SECTION 10: SLEEP DISTURBANCES

Sleep problems are common in MS, and may be the result of a variety of symptoms such as spasms, urinary frequency, depression, or anxiety, as well as medications used to manage a variety of symptoms associated with the disease. This can lead to the proverbial "vicious cycle," in which symptoms disturb sleep, and the lack of needed sleep in turns worsens a variety of symptoms, such as fatigue.

A variety of strategies can help manage sleep problems.

NON-PHARMACOLOGIC MANAGEMENT

Develop Good Sleep Habits

Some fairly simple changes can help enormously to ensure a good night's sleep. They include:

• Keep a regular schedule; go to bed and get up at the same time every day, including weekends. This will help your body adjust to a normal sleep pattern.
• To minimize nighttime trips to the bathroom, don't drink a lot of fluids in the evening.
• Don't exercise in the evening; whatever your exercise program, do it earlier in the day.

Manage Other Symptoms that May be Contributing to Sleep Problems

Many symptoms of MS can affect sleep, including spasticity, pain, depression or anxiety, and bladder and bowel issues. Addressing these problems can go a long way to improving your sleep.

Relaxation Techniques

There are many meditation tapes and other relaxation-oriented approaches to improving the amount and quality of your sleep. Your nurse or other healthcare professional may be able to guide you to strategies that may be effective.

Pharmacologic Management

Although the occasional use of sleep medications may be helpful, routine use of "sleeping pills" should be avoided, as they lose their effectiveness quickly, are potentially addictive, and do not provide a normal night 's sleep. Over-the-counter Benadryl and Benadryl-containing products may be helpful, but should not be used on a regular basis. If sleep aids are needed, consult your doctor for an optimal treatment plan. This will ensure the best rest possible using the least amount of medication.