MS Insomnia: How to Manage Multiple Sclerosis Insomnia

MS Insomnia

Do you constantly feel drained? Or are you having trouble sleeping well at night? Sleep issues are common among people with multiple sclerosis, although they may or may not be caused by the condition. Keep reading to find out more about MS insomnia and how to manage it better.

What is Multiple Sclerosis (MS)?

Multiple sclerosis, commonly known as MS, is a chronic illness that affects the brain, spinal cord, and optic nerves in the eyes. Vision, balance, muscular control, and other basic bodily functions have a risk of impairment due to MS. Everyone with the condition experience numerous symptoms. Some individuals just experience minor symptoms and might not require medical attention.

Others will struggle to get around and complete everyday duties. The immune system attacks myelin, a fatty substance that wraps around your nerve fibers to protect them. This is the main cause of MS.

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The nerves damage when myelin isn’t present. Because of the impairment, the brain is unable to convey messages appropriately throughout the body. The nerves don’t perform as well as they should to assist the body in moving and feeling appropriate.

Are You Sleep Deprived?

Are you undoubtedly tired, unproductive, and sluggish? Your under-eye circles may be more apparent than ever, and your desires may be more powerful than ever.

Sleep isn’t simply a nice way to unwind after a hard day; it’s also not a sign of weakness or sloth. Adequate sleep for adults is having at least seven hours of sleep every night. It is an absolutely important controller of every physiologic system in the human body. Our health and wellness might suffer in a variety of ways when we’re sleep-deprived, which affects more than one-third of individuals. To be called sleep-deprived, you don’t have to have pulled an all-nighter or fallen asleep in the middle of a sentence. You may not even be aware that you aren’t getting enough sleep since you aren’t very exhausted (1,2).

Does MS Cause Insomnia?

Insomnia is a typical symptom of multiple sclerosis (MS), and it may have a big impact on your quality of life by contributing to weariness and poor energy during the day. Rather than being distinct problems, many physicians feel that sleep disturbances are a direct result of physical and mental stress. Insomnia is a prevalent condition that affects around half of all individuals with multiple sclerosis (MS) who have sleep difficulties. In general, those who suffer from sleeplessness are more likely to acquire depression (2).

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Sleep is compromised in MS patients in many ways, some of them include, but are not limited to:

  • Due to weariness, additional naps during the day add to the cause.
  • Reduced physical activity. Lack of activity is due to weariness and MS-related impairment.
  • Emotional changes include stress, anxiety or depression.
  • Reduced physical activity due to fatigue and MS-related disability
  • Other MS symptoms include pain, urinary or bowel symptoms, and temperature dysregulation

Types of MS Insomnia

  • Initial Insomnia: Initial insomnia is also known as sleep-onset insomnia or early insomnia. Sleep trouble is associated with an increase in sleep latency or the period between going to bed and falling asleep. In MS patients, the first sleeplessness is commonly linked to anxiety issues. (3)
  • Middle Insomnia: Sleep-maintenance insomnia is another name for middle insomnia. It’s a term for having trouble sleeping. There is a lack of sleep efficiency, with fragmented, restless sleep and frequent awakening during the night. Middle insomnia links with medical conditions, pain disorders, and depression. This is the most common type of insomnia in MS patients. (3)
  • Terminal Insomnia: Patients with terminal insomnia, also known as late insomnia or early morning wakening insomnia, wake up earlier than necessary on a regular basis. Major depression is commonly linked to this symptom. Although the exact reason is unknown, a lack of exposure to sunlight, especially in people who are depressed, may have a role. (3)

Managing Sleep With CareClinic

We are more attentive and clear-headed after a good night’s sleep. Learning, problem-solving, and decision-making are all made simpler. However, when we don’t get enough sleep, our brain’s performance diminishes. We’re hazy and sluggish to respond. It is so important to get a good night’s rest. CareClinic Health App has a built-in feature to help you track your sleeping patterns.

MS and Sleep Problems

If you’re struggling with insomnia, you might wish to retain a note of your concerns. You may do this by using the sleep tracking function under the check-ins tab, which comes with a variety of useful features. The software may be used as an insomnia tracker, allowing you to monitor your sleep activities and uncover possible reasons for sleeplessness.

Additionally, you can write down the insomnia log’s possible reasons and figure out what’s causing the problem. Additional concerns, such as daytime drowsiness, number of hours of sleep per night, and naps taken throughout the day, can be recorded inside the app. One can add factors affecting their sleep – nightmare, trouble falling asleep, late bedtime, and many more. Tracking sleep could help link fluctuations in mood and productivity due to it and hence, manage these better. You may get even more information about your sleep behaviour during the day if you combine the app with wearable devices.

CareClinic enables users to calculate sleep time and mood after waking up. This means one can track their sleep cycle along with the feelings they wake up with. The sleep tracker is also equipped with sleeping music like white noise and binaural sounds for the ones who find it hard to fall asleep due to hyperactivity.

