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University Hospitals Dorset NHS Foundation Trust

Sleep

Sleep plays an important role in overall health and well-being. Everyone's sleep needs are different, but for people with MS, common symptoms can often lead to disrupted or poor-quality sleep.

Importance of sleep

Restoration and Healing: during sleep the body repairs tissues, muscles, and the immune system.

Cognitive function: sleep helps memories embed, helps with problem solving, learning and creativity. It enhances your ability to focus, make decisions and process information.

Emotional regulation: a lack of sleep can cause irritability and mood swings.

Immune function: sleep strengthens the immune system allowing the body to be better equipped to fight against infections.

Stress reduction: good sleep reduces stress and the production of stress hormones which in turn supports better mental and physical health.

Hormone regulation: sleep helps to regulate hormones including ones that control appetite (leptin and ghrelin) and growth hormones. Disrupted sleep can cause imbalances which can lead to weight gain.

Sleep can be a challenge for many people with MS due to symptoms such as pain, muscle spasms and bladder issues but it can also be difficult to unpick what is due to MS and what is sometimes due to more general problems such as worry, stress, hormones and environmental factors.

General tips to sleeping well:

  • Maintain a consistent sleep pattern by going to bed and waking up at the same time every day, even on weekends, to regulate your body's internal clock
  • Create a relaxing bedtime routine and establish calming activities before sleep
  • Consider reading, gentle stretches, breathing exercises, relaxation exercises or anything that signals time to wind down
  • Make sure your sleep environment is comfortable, such as not too hot or too cold
  • Limit screen time. Avoid phones, tablets, and TV at least an hour before you go to bed as the blue light can interfere with your sleep
  • Be mindful of your diet. Avoid heavy or spicy meals, caffeine, and alcohol close to bedtime
  • Try to get some physical movement in the day to promote better sleep but don't attempt exercises in the few hours before bedtime
  • Manage your stress. Relaxation exercises, meditation, yoga, progressive muscle relaxation are all ways to try and reduce stress and anxiety
  • Limit your naps. If you need to nap during the day, keep it short and no longer than 20-30 minutes at any one time, and preferably not too close to bedtime
  • Watch your intake of fluids close to bedtime, especially if you have bladder issues
  • Get exposure to natural light in the day, as this can regulate your sleep-wake cycle. Being outside in the daytime can help. At night, blackout blinds, or an eye mask in summer, may help with your body preparing for sleep
  • If you have trouble getting to sleep, or when you wake up in the night, avoid clock-watching as this can create anxiety
  • Consider a notepad beside your bed and jot down any concerns so that you can deal with worries in the morning, try to "park" your concerns
  • It may take time to establish good sleep habits, so remember to be patient and consistent when trying to maintain good sleep patterns

Sleep tips specific to MS:

  • Medication management: take prescribed medications for muscle spasms or other MS symptoms, especially if these interfere with your sleep. See Spasticity and Pain
  • Sometimes you may need medications to get you to sleep and discussing this with your GP is important
  • Manage temperature: MS can make some people very sensitive to temperature changes so keep your bedroom at a comfortable temperature to avoid overheating or getting too cold in the night. You may need to consider a different duvet or bedding to your partner
  • Consider using devices, such as cooling blankets or fans, if heat sensitivity is a problem for you
  • Gentle stretches can help muscle stiffness and spasms. The MS physiotherapist can advise if this is something you feel you suffer from. See Spasticity
  • If you have to get up to go to the toilet frequently in the night, consider stopping drinking three hours before you go to bed. See Bladder
  • Fatigue management is important in the day to prevent excessive fatigue and becoming over tired. Plan small regular rests into your day. See Fatigue
  • Pain management is important for some MS symptoms, especially if they interfere with you sleeping well. If this is something you think you need to consider, discuss with your MS nurse, or contact the MS helpline for advice. See Pain
  • Supportive positioning can be useful, and a good mattress can make a big difference

For further information see these links below.

https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/

https://www.nhs.uk/conditions/insomnia/

https://mstrust.org.uk/information-support/wellbeing-ms/sleep

https://www.nationalmssociety.org/Living-Well-With-MS/Diet-Exercise-Healthy-Behaviors/Sleep

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