Here I provide some practical guidance on managing the discomfort of being unable to turn in bed and suggest ways to reduce unpleasant sensations in the legs from restless legs syndrome (RLS) and other conditions that can hinder sleep.
Key points
- Stretching, exercises, medication and various physical devices and aids can help relieve your discomfort if you have difficulty rolling over in bed at night.
- RLS is common in people with MS; it has been associated with poor attention and concentration, memory issues, decreased productivity, depression and anxiety.
- It is important to get treatment for RLS. Before doing so, please check if it is caused by MS or by another condition, such as renal dysfunction, low iron levels or pregnancy.
- Various drugs are effective in controlling RLS symptoms, and some lifestyle changes and activities may relieve mild to moderate RLS.
- Other unpleasant, painful sensations in the legs may disrupt sleep in people with MS and need to be managed.
- Addressing these and other causes of poor sleep is essential to improving the functioning and quality of life of people with MS.
Among the MS symptoms that contribute to fatigue and insomnia in people with MS, several conditions deserve special mention because of the extreme pain or discomfort they cause. They include being unable to turn in bed, restless legs syndrome (RLS) and other unpleasant or uncomfortable sensations in the legs.
Pain from being unable to roll over
In November 2020, I was hit by a speeding motorcyclist while out jogging. Thankfully, I have made a reasonable recovery, with minor residual problems, and the horror of the accident is gradually receding from my memory. My post-traumatic flashbacks, typically triggered by the sound of a speeding motorbike, are now quite rare.
The one thing that still haunts me, however, is the chronic insomnia I experienced due to the pain and discomfort of not being able to roll over in bed. For about 6 months, I had to sleep on my back, unable to move because of a fractured pelvis and a neck brace. I can now appreciate what my patients go through when they have neuralgic pain or insomnia.
If you have problems rolling over in bed at night, there are things you can do to help yourself.
- Stretching and range of motion exercises: doing gentle stretching and range of motion exercises during the day can help improve flexibility and reduce muscle stiffness, making it easier to roll over in bed at night.
- Physical therapy: please see a physiotherapist or physical therapist who can provide a personalised exercise programme and teach you techniques to address specific mobility issues and improve overall movement.
- Medication: ensure you have been assessed and prescribed appropriate medications to manage muscle spasticity and spasms, and pain during the night.
- Supportive devices: utilising supportive devices such as bed rails, grab bars, monkey ropes or specially designed pillows can provide additional assistance and stability when transitioning in bed.
- Low-friction bed linen and pyjamas: using satin or low-friction linen and pyjamas can make the difference of being able to roll over in bed or not.
- Specialised beds: if all else fails, you may need to purchase a tilting bed that helps automate the process of rolling over. However, these beds are relatively expensive and are not generally covered by NHS budgets.
- A comfortable sleep environment: creating a comfortable and supportive sleep environment, including a supportive mattress and pillows, can help reduce discomfort and make it easier to roll over at night.
- Remember that the current treatment strategy for MS is to maximise your brain health, and part of this philosophy is holistic management, including sleep.
