Insomnia is a common symptom of multiple sclerosis (MS), one that can significantly interfere with your quality of life by contributing to daytime fatigue and low energy. Rather than being separate issues, many experts believe that sleep-related disorders are direct consequences of the physical and emotional burden commonly experienced by people with the disease.
One study reported that the rate of moderate to severe insomnia in people with MS was 32 percent—more than twice the national average. Moreover, 51 percent said that it took them more than half an hour to fall asleep at night.
Still, these sleep concerns are grossly underdiagnosed in people with MS.
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Causes
The UC Davis researchers concluded that uncontrolled or worsening MS symptoms combined with anxiety and depression were largely to blame for the insomnia rates they reported.
Other contributing factors to sleep disturbances seen in those with MS include:
- Certain hormonal irregularities that may cause breathing disruption and sleep apnea
- Disruption of dopamine and norepinephrine (chemical messengers in the brain) that may result in narcolepsy and interfere with sleep patterns
- Napping in the daytime due to fatigue, which may lead to insomnia at night
- MS symptoms like restless legs, temperature dysregulation, and urinary control, which may also interrupt sleep
Types
There are three different types of insomnia. Each affects a different phase of sleep and has different MS-related causes.
Initial Insomnia
Initial insomnia is defined as the inability or difficulty to fall asleep. In people with MS, initial insomnia may be caused by neuropathic or musculoskeletal pain as well as certain medications known to cause sleeping difficulties.
Middle Insomnia
Middle insomnia is when you awaken during the night and cannot fall back asleep. Ironically, people with higher daytime fatigue are more likely to experience middle insomnia. Other MS-related symptoms such as muscle spasms and nocturia (the urge to urinate at night) can also cause this effect.
Terminal Insomnia
Terminal insomnia is simply waking up too early. The cause of terminal insomnia in people with MS is not well-understood, but some believe that a lack of exposure to daylight (particularly in those with depression) may contribute to this.
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