Are bladder control issues making it difficult to take on your everyday life with confidence? MS bladder control is possible! Read a physical therapist's recommended treatments and exercises for your bladder symptoms here.
Does it feel like you just cannot get a good night’s sleep no matter how hard you try?
Sleep is an essential part of living a quality life, but trouble sleeping makes it hard to take on each day with a refreshed mind and body. Unfortunately, MS symptoms can make it even more difficult to both fall and stay asleep, but there are solutions to help.
Today, I want to talk about what exactly is causing your MS symptoms to become worse at night, and more importantly, tips to help manage this discomfort. While your body is unique, hopefully, a combination of these techniques will help you rest with more ease.
What Causes My MS Symptoms To Worsen At Night?
The body's internal clock, called circadian rhythms, plays a big role in impacting MS symptoms at night. These rhythms regulate sleep, hormone levels, and body temperature. As the day progresses and distractions fade, you might feel more pain and muscle tightness, making it hard to relax in bed. Sensory issues, like tingling, can also feel stronger when there are fewer distractions.
Also, lower nighttime cortisol levels can increase pain perception. Muscle inactivity during sleep can lead to stiffness and spasms, while cooler nighttime temperatures can worsen muscle tightness. Additionally, frequent nighttime urination and sleep disorders can make symptoms feel more apparent at night
These changes (either separately or together) can make it harder to relax and sleep well. The first step in helping yourself sleep better is taking the time to see which patterns are occurring.
Ask yourself: Which MS symptoms am I feeling the most in the evening? From there, you can begin to get to the crux of the issue.
Here are some of the most common MS symptoms that my clients and I have worked through for a better night’s sleep:
Common MS Symptoms That Are Worse At Night:
- Fatigue
- Pain and discomfort
- Muscle spasms and spasticity (or muscle tightness)
- Bladder problems
- Sensory disturbances (e.g., tingling, numbness)
- Sleep disturbances
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Fatigue
I know what you’re thinking: “Isn’t fatigue great for bedtime”? Yes, but only if your body is tired when it’s actually time to go to sleep.
During the earlier parts of your day, you may be able to push through your fatigue because of distractions and activities. However, as the day goes on and you become more tired, the fatigue can hit you harder in the later afternoon when it’s still not quite time to go to bed.
This can make it difficult during the proper time to rest to fall asleep and stay asleep, leading to a cycle of poor rest and increased fatigue.
If fatigue is making you tired before it’s officially time for bed, here’s what to try:
- Prioritize Rest: Take short naps during the day if needed, but avoid long naps that could interfere with nighttime sleep. 15-30 minutes is the ideal time for a quick recharge.
- Manage Your Energy: Plan your day to include periods of rest and avoid overexertion.
- Stay Active: Gentle exercise can help improve energy levels, but be careful not to overdo it.
Pain and Discomfort
Many people with MS experience pain and discomfort, but unfortunately these symptoms can be worse at night. This can include nerve pain, muscle pain, and joint pain. At night, when you’re trying to relax and sleep, you may be more aware of these sensations. The body’s natural circadian rhythms, which regulate sleep and other bodily functions, can also make pain feel more intense at night.
Feeling pain or discomfort? Here’s what to try:
- Pain Management: Talk to your doctor about pain management options, such as medication or physical therapy dedicated to helping aid in rest.
- Relaxation Techniques: Practice relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation before bed.
- Comfortable Sleeping Environment: Ensure your mattress and pillows provide adequate support and comfort.
Muscle Spasms and Spasticity
Muscle spasms and spasticity, or the feeling of tightness and stiffness in the muscles, can be particularly bothersome at night. These symptoms can make it hard to get comfortable in bed and can wake you up during the night. Spasticity tends to be worse when you’re lying still for a long time, which is why it can be more noticeable at night.
If muscle spasms and spasticity are making sleep difficult, here’s what to try:
- Stretching Exercises: Perform gentle stretching exercises before bed to help relax your muscles. Try holding the stretches for at least 30 seconds and make sure to stretch the specific muscle(s) that feels tight.
- Warm Bath: Taking a warm bath before bed can help reduce muscle tension.
Bladder Problems
Bladder problems are another common issue for people with MS, and they can be especially difficult at night. Frequent urination, urgency, and incontinence can all disrupt your sleep. If you’re getting up multiple times during the night to use the bathroom, it can be hard to get a good night’s sleep.
Are bladder issues making it difficult to fall or stay asleep? Here’s what to try:
- Limit Fluids: Try to limit fluid intake in the evening and avoid caffeine and alcohol, which can irritate the bladder.
- Bathroom Routine: Use the bathroom right before bed to reduce the chances of needing to get up during the night.
- Medications: Talk to your doctor about medications that can help manage bladder symptoms.
To see a post completed dedicated to MS bladder control tips read - MS Bladder Control: Treatments & Exercises for Bladder Symptoms.
Sensory Disturbances
Sensory disturbances, such as tingling, numbness, and itching, are also common in people with MS. These sensations can be annoying and uncomfortable, especially when you’re trying to fall asleep. Like pain, sensory disturbances can feel more intense at night when you’re not distracted by other activities.
If sensory disturbances are making you uncomfortable, here’s what to try:
- Cooling Techniques: Sometimes cooling the affected area can help relieve tingling and itching. Try using a cool compress or an ice pack.
- Topical Treatments: Over-the-counter creams and ointments designed for nerve pain may provide some relief.
- Mindfulness: Practicing mindfulness or meditation can help distract you from these sensations.
If you’re looking for more in-depth information on how to work through sensory disturbances, read my post - MS Pain Management - for additional information.
Overall Sleep Disturbances
All of these symptoms can lead to sleep disturbances. Difficulty falling asleep, waking up frequently, and poor sleep quality can all be the result of MS symptoms. Sleep disturbances can, in turn, make other MS symptoms worse, creating a vicious cycle that can be hard to break.
If you can’t pinpoint exactly why sleep is difficult, but it is, here’s what to try:
- Create a Sleep-Friendly Environment: Make sure your bedroom is cool, quiet, and dark. Use comfortable bedding and consider using a white noise machine if you’re easily disturbed by sounds.
- Stick to a Routine: Go to bed and wake up at the same time every day, even on weekends. This can help regulate your body’s internal clock and improve your sleep quality.
- Practice Good Sleep Hygiene: Avoid caffeine and heavy meals close to bedtime. Create a relaxing bedtime routine, such as taking a warm bath or reading a book, to help you unwind before bed.
MS Symptoms Should Not Interfere With Nightly Rest
Night-time can be a challenging time for people with MS, but there are strategies you can use to manage your symptoms and improve your sleep. By understanding why your symptoms are worse at night and taking steps to address them, you can improve your quality of life and get the rest your body needs.
If you're looking to receive a wealth of information from me (plus many other MS specialists!) read my book: The MSing Link. This guide is specifically meant to make the symptoms of MS feel more manageable, allowing you to take back control and live life to the fullest.
Do you have any further questions on how to help your MS symptoms at night? Please let me know in the comments or DM me on Instagram @doctor.gretchen.