SPMS Sleep Problems: Tips for Better Rest

If you have secondary progressive multiple sclerosis (SPMS) and have trouble sleeping at night, you're not alone. Research shows more than half of people with multiple sclerosis (MS) have sleep problems, and those with SPMS have even more sleep issues. Sleep problems may be caused by your SPMS symptoms, medications you take, or the disease itself. For some, pain or spasms cause trouble sleeping. For others, it's depression, insomnia, or sleep apnea. To get better sleep, try these tips for some common sleep problems linked to MS.

People with MS are five to seven times more likely to have restless legs syndrome (RLS). This condition causes discomfort in your legs along with an urge to move them. To help with RLS at night, try these changes:

Get more iron: Iron helps make dopamine, a brain chemical that helps with muscle control. Take an iron supplement or eat more foods high in iron such as whole grains, spinach, beans, seafood, lentils, and lean meats.

Massage your legs: This can improve your blood flow and ease muscle tension, which can lessen RLS symptoms. It may also reduce pain in your legs that may wake you up.

Learn your triggers: For some, certain activities or feelings worsen symptoms of RLS. Keep a log of things that seem to make your RLS worse.  

Use compression socks: These special socks improve blood flow in your legs and reduce muscle spasms that can disrupt sleep.

Bladder problems affect at least 80% of people with MS. For many, bladder problems are worse at night. These steps can help:

Change your diet: Avoid alcohol, caffeine, citrus foods, salsa, spicy food, and foods with lots of water such as cucumbers, strawberries, and watermelon. In the evenings, stop drinking liquids at least two hours before bedtime.

Exercise during the day: Cardio exercise has been shown to improve bladder function for people living with MS. Some options include walking, water exercise, or cycling. Exercise in a cool place so you don't get overheated and stay hydrated.

Take care of your bowels: That means going "No. 2" on a regular basis which can lessen pressure on the bladder. Talk to your doctor if you're having trouble going to the bathroom.

Do pelvic exercises: Doing regular pelvic exercises can strengthen the muscles around your bladder and give you more control. A trained physical therapist can check your pelvic floor and help you with exercise guidance.

Getting comfortable while sleeping can be hard when you have MS, especially if you get stiff muscles or muscle spasms. As soon as you settle into your bed, your limbs may twitch or jerk, preventing you from falling asleep and making you uncomfortable. Consider these changes:

Check your mattress: Make sure your mattress is comfortable. You can also make easy, cheap changes to your current mattress. Try using extra pillows or foam wedges under your body while you sleep.  

Take spasm medication before bed: If you're taking a medication that helps reduce spasms and stiffness, ask your doctor about taking your meds closer to bedtime -- about 30 minutes before.  

See an occupational therapist (OT): Occupational therapists know ways to reduce muscle spasms, such as exercises that may help. They can also visit your home to look at your sleep environment and suggest strategies.

Insomnia related to SPMS can make for a restless night and a tired morning. Medications you're using to treat your MS may be behind your insomnia, or symptoms like pain and stress could be causing it. Try these fixes:

Take your medications earlier: Side effects from some MS drugs, such as headaches, can hurt sleep. For example, beta interferon drugs Betaferon, Extavia, Plegridy) sometimes make it harder to sleep. Talk to your doctor about how to minimize side effects.

Get pain help: There are a number of pain therapies and medications that can help with pain. Tell your doctor if pain interferes with your sleep and ask about the best pain-management approach for you.

Address stress: Stress and worry can make it tough to sleep. If your mind is racing at night, consider writing in a journal to get your thoughts out. Relaxation exercises can also help before bed. Try deep breathing or thinking about a peaceful place.