Although multiple sclerosis (MS) is linked to sleep problems such as insomnia, we still don’t fully understand the psychological influences that appear to make us more likely to struggle with sleep when we are living with MS. This prompted researchers to investigate how our minds and our behaviors may be influencing the development and maintenance of insomnia when present alongside MS. Their findings were published in the journal Sleep in 2018.
How big of a problem is insomnia with MS?
The authors of the study pointed out that as many as one in four people living with MS meet the criteria for insomnia — and this prevalence rate is up to three times higher compared to the general population. Despite this, insomnia still remains underdiagnosed and, therefore, undertreated and this can lead to a number of negative outcomes including higher pain sensitivity and fatigue.
The link between MS and insomnia
Researchers recruited 83 individuals for the study:
- 26 had insomnia with MS
- 26 had insomnia without MS
- 31 had MS without insomnia
Participants filled out the following surveys to assess the quality of their sleep:
- Insomnia Severity Index (designed to assess insomnia severity and the distress caused by insomnia)
- Dysfunctional Beliefs and Attitudes about Sleep (designed to assess the negative thoughts associated with insomnia)
- Sleep-Related Behaviors Questionnaire (designed to identify behaviors that can harm sleep)
- Pre-sleep Arousal Scale (designed to assess pre-sleep arousal that can make sleep more difficult)
Levels of depression and anxiety were also measured using the Beck Depression Inventory and Spielberger Trait Anxiety Inventory, respectively. Finally, those with MS also completed the Fatigue Impact Scale to measure levels of fatigue and those who reported pain were asked to describe its impact on their sleep.
What did the study reveal?
The study found that the psychological influences of insomnia were no different between those with MS and those without MS. In other words, the intensity of emotional, behavioral, and thought-related processes was generally the same among those with insomnia regardless of whether they had MS.
This finding led the authors of the study to suggest that insomnia should be seen as a problem that needs to be addressed on its own terms, rather than as a symptom of MS that can be tackled by treating MS.
Perhaps unsurprisingly, the study also found that insomniacs with MS reported that pain had a negative impact on their sleep. Individuals with MS and insomnia were also found to have higher levels of depressive symptoms and anxiety symptoms compared to MS sufferers without insomnia. This further emphasizes the importance of seeking treatment for sleep-related issues.
How to improve sleep with MS
As pointed out by the authors of this study, cognitive behavioral therapy for insomnia (CBT-I) can help improve sleep in those with MS. This makes sense when we consider that this study found the psychological issues associated with insomnia were largely the same regardless of the presence of MS.
CBT-I helps improve sleep by tackling the root causes of most sleep issues. These tend to be incorrect, inaccurate, or inappropriate sleep-related thoughts and behaviors, including:
- Obsessing about sleep
- Napping during the day
- Spending too much time in bed
- Thinking that we need eight hours of sleep
- Skipping work or social commitments after a bad night of sleep
- Using the bed and the bedroom for activities other than sleep and sex
Don’t ignore your struggles with sleep or think of your sleep problems as a symptom of MS that can’t be treated. Insomnia can be successfully treated, even when present alongside other conditions such as MS. Talk to your doctor about CBT-I to determine whether it could be a suitable treatment option for you.
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