Fatigued by MS? It Could Be Sleep Apnea

Study suggests treating sleep disorders could help relieve fatigue in multiple sclerosis

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Almost everyone who has multiple sclerosis (MS) battles with a crushing sense of fatigue. Arms and legs can feel heavy, and it can be difficult to carry on a conversation or even think straight. Only a few medications seem to help, but one small study suggests that treating a common sleep disorder—called sleep apnea—could be the answer.

Feeling sleepy?

Researchers from the University of Michigan looked at the relationship between sleep disorders and fatigue in people with MS. For the study, 195 people with MS completed a sleep questionnaire and were evaluated for daytime sleepiness, insomnia, fatigue severity and sleep apnea. Obstructive sleep apnea, the most common type, occurs when the muscles inside the throat relax and the airway temporarily becomes blocked, causing a brief pause in breathing.

In the study, 20 percent of people with MS had an official diagnosis of sleep apnea, and over half were at high risk for it. The risk of obstructive sleep apnea was based on a "STOP-Bang" screening, which assesses snoring, tiredness, observed gasping while asleep, high blood pressure, body mass index (over 35), age (over 50), neck size (larger is worse) and gender (men are more prone to sleep apnea).

The researchers concluded in the Journal of Clinical Sleep Medicine that sleep apnea seems to be a common but under-recognized part of the fatigue problem. The results suggest that a good portion of MS-related fatigue could be reduced by finding and treating sleep apnea.

The problem—aside from feeling exhausted for days or weeks on end—is that sleep apnea is known to have a huge impact on your health and quality of life. It can drive your partner to sleeping in the other room, for a start. Worse, it can also lead to attention problems, high blood pressure and a higher risk of heart disease. And one mouse study hinted that sleep deprivation may even cause lasting brain damage.

Fighting fatigue

If fatigue is getting in your way, talk with your doctor about whether you may be at risk for sleep apnea. Your doc may refer you to a sleep medicine specialist for a comprehensive sleep evaluation. While some people may need to spend the night at a sleep clinic, it may be possible for you to take the sleep test in your own bed at home. If you have sleep apnea, the solution could be as simple as sleeping with a special mouthpiece or a breathing device called a CPAP machine to keep your airway open as you get some much-needed rest.

Keep in mind, other MS-related problems can also bring on tiredness, such as depression or bladder problems that keep you up at night. And doctors don't fully understand why, but many people with MS still feel fatigued even without one of these problems. It's thought that changes in the brain, hormone production or chemicals in the muscles could play a role. Or, your fatigue could be part of completely unrelated problem, such as thyroid disease or anemia. Talk with your doctor to find out for sure and learn what can be done about it.

You can also try these sleepy-time tips:

  • Avoid caffeine. It might give you a little boost during the day, but the quick fix has its price.
  • Power down your laptop or TV well before bedtime.
  • Hit the hay before 10 p.m. to get the best night's sleep.
  • Get a handle on stress and anxiety through diet, exercise and meditation.

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