Ask the expert: MS and sleep problems

25 January 2024

Person in bed sleeping

Struggling to get a good night’s sleep? Trouble with anxiety or MS symptoms during the night? You’re not alone. Sleep issues are common for people living with MS and not catching enough winks can be a source of frustration. We caught up with sleep specialist, Professor Michael Banissy, to find out what steps you can take to tackle sleep issues.

How important is sleep?

Michael says:  There’s lots of research out there showing that sleep is beneficial for our wellbeing and functioning throughout the day. If you’re struggling to get a good night’s sleep, you might find day-to-day tasks more difficult. Plus, you may find it harder to regulate your emotions, or concentrate for extended periods of time.

Sleep can play such an important role in many areas of your life. Getting into a good sleep cycle can positively impact your relationships, communication, memory, creativity, mood, and physical health. 

Do you have any tips for getting to sleep?

Michael says: Sleep can be impacted by environmental and psychological factors. Throw in physical health issues and medications and you’ve got quite a difficult puzzle to unpick. However, there are strategies that have been shown to help in some situations.

Positive sleep hygiene is always a good move. Establishing a consistent sleep schedule can make such a change. Try to sleep at the same time every night, even at weekends, and aim to wake up at a consistent time. You might need to be patient as you get into this habit.

Having a relaxing night-time routine can be beneficial. But it’s worth noting that this will be different from person to person. We’ve found that practices like meditation, gentle massage, stretching and reading can work positively in routines. You could play around with different relaxing activities and see what works for you.

People often think of night-time routines as what you do immediately before bed, but they can start at any point in the day. If you find that caffeine is keeping you up, you might want to have a cut-off point in the afternoon. Limiting the amount of blue light exposure from devices like phones, tablets and laptops can be beneficial for your sleep too.

What can you do if you’re struggling to drift off at bedtime?

Michael says: If you’re finding that you just can’t sleep and you’ve been trying to drift off for a while, it can be useful to get out of bed. Take yourself out of the room for 10–20 minutes, then give it another go.

Some people have reported that listening to white noise can help them drift off. We’ve also worked with people who have seen positive results from listening to relaxing music or stories on sleep apps.

What impact does temperature have on sleep?

Michael says: Temperature can regulate the release of melatonin. Although there’s no one-size-fits-all approach to temperature, it’s often best to go to a slightly cooler environment to help this release.

Of course, you don’t want to be in a freezing cold room, but dropping the temperature to a cool but comfortable level can be helpful.

It’s also worth thinking about how the temperature might change throughout the night. For example, someone sleeping next to you might raise your temperature. As a general rule, aim to keep the space cool throughout the time that you’re sleeping.

Any tips for managing pain and sleep?

Michael says:  I’d always encourage people to talk to their healthcare professionals about pain and sleep. The approaches can be very nuanced and differ from person to person.  Plus, neuropathic pain and musculoskeletal pain would be treated differently too.

However, there are some strategies that can have positive impacts on managing pain. Depending on the type of pain you’re experiencing, relaxation techniques like gentle stretching or moderate pressure massages may work for some people. 

Of course, people can explore pain medication with their health professional team. This would depend on what medication you’re already taking and whether it would be good a fit for your personal circumstances.

You’d normally look to incorporate medication alongside the techniques that we mentioned, rather than using it instead of sleep hygiene strategies.

What can you do if you wake frequently at night?

Michael says: We call this sleep fragmentation. We know this is common for people living with MS. Like we mentioned earlier, leaving the bedroom for 10–20 minutes can be a good solution, especially if you’re feeling frustrated. Have a break and try again after that time out. 

Distraction can be a good way to manage sleep fragmentation too. Using blue light emitting devices, like phone screens, might not be the best way to do this. Instead, try listening to relaxing sounds or doing gentle stretches. You might want to try listening to white noise or music too.

What if I’m feeling fatigued but struggling to sleep?

Michael says: This is such a frustrating situation for so many people living with MS. That frustration can lead to higher levels of anxiety, which can then have a negative impact on sleep. Stress and anxiety can really get in the way of us unwinding and relaxing before getting to sleep. 

That’s why I’d always go back to those sleep hygiene routines that we mentioned. Try to have a consistent sleep schedule.

Try to build in consistent, achievable sleep habits that work for you. Do your best to stick to them, even if you’re struggling with fatigue.

That might include things like meditation, reading, gentle massage, stretching and limiting caffeine consumption and blue light exposure throughout the day.

It may be worth talking to your health professionals about fatigue management strategies, which could be used alongside your sleep hygiene routine.

How are sleep problems treated?

Michael says: Michael says: Initially, we might look at the sleep hygiene practices that are mentioned in this article and look at changing some of those behaviours to build more consistent habits. 

Cognitive behavioural therapy (CBT) can also be an option for some people to help them regulate their anxiety, which could help them sleep better over time. Other psychological interventions can help too, depending on the individual and their needs.

Medications can also work alongside your behavioural and psychological interventions. I’d always recommend talking to your healthcare team about medication to see what options would be best for you.

Sleep clinics may be beneficial for some people too. There’s lots of expertise out there and often clinics will focus on specific aspects of sleep. If you’re really struggling to get a good night’s sleep, it might be worth talking to your GP about sleep clinics.

Michael Banissy is an award-winning Professor of Psychological Science at the University of Bristol (where he is also Head of Psychology).

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