Link Between Multiple Sclerosis and Sleep Problems—Plus, How to Sleep Better

MS and Sleep

Nearly 60% of people with multiple sclerosis (MS) face challenges with sleep, such as difficulty falling asleep, staying asleep, returning to sleep, or getting enough sleep (insomnia). These sleep problems may be due to the direct effects of the condition or a result of problems like fatigue or depression. But there are things you can do to overcome them.

Learn more about the link between MS and sleep and how to sleep better with MS.

Woman sleeping in bed at home

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Common Types of Sleep Disturbances in MS Patients

Sleep disturbances interfere with sleeping well and are caused by sleep disorders and lifestyle habits. Sleep disorders are medical conditions related to difficulties getting enough sleep, sleeping well, being able to sleep when needed, and being rested enough to function during the day.

MS patients face unique challenges when it comes to sleep due to:

The Effect of Mental Health on Sleep

People with MS may face mental health challenges such as anxiety, depression, or pseudobulbar affect, or PBA. This is a medical condition that involves a loss of control of emotions, including extreme laughing or crying. Mental health challenges can make it harder to sleep or sleep well.

Is MS Worse at Night?

Some people with MS experience worse symptoms at night. Muscle tightness called spasticity is a symptom of MS that can get worse at night because the muscles are not as active as in the daytime. This can make it harder to fall asleep and can interfere with sleep quality.

Solutions for MS Sleep Problems

The solutions to sleep problems depend on the cause, which is true for everyone, but there are special considerations for people with MS.

For example, people who do not exercise or move enough during the day are more likely to have trouble sleeping, so increasing activity and exercise can improve sleep. Up to 90% of people with MS experience debilitating fatigue, making it harder to be active.

Habits to Avoid

Many daily habits can help or interfere with sleep. Paying close attention to these habits is critical for people with MS to manage sleep-related symptoms.

Here are some habits to avoid for better sleep:

  • Drinking caffeine or alcohol or eating chocolate, especially later in the day
  • Eating or drinking too much close to bedtime
  • Exercising later in the day
  • Using electronics or screens before going to bed

Here are some tips to follow for better sleep:

  • Create a bedtime ritual.
  • Dim the lights before bed.
  • Do something physically active early in the day.
  • Keep a regular sleep schedule.

Sleep Positions to Try

There is no perfect sleep position that works for everyone. However, it helps to be comfortable and ensure that your spine is aligned, which tends to coincide with sleeping on your side or back.

For people with MS, getting comfortable at night may be more challenging due to symptoms such as pain and spasticity. Even so, finding a good position and sleeping well is possible. For example, lying in positions that reduce spasticity and using pillows for support can help.

Healthcare professionals can help you find the most comfortable sleep position for you. Reach out to a member of your healthcare team for support.

Sleep Positions for MS

Here are some sleep position options for people with MS:

  • Lying on your left side if you have digestive challenges with MS
  • Sleeping on your side or back to keep your spine aligned
  • Trying stomach- or side-sleeping positions if you have sleep apnea (breathing that stops and starts throughout the night) with MS
  • Using pillows to provide support for problems of spasticity

When to See Your Healthcare Provider

It is important to see a healthcare provider when sleep problems last longer than a few weeks or interfere with daily life. Seek care immediately if there are any signs of sleep apnea or difficulty breathing during sleep. This condition can lead to heart problems and even death; some people do not know they have it.

Sleep Apnea

Obstructive sleep apnea is a serious sleep disorder that involves difficulty breathing while sleeping. Signs of sleep apnea include:

  • Snoring
  • Not feeling rested in the morning
  • Coughing or gasping for air during sleep
  • Waking with a dry mouth in the morning
  • Breathing pauses during sleep
  • Having headaches in the morning


Medical professionals, like neurologists, who treat multiple sclerosis can help with MS symptoms that interfere with sleep. Pulmonologists specializing in and breathing-related problems and sleep medicine can help with sleep disorders.

Summary

Sleep problems are common among people with MS. Not getting enough sleep can worsen MS symptoms and interfere with daily life. People with MS can sleep better by seeking treatment for symptoms that make it hard to sleep well, finding a comfortable sleeping position, and consulting with a healthcare provider about possible sleep disorders.

A Word From Verywell

Living with MS and having sleep problems can be challenging and overwhelming, especially when one condition makes the other worse. If you or someone you know has MS with sleep problems, know that help is available. Reach out to a healthcare provider for support. It is possible to sleep well with MS and live a happy, fulfilled life.

Frequently Asked Questions

  • Is there evidence to support the use of weighted blankets for MS symptoms?

    Weighted blankets may have a calming effect or relieve symptoms such as pain to help people fall asleep. However, there is currently insufficient scientific evidence to support using weighted blankets for MS symptoms.

  • Is melatonin safe for MS patients?

    There is currently no research available for MS and melatonin use or dose information. Anyone with MS considering melatonin supplements should talk with their healthcare team first.

  • What’s a good bedroom temperature for promoting MS sleep?

    Colder temperatures are generally better for sleep. However, people with MS may be sensitive to colder temperatures. A good bedroom temperature to promote sleep for people with MS may be a little on the cooler side, as long as it's still comfortable.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Encyclopedia of Clinical Neuropsychology. Sleep disturbance.

  3. American Psychiatric Association. What are sleep disorders?

  4. Multiple Sclerosis Association of America. Sleep issues.

  5. Johns Hopkins Medicine. Multiple sclerosis and mental health: 3 common challenges.

  6. American Psychological Association. Pseudobulbar affect (PBA).

  7. Sleep Foundation. Mental health and sleep.

  8. Overcoming Multiple Sclerosis. Why is MS spasticity worse at night?

  9. Passos GS, Poyares DLR, Santana MG, Tufik S, de Mello MT. Is exercise an alternative treatment for chronic insomniaClinics (Sao Paulo). 2012;67(6):653-659. doi:10.6061/clinics/2012(06)17

  10. Strober LB. Fatigue in multiple sclerosis: a look at the role of poor sleepFront Neurol. 2015;0. doi:10.3389/fneur.2015.00021

  11. National Multiple Sclerosis Society. Sleep.

  12. Sleep Foundation. Best sleeping positions.

  13. National Health Service. Positioning for managing spasticity.

  14. Johns Hopkins Medicine. The dangers of uncontrolled sleep apnea.

  15. Sleep Foundation: Sleep apnea.

By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.