What is Insomnia?
This is really easy to explain;
Insomnia is the inability to sleep. In MS, 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, 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 (spasms) and cause you to jump awake. Of course you might
slowly wake up a few times a night to go to the bathroom or after the stress of not being able to fall or
stay asleep finally overwhelms you, you might be awake staring at the ceiling at 3am due to the stress of not being able to sleep more than anything else.
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.
- 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.
- 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!
- 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 bed time. 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!
- Avoid alcohol and nicotine in the evening.
- Try playing some kind of music or white noise as you fall asleep. This can even be the faint hum of a fan to give you something to focus on rather then listening to your thoughts go on and on all night. This helps some people but others do not like it. I don't recommend anything with vocals or else you will be thinking about the lyrics!
- TV before bed is not a good idea because of the light but what I do is cover the screen so all I can do is listen to the TV and then I put the timer on so that the TV turns off after I fall asleep.
Medication:
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 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)
Benzodiazepines
- Halcion (Triazolam)
- Restoril (Temazepam)
- Klonopin (clonazepam)
- Xanax (alprazolam)
Over The Counter (OTC)
- Diphenhydramine (Benadryl, Zzzquil, Allermax, Dytuss, Q-Dryl, Siladryl, Theraflu Thin Strips Multisymptom Triaminic Thin Strips Allergy, Unisom Sleepgels Maximum Strength, Valu-Dryl, etc)
- Tylenol PM
- Unisom
My Experience
I get insomnia
all the time, it just comes and goes 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. I cover my TV screen, set it to the History Channel, set the timer for about an hour an a half, and listen to some educational facts until I drift away. 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!
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 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!
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Dr. Bailey went over all the main therapies and asked who was on which ones by show of hands. Of course most the people there were on Copaxone (since this was a Shared Solutions event) and I was the only one in the room on Tysabri (haha). He went over other medications from Solu-Medrol to Baclofen for relapse treatment and symptom control.
