“The key question here is, are you sleeping continuously? In individuals that are telling me they’re waking up a couple times a night, my biggest concern is that they’re not getting to the restorative sleep levels they need.” — DR. ANNA SHAH, Rocky Mountain MS Center
Start with general sleep hygiene. Is the room dark enough? Quiet enough? Are you using the bed only for sleep and sex? Do you go to bed and wake up at the same times every day? Are you limiting caffeine after noon? No liquids for a few hours before bed? Limiting screentime before bed? Temperature matters a lot for falling asleep. Do you need to add a heated blanket or put on socks? Maybe you need sheets designed to feel cool all night. Consider your personal circumstances and preferences. These may be different from your partner; how can you arrange the bed and room so that you can both get restful sleep?
Create a nighttime ritual that prepares your brain and body for sleep. Have a set time that you will brush your teeth, change into your PJs, wash your face. This may be long before you plan to climb into bed. Turn off some of the lights around you an hour before bed. Spray a calming scent on your wrist or pillow. Listen to calming music. Write down your to-do list for tomorrow, or write in a gratitude journal (or any journal). All of these things will train your brain that bedtime is coming. It may take a few weeks of doing these activities consistently to see the benefits in action.
Spend time pinpointing where your sleep issues originate from. Are you getting up multiple times during the night to use the bathroom? Do you have spasticity that keeps you up or wakes you up? Talk to your care team about these concerns, they will probably have suggestions ranging from behavior modifications (stretching throughout the day to help with spasticity, limiting liquids to help with the bathroom) to medications.
Be open to additional testing for things like sleep apnea and anxiety or depression. The rate of sleep apnea for Americans generally is estimated at 3%, for people living with MS that jumps to 4-20%. Both obstructive and central sleep apnea are seen at higher rates in people living with MS. For more information about sleep apnea and its potential effects on cognition, please watch Dr. Anna Shah presenting on Cognition in MS from our 2023 Fall Education Summit.
FOR MORE ON SLEEP… See “Sleep,” and other articles in the Fall 2017 issue of InforMS. Visit MSCenter.org/informs or scan the QR code below.
