A night sky beside the morning sun symbolises insomnia and fatigue.

Insomnia and Fatigue, a Dueling Battle

"You sleep like a vampire; we have to reset your sleep schedule!" My husband says this to me all the time. Most nights (well, mornings), I am now going to sleep at 4 am – causing me to be exhausted for most of the day. Then once the sun goes down, I'm full of energy. I can clean my whole house at 1 am and not be tired at all. I thought I was crazy until I learned this is related to my MS.

MS insomnia versus fatigue

I thought I had a weird sleeping schedule. I didn't realize what I was experiencing was insomnia. Insomnia is one of the most common symptoms of MS. Trying to get proper sleep while having chronic fatigue is very difficult. Many different factors can hinder a good night's sleep. Some of the causes of insomnia can be "pain, discomfort, sleep disorders, frequent nighttime urination, and other factors can all contribute."1 In my case, my circadian rhythm is off. I have low melatonin production levels, which "affect the body's natural sleep-wake cycle and can lead to insomnia, daytime sleepiness, or both."1

What can I do about my insomnia and fatigue?

There are many available options to try to combat sleep disorders. Here are a few you can try.

  • Maintain a sleep schedule: Set alarms for the morning to wake up early daily, including weekends. I know this sounds a bit drastic, but this can be a big help. Get up even if you are tired; this will make going to sleep at night easier.
  • Avoid napping: This is very hard to do. I understand the urge to sleep when exhausted. We all need rest, that is true. But cutting out naps help to make sleep at night easier. If you do need a nap, make it quick – 20 minutes maximum.
  • Avoid stimulants: Avoid caffeine, alcohol, and nicotine before bedtime. I stop drinking all beverages at least two hours before bed to avoid excessive trips to the bathroom. I've made the mistake of drinking too much before bed, then ended up in the bathroom every two hours.
  • Avoid electronics: Try your best to stop using electronic devices and watching tv at least an hour before bed.
  • Don't lie awake: If you notice you are not falling asleep after 20 minutes. Get up and do any activity that will relax your mind. Once you feel tired again, go back to bed.
  • Speak to your doctor: Sometimes, doctors can prescribe mediation to help. I do not use any medication but I do take 10mg of melatonin daily. I consulted with my doctor beforehand.
  • Maintain bedroom aesthetic: Keep your bedroom at a suitable temperature for you. Follow the goldilocks method, not too hot or not too cold. Find the temperature that is just right! Also, make your bedroom cozy and comfortable. This can aid in sleep.

Not getting enough sleep can only exaggerate preexisting conditions. Some chronic illness symptoms can lead to insomnia and sleep issues. Making use of these strategies can provide some relief. If not, consult your MS specialist. You may be able to come up with a better solution.

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