How to Sleep Well with Multiple Sclerosis (MS)

Learn about link between MS and poor sleep quality and how to achieve better sleep with this condition.

By Nicole Gleichmann

Do you ever feel like your energy levels disappear during the day? If so, you’re not alone. One of the hardest parts of living with Multiple Sclerosis (MS) is fatigue.

MS fatigue is unique. Instead of the typical “tired” feeling that the general population might feel when they didn’t sleep much, MS fatigue is more all-encompassing. While daytime sleepiness is usually part of it, you might also experience:

  • Brain fog
  • Trouble thinking
  • Confusion
  • Physical weakness
  • Memory difficulties
So, what causes this fatigue?

While researchers once thought it was mainly disease progression, a recent study has found that there are other factors that are stronger predictors…and one of them is the presence of sleep disturbances.

Sleep and MS have a complicated relationship. When you have MS, it can be harder to sleep. On the flip side, when you don’t sleep well, your MS symptoms can be more severe.

With 50% of people with MS reporting sleep disturbances, understanding how sleep and MS relate is the first step towards reducing MS fatigue. Read on to learn more about how MS and sleep interact and what you can do to take back control.

What is MS?

Multiple Sclerosis, or MS, is a disease of the central nervous system. Damage happens to your central nervous system as your immune system attacks myelin, a protective fatty layer that surrounds nerve fibers.

MS is marked by a slow disease progression that can impact your brain, eyes, and spinal cord. It’s more common in women than men, and in smokers than non-smokers. Additionally, MS is:

  • More common in climates with less sunlight
  • Believed to have a genetic component
  • Possibly tied to a viral infection

MS symptoms and severity can differ greatly from one person to another. For some, the disease only results in mild symptoms. For others, it can shorten lifespan and make everyday life incredibly difficult.

For MS, some common symptoms include:

  • Feeling tired/fatigue
  • Depression and other mood disorders
  • Coordination problems
  • Loss of balance
  • Muscle spasms
  • Muscle weakness
  • Vision problems
  • Trouble focusing
  • Memory and learning difficulties
  • Pain
  • Loss of bladder control and sexual function
  • Sleep disorders

How MS Affects Sleep Quality

Multiple Sclerosis can have a negative impact on sleep quality. As the disease progresses, there are many changes that can cause sleep disturbances. These include:

  1. Pain: Chronic pain can make every aspect of sleep challenging. It can make it hard to fall asleep and sleep soundly throughout the night.
  2. Medications: Some MS medications have side effects that impact sleep.
  3. Frequent urge to urinate: It’s not uncommon for MS patients to experience an increased need to urinate. During the nighttime, this can lead to waking up frequently during the night.
  4. Muscle spasticity: Muscle spasms in the arms and legs can interrupt sleep and make it hard to fall asleep.
  5. Stress: Anxiety and chronic stress can happen as patients learn to cope with disease symptoms.
  6. Depression: Depression is common in MS patients, and it can also lead to trouble sleeping.
  7. Sleep disorders: Many sleep disorders are more common in MS patients than in the general public. These are often caused by MS progression.
  8. Brain lesions: MS can lead to brain lesions in regions that impact sleep.
  9. Poor temperature regulation: Some patients can experience difficulties regulating temperature. As our sleep/wake cycle is tied to body temperature changes, this can lead to insomnia.
  10. Poor sleep schedule: Daytime napping is often necessary to fight fatigue, but too much napping can make sleeping during the nighttime difficult.

As MS progresses, nerves aren’t able to communicate as well with one another. Body processes like hormone and neurotransmitter release can be impacted, resulting in many of the above sleep disturbance contributors.

Does Sleep Deprivation Make MS Worse?

In MS patients, sleep problems and symptom severity are tied. Unfortunately, not getting enough sleep can exacerbate MS symptoms. This is particularly true of daytime fatigue, which is very common in MS patients and whose primary causes are believed to be depression and sleep disturbances.

Sleep Tips for People with Multiple Sclerosis

Getting enough sleep is critical to improving symptoms like fatigue, depression, memory difficulties, stress, and more. While getting quality sleep can be a challenge with MS, there are many things that you can do to improve your quantity and quality of sleep.

Relax Before Bed

After a challenging day, it can be hard to turn off our thoughts and worries and fall asleep. Rather than worrying about tomorrow or stressing about what happened today, do what you can to calm your mind and let go of your stress.

Some great options include meditation or breathing exercises. Both of these have been shown to help reduce stress and lessen the amount of time that it takes to fall asleep.

Stop Drinking Before Bedtime

Waking up in the middle of the night because you need to run to the bathroom can be frustrating…particularly if you find falling asleep afterward difficult. If you find yourself running to the bathroom in the middle of the night, you might want to stop drinking for two hours or more before bedtime.

Set a Sleep Schedule

It can be helpful to go to bed at the same time every day. This bedtime routine helps to keep your body’s internal clock, known as its circadian rhythm, functioning properly. Additionally, try to go to sleep when it’s dark out and wake up around sunrise or a little after to avoid future sleep issues.  

Exercise During the Day, But Not at Night

Moderate exercise on a daily basis can help you sleep better while helping your mood and health. One thing to note: exercise shortly before bed can make it harder to fall asleep. Avoid working out three hours or more before bedtime.

Limit Alcohol and Caffeine

Both alcohol and caffeine can disrupt your natural sleep/wake cycle and make getting quality sleep hard to do. If you’re going to have caffeine, try to stop drinking it around midday. As for alcohol, the less the better. Even one or two drinks before bedtime can reduce how much deep sleep you achieve, and it can exacerbate sleep disorders like sleep apnea.

Prepare Your Room for Sleep

In order to sleep soundly throughout the night, there are a few things that you will want to take care of. First, be sure to limit distractions. This might mean having pets sleep outside of your bedroom and turning your phone to airplane mode, so you don’t get interrupted while you sleep.

Next, control the sound and light in your room. If ambient light comes through your windows, use dark curtains or blackout shades to limit it. If you find that noises wake you up at night, try a white noise machine to drown out outside noise.

Limit Light Exposure Before Bedtime

Humans are sensitive to light. When we’re exposed to excess blue light at night, it can throw off our natural sleep/wake cycle, resulting in difficulties falling asleep. Electronics are particularly high in blue light, so try not to watch TV or use your computer or smartphone for an hour or more before bed.


Multiple Sclerosis and sleep can be a challenging combination, but learning how to sleep well when you have MS is incredibly important for your happiness, health, and overall quality of life.

When you find yourself excessively sleepy during the day or struggling to get a good night’s sleep, talk to your doctor. Whether your fatigue is due to sleep troubles or something else, they can help you come up with a plan.


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