Recently, in my blog No Rest for Multiple Sclerosis, the prevalence of sleep disorders in those with multiple sclerosis was explored. Research in the Journal of Clinical Sleep Medicine indicates that approximately seven in every 10 people with multiple sclerosis appears to have a sleep disorder (such as obstructive sleep apnea, insomnia, or restless legs syndrome). These sleep disorders, in turn; explain why 60% of those with multiple sclerosis in this study reported an abnormal level of fatigue and 30% experienced excessive daytime sleepiness.
If 70% of people with multiple sclerosis has a sleep disorder (with most not knowing about it), what comes next? The next important step is to talk with a doctor about getting screened and diagnosed with the sleep disorder. Treatment will depend on which disorder is diagnosed.
Here’s a short review of the basic treatment for each of the most common sleep disorders:
Obstructive Sleep Apnea
For overweight patients, losing weight can improve the condition of obstructive sleep apnea. Sleep positioning can also help; with side sleeping being far preferable to back sleeping. Oral appliances can be tried, which alter the jaw position. If none of these work, a positive airway pressure machine with a mask can be worn during sleep. This supply of pressurized air prevents the airway collapse of sleep apnea.
Treatment for insomnia falls into two categories: non-medical and medical, according to The National Sleep Foundation. The non-medical techniques include relaxation training, cognitive behavioral therapy, and stimulus control, such as only going to bed when sleepy, not having a TV in the bedroom, and following a strict schedule of bedtime and waketime. For medical treatments, there are several non-prescription and prescription sleep aids.
Restless Legs Syndrome
With restless legs syndrome, treatment focuses on symptom relief, according to the National Institute of Neurological Disorders and Stroke. Some medications can be useful, such as dopaminergic agents, gabapentin enacarbil, and benzodiazepines. In addition, caffeine, alcohol, and tobacco should be avoided. Deficiencies of iron, folate, and magnesium should be corrected. Exercise, leg massages, and hot baths can help, too.
Proper treatment of sleep disorders will help minimize the difficulties of living with multiple sclerosis.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
What do you think?
I’d love to hear your opinion in the comments section below.
Brass SD, Li CS, Auerbach S. The underdiagnosis of sleep disorders in patients with multiple sclerosis. J Clin Sleep Med 2014;10(9):1025-31.
American Sleep Apnea Association
National Institute of Neurological Disorders and Stroke
The National Sleep Foundation