When it comes to keeping healthy, medical experts always talk about diet and exercise. They don’t talk about sleep, but in my experience, sleep has been among the best medicines. When I sleep well, I don’t get sick as often, I think better, and I have more energy. Studies confirm that insomnia (difficulty sleeping) is a big problem for people with multiple sclerosis (MS) and is closely connected with one of the worst symptoms, fatigue.
I’ve written about sleep frequently for diabetes publications, because poor sleep worsens blood sugar control. I find a night of poor sleep leaves me a little depressed and anxious, which studies show is a common pattern in people with MS.
They say MS is caused by our immune systems, and sleep is vital for good immune function. Sleep is when the immune system can get to work without all the demands of waking life. People with insomnia have higher levels of inflammatory immune system proteins such as tumor necrosis factor, and inflammation is a major part of MS. So most of us can benefit from more sleep.
The problem is that MS can interfere with sleep, because we tend not to move as much while awake as healthy people. So our bodies don’t get tired, even if our brains do. And if your body isn’t tired, it won’t sleep (unless you’re drugged). Other MS symptoms, such as pain, muscle spasms, and bladder issues, also can interfere with sleep.
When we go to bed and can’t sleep, or wake up for whatever reason, lying there thinking or tossing and turning won’t help. If you’re coming up with great ideas more important than sleep, write them down so you don’t forget them! (That happens to me sometimes.)
But if you really want to get to sleep, give it no more than 15 or 20 minutes. If you’re still awake, get up and do something useful or stay in bed and do something really boring. Nothing puts me to sleep faster than reading a boring book or doing a stupid puzzle, but washing dishes or doing gentle exercises seems to lead to better rest.
Vigorous exercise before bed can keep some people from sleeping, but then vigorous exercise is not really a thing for many people with MS. Gentle exercise – I do seated qi gong or very light (2 lb.) weight upper-arm exercises – really helps me relax and fall asleep. Sitting at a computer scrolling through social media makes it harder.
Sleep experts talk about having a bedtime ritual, which means a regular pattern of behavior that tells your body, “time to unwind.” Often this includes turning lights down low, remembering good things that happened that day, making a list of what you’ll do tomorrow, some gentle stretching, maybe drinking some herbal tea, warm milk, listening to peaceful music or relaxation sounds, or eating a snack. (No caffeine!)
I find it helpful to remember my loved ones and give thanks for what I’ve been given. If possible, resolve any small issues, like a misunderstanding with a spouse that might keep you up worrying. Like the marriage counselors say, don’t go to bed angry.
It’s important to have a quiet, dark, comfortable place to sleep. Not everyone has that, unfortunately, but if you can create such a space, you will almost certainly sleep better and feel better.
It helps to have a sleep schedule. I used to work night shift as a nurse, and I sometimes wonder if that contributed to my MS. Some studies have shown shift work can affect many people’s immune systems. Now I try to get into a sleep pattern, going to bed at the same time, turning off the light after 30 or 60 minutes of reading. I try to get outside every day, especially on sunny days, because daytime sun helps people sleep.
That schedule has been working really well, except I have to get up to urinate (actually self-cath) once a night. Then I lie down again, but if sleep doesn’t come rapidly (within 5 minutes) I get up and stretch, write, or wash dishes.
What about naps? Nap time is a ritual in many cultures, and for people with MS, napping may be unavoidable. Short naps (so-called power naps) are great, and you may even be able do them on a lunch break at work. I like longer naps, too, but some scientists say long naps can interfere with nighttime sleep. I haven’t noticed that problem, but maybe you can see how they work for you.
I advise not using sleep medicines. They aren’t being prescribed much anymore, because they can leave people as tired as if they had not slept, and they’re not safe. Especially for older people with MS, they cause too much risk of falling when we get up while still under their influence. This applies to cannabis as well as to prescription drugs.
At this point in my life, sleep has become one of my favorite things. No stress, no pain. I imagine all my little cells streaming around repairing damage and getting my body ready for the next day. And I look forward to dreams, like trips to another world or to a great movie. Sometimes in dreams, I have all my abilities back, sometimes not, but they’re always interesting and often teach important lessons.
We live in an anti-sleep society, where we’re supposed to be productive all the time. But don’t believe that hype. Sleep is great medicine.
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