What is Insomnia?
This is really easy to explain; Insomnia is the inability to sleep. In Multiple Sclerosis, though many patients experience insomnia, this is usually not a direct result of the disease itself but instead the result of a secondary factor such as spasticity, muscle spasms/jerks (A form of Myoclonus), stress, depression, or the need to use the restroom. Tight muscles (spasticity) can be painful and keep you awake or maybe you can fall asleep but keep waking up because your legs or arms will jerk and cause you to jump awake. Hopefully, after laying there staring at the ceiling till 4am, you will finally become so tired you can manage to doze off, if your lucky that is.
How to Treat Insomnia
Sleep is important to everyone but for those of us with MS sleep is a vital part of maintaining our health. Poor sleep can cause symptoms to flare which can lead to accidents, which lead once again to a larger flare, a vicious circle that is hard to brake out of, here are some remedies for insomnia.
1) Create a habit. Go to bed at the same time every night to help train your body.
Take Melatonin every night at the same time before bed. Melatonin is a natural supplement produced by your body when it believes it is time to go to sleep. Melatonin does not induce sleep, it just tells your body it’s time to start shutting down by setting your internal clock. Do this for about 2 weeks.
2) Avoid lights about an hour before bed, this means no computers or cell phones! Light INHIBITS the body’s production of melatonin which means your body will not start shutting down for the night.
No games or anything that keeps your brain interacting/thinking. You need it to relax not think! For people with insomnia, this even means no reading before bed!
3) No caffeine! This should go without saying but make sure you don’t have things like coffee, soda, or certain teas before or around your bedtime. How long should you avoid drinking caffeine before bed you ask? Well everyone is different, some people can drink it right before bed and some people can’t have it after noon or else they can’t sleep so you kind of have to figure it out, the earlier you cut it off the better if you ask me!
4) Avoid alcohol and nicotine in the evening.
[I have an app on my phone called “Calm Radio” (also available on your computer) and it offers many different stations to listen to to help you sleep. It’s intended for people with tinnitus (ringing in the ears) so they are really good at what they produce. I listen to solo piano but you can listen to all sorts of classical music, the sounds of nature, or even the humming of an A/C! All you do is set the timer for however long you think it will take you to fall asleep and then you just relax! You can also use it as an alarm to slowly wake up to something peaceful, I love it!]
If you still can’t make sleeping a habit again talk to your doctor about medication. Typically they will prescribe a benzodiazepine which works my reducing/slowing the electrical signals in the brain. These should only be taken as needed because they are definitely habit forming and do loose their kick after a while so the less you use them the longer they will keep that kick you need for those really bad nights.
Some common medication for insomnia may include (but are not limited to):
- Ambien (zolpidem)
- Lunesta (eszopiclone)
- Rozerem (ramelteon)
- Sonata (zaleplon)
- Silenor (doxepine)
- Halcion (Triazolam)
- Restoril (Temazepam)
- Klonopin (clonazepam)
- Xanax (alprazolam)
Over The Counter (OTC)
- Diphenhydramine (Benadryl, Zzzquil, Allermax, Dytuss, Q-Dryl, Siladryl, Theraflu Thin Strips Multi-symptom Triaminic Thin Strips Allergy, Unisom Sleepgels Maximum Strength, Valu-Dryl, etc)
- Tylenol PM
I used to get insomnia all the time, it just came and went even when the previous day I was dealing with horrible fatigue. For me setting a schedule and avoiding light really did the trick. I have to have white noise to sleep though or else my mind keeps ticking all night. That is where Calm Radio comes into play. Sometimes I have really bad nights and have to use medication but I really try not to take anything because I don’t want to need a pill to fall asleep every night. I take Restoril (Temazepam) and that usually knocks me out in about – well, I don’t know, must be fast if I can’t remember haha! My OTC medication of choice is Diphenhydramine but don’t waste you money on a name brands like Zzzquil, generic medication is the same exact thing but way cheaper!
But seriously, I can not stress this enough, you have to have a “getting ready for bed” time every night, a routine. I turn off my computer about an hour before bed, dim the lights, take my shower, and lay down nice and relaxed. I then flip on Calm Radio, take my Baclofen to prevent twitching at night, shut off the lights, and close my eyes. I can’t just jump from working on the computer into bed no matter how tired my body is because my brain will just stay wide awake!