleeping environment will promote sleep. Most people can’t fall asleep with loud music blaring and bright lights blinking!
    • Temperature — For most people, cool is better than hot. Try cracking or opening your window. Warm feet are important for falling asleep; otherwise cooler is better.
    • Light — Keep your bedroom as dark as possible. You might even consider wearing an eye mask. Remember to look for nonobvious sources of light – hide the blinking electric toothbrush; turn the LED alarm clock around so you can’t see it.
    • Noise — Less noise means more sleep. You can reduce noise levels with rugs and drapes, earplugs, background “white” noise (such as a fan), or soothing music. Music without words may deepen sleep quality greater than music with words.
    • Comfort — A good mattress and comfortable pillow can improve the quality of sleep.
    • Function — Try not to use your bedroom for work activities, such as balancing the checkbook, studying, or scrolling through email on your phone or tablet. Make your bedroom a stress-free zone. The bedroom is for sleep only.

AVOID ALCOHOL AND CAFFEINE

Alcohol may help you get to sleep, but it will make your sleep restless and uneasy. Many people who drink experience an alcohol rebound and may wake up early in the morning. Caffeine can certainly keep you awake and most people are aware of this. The problem is that caffeine can be found in unexpected places, such as chocolate or soda. Caffeine – contained in tea, cola, and chocolate, (and, of course, in coffee) – is a stimulant and can cause problems for people trying to fall asleep. The half-life of caffeine is usually reported to be about 5 or 6 hours. For those who are sensitive to caffeine, it may be best to stop drinking coffee 10 hours before bed.

WATCH YOUR DIET

A heavy meal or spicy foods before bedtime can lead to nighttime discomfort, and uids can require disruptive trips to the bathroom. A light snack, however, can prevent hunger pangs and help you sleep better.

GET OUT OF BED IF YOU’RE NOT SLEEPING

If you don’t fall asleep within 10 to 30 minutes, get up. Get back into bed only when you feel sleepy. This tip is especially difficult to follow in the cold winter months when that warm bed is all the more comfortable. But, this is one of the most important tips to follow. We need our minds to associate getting comfortable in bed and drifting off into deep, restorative sleep. The more time we spend in bed lying awake and frustrated, the more our mind associates getting comfortable in bed with anxiety and then we’re less likely to fall asleep.

Instead, have a comfortable spot in your home where you can do a soothing activity like reading to calm your overactive mind. Avoid the temptation to turn on the TV or computer, the light stimulation from both just stimulates our brains further though the activities may feel calming.

EXERCISE REGULARLY

Regular exercise has been shown to improve sleep. Exercising in the morning or afternoon – at least three hours before bedtime, so you won’t be too “revved up” – will help you get a deeper, more restful sleep. Exercise helps us to burn off those stress hormones that have been triggered in our bodies during the day.

STOP TOBACCO USE

Nicotine, like caffeine, is a stimulant and can cause problems for people trying to fall asleep. Also, as a stimulant, nicotine causes the sleep we do get to be less restorative.

AVOID WATCHING THE CLOCK

Set the alarm and place the clock out of sight. Constant checking can even cause insomnia. Every time we look over and notice more time has passed, we begin fretting about how sleep deprivation is going to interfere the next day.

CREATE A RELAXING BEDTIME ROUTINE

Read a good book, listen to music, practice relaxation techniques, or sip on a warm cup of Sleepytime tea.

MAKE SURE YOUR URINARY PROBLEMS ARE WELL MANAGED

Many people with MS have urinary frequency. If you are waking up frequently to go to the bathroom and not falling back asleep, it may be helpful to try to address this problem through behavioral strategies (e.g., not drinking within two hours of bedtime, using physical techniques for promoting maximum urination) or medications. Of course, if you experience this problem, you should discuss it with your health care provider.

FOR MORE INTRACTABLE SLEEP PROBLEMS: SLEEP STUDIES AND CBT

For those who have tried the simple steps above and still have trouble sleeping, it is definitely a good idea to discuss sleep problems with your health care provider. Your health care provider may recommend a sleep study, which may identify specific, medical causes of your sleep issues.

If medical conditions have been excluded, keep in mind that even severe insomnia can sometimes be managed without medications. Cognitive behavioral therapy for insomnia (CBT-I) includes regular, often weekly, visits to a clinician, who will give you a series of sleep assessments, ask you to complete a sleep diary and work with you in sessions to help you change the way you sleep. Working with a specialist in this way, you should be able to identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep.