Summer slumber

People with MS often have trouble sleeping. In the summer, when the days are hotter and longer, it only gets worse. Here’s help.

by Matt Alderton

Sleep is sacred.

According to the National Institutes of Health, shut-eye is mission-critical for the human body, influencing everything from metabolism and immunity to cognition and mood. Without a good night’s sleep, people have difficulty focusing, reasoning and problem-solving; they also can become irrational and irritable. In the event of long-term sleep deprivation, people are prone to depression, weight gain and accidents, as well as chronic conditions such as diabetes and heart disease. Clearly, sleep disturbances can be serious. But on a hot summer night—particularly for people with MS who are already sensitive to heat—the prospect of nodding off can feel like a pipe dream.

Restless sleep

People with MS have a higher risk of sleep disorders than the general population, according to Dr. Rock Heyman, associate professor of neurology, director of the MS Center and chief of the Division of Neuroimmunology/Multiple Sclerosis at the University of Pittsburgh Medical Center. “Nobody has done the perfect study comparing 1,000 people with MS to 1,000 people without the disease, but the impression from those of us who treat MS and pay attention to sleep is that there are an awful lot of sleep problems out there in the MS community,” he says.

Many people with MS seem to struggle year-round with true sleep disorders, such as sleep apnea (periodic interruptions in breathing) and periodic limb movement disorder (a cousin of restless leg syndrome).

“Sleep apnea may occur more frequently in people with MS because they tend to be less physically active; they’re fatigued and have trouble walking, which causes them to gain weight [a common risk factor for sleep apnea],” says Dr. David Brandes, a neurologist at Hope Neurology Center in Knoxville, Tenn., and assistant clinical professor at the University of California Los Angeles School of Medicine. And, Dr. Brandes adds, some studies have shown that periodic leg movements occur in people with MS at nearly twice the rate of the general population.

MS on the mattress

In addition to these disorders, MS itself can ruffle bed feathers. Some MS-related symptoms, like anxiety and pain, can make falling asleep more difficult, Dr. Heyman says, while others can make it harder to stay asleep, preventing the body from entering the most restful stage of sleep, known as delta or slow-wave sleep.

“Depression and incontinence, for instance, can certainly cause people to wake up well before their alarm, even though they’re not refreshed,” he explains.

Dr. Heyman says some medications used by people with MS, such as interferons, steroids and stimulants, can create a vicious cycle. “If you take interferon injections [which can cause flu-like symptoms as side effects], your doctor may say, ‘Take them at night so they don’t bother you during the day.’ But then you don’t sleep well because you have aches and pains at night from the interferon.” The resulting sleeplessness can exacerbate MS-related fatigue the following day.

Managing seasonal insomnia

Sleep disruptions can occur all year round, but summer is an especially difficult season for some sleep-challenged individuals.

“When MS patients get hot, it makes their MS symptoms worse,” explains Dr. Brandes. And, he says, “If your MS symptoms are worse, certainly that can disturb your sleep.”

Discuss sleep concerns with your doctor, who may recommend a sleep study or sleep diary to determine the source of your problems, or possibly recommend medication. Your physician also can help you address lifestyle issues such as diet, exercise and stress—all of which can impact sleep quality—and rule out other sleep-disruptive conditions, such as diabetes.

Matt Alderton is a Chicago-based freelance writer.