MS Severe Insomnia & Fatigue

It’s unclear why someone develops multiple sclerosis (MS). It’s not linked to any specific health practice, and it’s unclear whether it is avoidable. So far, research reveals that a mix of hereditary and environmental variables contribute to the cause.

MS fatigue is also among the most unpleasant symptoms of the disease. MS fatigue may be distressing, and it can interfere with job and family life, mental and physical health, and social and recreational activities for some people. Fatigue can be a major symptom of the active inflammatory disorder, or it can be a secondary sign of other medical disorders. Most often fatigue also causes insomnia and the two symptoms interconnect.

Why Am I So Restless?

  • Dehydration – Dehydration might make you tired. Drink six to eight cups (1.5 litres) of liquids every day. Caffeine-containing drinks might give a boost at first, but too risks dehydration, so try moderating the usage.
  • MS symptoms – Urinary frequency during the night, tension, melancholy, and discomfort can all interfere with getting a good night’s sleep. It is critical to discuss symptoms that keep you awake at night with your doctor as soon as possible in order to determine the most efficient strategy to treat them with the least amount of disruption to your sleep.
  • Medications – Certain MS drugs cause fatigue and insomnia. These can be either the abortive or preventative therapy medications prescribed to you by your physician.
  • Lack of physical activity – MS causes a lack of physical activity because the immune system is continually attacked. This is due to a loss of motivation. Regular physical exercise minimizes weariness and boosts strength and energy levels.

Strategies To Get A Proper Sleep

Medications and therapy methods are more meaningful methods to invade when you are struggling with insomnia. Before engaging in serious interventions to help relieve insomnia, try the following strategies to help control insomnia. (4)

  • During the day, get lots of natural light exposure.
  • Exercise on a regular basis to increase sleep quality, but avoid doing so within four to six hours of bedtime to avoid overstimulation.
  • Every day, including weekends, go to bed and wake up at the same hour. Creating a night routine before bedtime that lasts between 30 and 60 minutes and helps you unwind for the day and prepare for sleep will help you drift away from insomnia.
  • Eliminate caffeine, alcohol, and nicotine six hours before bedtime.
  • A couple of hours before going to bed, stop consuming any liquids.
  • When you’re in bed, try to empty your head. Avoid watching TV and using gadgets.
  • Maintain a dark and chilly environment in your bedroom.
  • Don’t get up in the middle of the night if you can avoid it.
    • Before going back to bed, get out of bed and read a book or do something else to clear your thoughts. Using a journal entry will help clear your thoughts and prevent you from going to bed overwhelmed.

Journal Entries to Clear Your Mind

Can MS Cause Insomnia

Do you need a place to write down your thoughts? Are there too many emotions running through your head? Going through your daily routine and managing MS simultaneously can add to your thought bubble. Life has its ups and downs and clearing your thoughts using a journal entry might help relieve stress and insomnia.

With the built-in journal feature in the CareClinic app, you may enter up to 144 words each entry and upload an infinite number of posts every day with diary entries. You may either input your ideas or utilize the prompt option if you’re unsure what to write. Each topic focuses on a different element of mental health, and the premium user provides access to 16 journal prompts. The subjects vary from “acceptance” to “daily productivity planner.”

You may also use lists, bolding, italicizing, and underlining to emphasize key points. To emphasize your emotion, you may alter the colour of the text. Finally, you may customize your journal by adding images. They may be anything from family, friends, or experiences to internet motivating images and anything in between. The additional features help make your entry unique and catered to your preferences.

Cognitive Behavioural Therapy (CBT) for MS Insomnia

CBT, or Cognitive Behavioural Therapy, focuses on the relationship between how we think, what we do, and how we sleep. During therapy, a skilled CBT professional aids in the identification of thoughts, feelings, and behaviours that contribute to insomnia symptoms. Sleep-related thoughts and sensations evaluate and test to see if they are true. Furthermore, sleep-promoting activities are examined. Following that, a healthcare provider will clarify or reframe beliefs and problems in a way that promotes peaceful sleep. Treatment usually lasts 6-8 sessions, however, this might vary based on the individual’s requirements. (5)

CBT’s cognitive component teaches you how to notice and modify thoughts that interfere with your sleep. This sort of treatment can assist you in gaining control over or eliminating unpleasant thoughts and anxieties that keep you awake at night. CBT’s behavioural component aids in the development of excellent sleep patterns and the avoidance of behaviours that prevent you from sleeping soundly. (5)

CBT Techniques

Some CBT techniques include but are not limited to:

  • Sleep Restriction: It’s easy to fall into the habit of lying in bed when you’re awake, which can contribute to bad sleep. This therapy shortens your time in bed, creating partial sleep deprivation and making you sleep more soundly the next night. The rest time in bed increases as the sleep schedule improves.
  • Relaxation Training: This practice aids in the relaxation of both the mind and the body. Meditation, visualization, muscular relaxation, and similar techniques aid in relaxation training.
  • Sleep hygiene: Sleep hygiene is important. This kind of treatment entails modifying basic lifestyle choices that affect sleep. As previously mentioned activities like smoking or drinking too much caffeine late in the day, drinking too much alcohol, or not exercising regularly. It also contains sleep-related suggestions, such as how to relax an hour or two before night.

