Understanding Sleep and MS

Sleep problems are far more common in people with MS than in the general population. Roughly 50–60% report poor sleep quality or daytime sleepiness, and about 20% meet criteria for clinical insomnia (MS Trust, ScienceDirect). Unfortunately, these issues are often under‑diagnosed and under‑treated.

I can definitely relate. Lately, my nights have been more restless than usual—not just from MS, but because our dog, Ghost, is declining. He’s been struggling with breathing issues due to his collapsing airways, which often keep me awake listening to heavy wheezing, coughing, and rapid breathes. It’s heartbreaking, and the stress of it only adds to the challenge of trying to get quality rest (for him as much as me). That combination—MS symptoms, life stresses, and loved ones needing care—can make good sleep feel like an impossible goal.

For many people with MS, disrupted sleep stems from a mix of nerve-related symptoms (pain, spasticity), nocturia (nighttime urination), restless legs syndrome (RLS), anxiety, depression, and even medications (WebMD). But sometimes, as I’m experiencing now, it’s the emotional toll of caregiving or stress that robs you of sleep.

Short and Long-Term Consequences of Sleep Loss in MS

1. Increased fatigue

Fatigue is by far the most common and debilitating MS symptom, affecting 53–90% of patients (PMC). Research shows that sleep disturbance is a significant contributor to fatigue—even when accounting for disease variables and mood disorders.

When Ghost keeps me up most of the night, I can feel it the next day. The fatigue hits harder, not just the regular “MS tired” but that bone-deep exhaustion that makes even simple tasks feel like a marathon.

2. Worsened mood and emotional regulation

Poor sleep is tied to higher rates of depression, anxiety, irritability, and stress—already common in MS (Wikipedia).

For me, those sleepless nights listening to Ghost struggle to breathe add a heavy layer of sadness on top of the irritability that comes from lack of rest. Sleep deprivation makes it much harder to keep a positive outlook, especially when you’re dealing with both MS and the emotional weight of watching a loved one decline.

3. Cognitive decline & reduced mental clarity

Chronic poor sleep in MS is linked to memory and thinking problems, including long-term cognitive decline (MS Society).

I notice this on days after particularly rough nights with Ghost—I’m slower to find words, more forgetful, and less sharp overall. It’s like my brain is wading through fog, and that’s on top of MS-related cognitive issues.

4. Impact on disease progression (risk factor?)

Emerging research even suggests that lack of sleep in adolescence may increase the risk of developing MS later in life, raising risk by around 40% (Medical News Today). While this doesn’t change much for me now, it highlights just how important sleep really is to brain health.

Specific Sleep Disorders in MS

• Restless Legs Syndrome (RLS): People with MS are about six times more likely to develop it, leading to nighttime leg discomfort that disrupts sleep (Verywell Health).

• Insomnia: Up to 66% of people with MS struggle with insomnia (Verywell Health).

• Sleep Apnea: More common in MS, and treating it can significantly improve fatigue (The Neurology Hub).

  
  

I don’t deal with all of these personally, but even without a diagnosis of sleep apnea or RLS, the effect of disrupted nights is very real. Ghost’s condition has given me a crash course in how fragile rest can be.

Finding Better Sleep

• Good sleep hygiene: A regular sleep schedule, limiting caffeine, and creating a calming bedtime routine all help, even if life doesn’t always cooperate.

• Symptom management: Treating pain, spasms, or nocturia can reduce nighttime awakenings.

• CBT‑I (Cognitive Behavioral Therapy for Insomnia): A proven tool for insomnia without the side effects of medications.

• Address emotional stress: For me, that means recognizing the toll Ghost’s decline is taking on my mental health and finding ways to manage that grief and stress alongside my MS.

  
  

In Summary

For people with MS, lack of sleep is more than just a bad night—it amplifies fatigue, worsens mood, clouds thinking, and chips away at quality of life. Add in the emotional strain of caring for a loved one, like I’m experiencing with Ghost, and the impact becomes even greater.

Sleep might not be something we can fully control, especially when life throws challenges our way, but making it a priority is essential for managing MS and protecting both body and mind.