Keeping Track of Activities With CareClinic

Using CareClinic as a CBT Tracker gets you closer to cognitive behavioural therapy, which teaches you how to change your thinking and fill your mind with good thoughts. You must, however, continue if you are to succeed in making the essential adjustments. It’s critical to conclude each journal entry with a constructive remark or reasoned challenge. This will allow you to see things from a fresh perspective, allowing you to gradually achieve the balance you seek in your life. Finding something positive to say about your day or challenging unreasonable views with sensible beliefs might help you avoid negative thinking.

You don’t have to write only about big events, as you may have predicted. You might create posts on tiny events that occurred throughout the day to help you practice writing and guide your thoughts in a good direction. Regularly review your entries, paying specific attention to the logic problems. The thought notebook helps you become more conscious of your thoughts, helping you to make better decisions and create a healthy sense of self-esteem.

You can even set up your own healthcare team that manages your health and therapy schedule. Add your physician, counselor, registered nurse, other health care providers, and family members to keep them in the loop.

Medications for MS Insomnia

Although therapy and sleeping strategies are the first resort to insomnia, it might be necessary to consume medications to help regulate a proper sleep schedule. Before consuming any medications, it is important to refer to a physician.

  • Antihistamines: These may make you sleepy the next day. Antihistamines are available over-the-counter and do not require a prescription. However, if you’re taking other prescriptions that contain antihistamines, such as cold or allergy meds, there’s a chance you’ll take too much. Before taking any drug, consult your doctor. (6)
  • Melatonin: Melatonin is a hormone produced in the body on its own. The pineal gland in your brain produces it. Melatonin is also found in other places, including your eyes, bone marrow, and stomach. It is called the “sleep hormone” since high levels can aid in sleep regulation. Melatonin, on the other hand, will not put you to sleep. It merely informs your body that it is bedtime, allowing you to unwind and fall asleep more quickly. Melatonin is available over-the-counter and does not require a prescription. Most often melatonin is available for oral use through gummies or in other flavoured forms. (6)
  • Benzodiazepines: These are available over the counter and may be effective if you want an insomnia medicine that lasts longer in your system. Benzodiazepines are useful in treating sleep issues, including sleepwalking and night terrors. (6)
    • These drugs have a number of major drawbacks. They have the potential to create addiction and dependency. When you stop using them, you will experience physical withdrawal. There is also a black box warning against mixing them with opioids since they both slow breathing and raise the risk of overdosing. (6)

MS Insomnia Medication Tracking

MS Severe Insomnia and Fatigue

A medication log or tracker is the simplest way to keep track of prescribed drugs. Tracking medication is key to remembering the course of the prescription. Health applications, such as CareClinic, allow you to record everything related to the medication taken, including dosage, instructions, purpose, side effects and physician/pharmacist(s) who prescribed the drugs, together with the necessary contact information (useful for refills).

Tracking your medication intake also forces you to stay organized and in control of your treatments. It increases medication adherence, as you will be able to track the efficacy of your treatment and the impact on general health.

It’s fantastic to have a resource where you can keep track of your whole pharmaceutical history. It is a helpful reference tool that speeds up the retrieval of medical data. Furthermore, by utilizing CareClinic to keep track of your previous and present medications, you will limit the chances of misunderstanding. You will make your therapy run more smoothly and you will attain your health goals.

CareClinic is an all-in-one platform. What are you waiting for? Download here on the iOS AppStore or Google Play!

References

(1) The Basics of Multiple Sclerosis. (n.d.). WebMD. Retrieved March 19, 2022, from https://www.webmd.com/multiple-sclerosis/what-is-multiple-sclerosis

(2) Alhazzani, A. A., Alshahrani, A., Alqahtani, M., Alamri, R., Alqahtani, R., Alqahtani, M., & Alahmarii, M. (2018). Insomnia among non-depressed multiple sclerosis patients: a cross-sectional study. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 54(1). https://doi.org/10.1186/s41983-018-0016-0

(3) Sleep-Wake Disorders Clinical Presentation. (2021, July 19). https://emedicine.medscape.com/article/287104-clinical

(4) Sleep Issues. (2015, December 23). MSAA. https://mymsaa.org/ms-information/symptoms/sleep-issues/

Sleep. (n.d.). National Multiple Sclerosis Society. Retrieved March 19, 2022, from https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Sleep

(5) Cognitive Behavioral Therapy for Insomnia (CBT-I). (2020, September 15). Sleep Foundation. https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia

(6) Ramakrishnan, K., & Scheid, D. C. (2007). Treatment Options for Insomnia. American Family Physician, 76(4), 517–526.

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Nawal Masood