Fiona d’Young, MS Clinical Nurse Specialist at ADHB shares her guide and recorded webinar on MS and Sleep, giving a comprehensive overview of sleep issues and strategies to help.

 

Video Summary

  • Length –  25 minutes
  • What is a healthy sleep
  • Sleep related issues
  • Tips for healthy sleep
  • Sleep dysfunction causes in MS
  • Insomnia management and referrals
  • Alcohol impact on sleep
  • Bladder management and sleep
  • Restless leg syndrome
  • Sleep apnoea
  • Case study

 

Fiona d’Young’s Presentation Slides

Sleep Webinar Slides by Fiona d’Young

Guide to Simplifying the Complexities of Sleep.

A good night’s sleep. It sounds so simple doesn’t it?  I’m just back from a conference in the USA and forgot the hideousness of changing time zones and long-haul flights.  Sleep should probably be given a higher priority in our lives as it impacts on so many other functions: fatigue, mental health, cognitive function to name a few.

Much has been written about sleep and MS but I feel like what we need is some simple guidance and direction for everyday life. (This reference is for those who want something deeply academic. Brass et al Sleep disorders in patients with multiple sclerosis. Sleep Medicine Reviews. 2010:14(2):121-129)

In MS when fatigue, mental health and cognition can already be problematic, poor sleep adds another layer or complication. Up to 70% of people with MS have at least one sleep disorder. Insomnia (maintenance and/or sleep onset issues) effects between 42-58%PwMS and restless legs syndrome effects 19% of PwMS compared to 4% non MSers.

Mental health impacts sleep. The presence of anxiety and or depression will impact sleep often causing early morning waking or difficulties getting to sleep and let’s not forget sleep apnoea.

So there are a few things to consider and assess about your sleep and some very practical steps you can take. Start by completing a simple sleep assessment. This will inform you and your MS Care team of where your sleep issues lie.  Try: Pittsburgh Sleep Quality index or NHS Sleep Questionnaire for adults.

Consider

  • Do you have low mood and signs of anxiety or depression? These will alter your sleep and you should speak to your GP about this- what have you got to lose?
  • Does your bladder wake you at night? Once is ok but anything more you should discuss with your GP or MS team (community advisor/MS nurse/neuro). For many PwMS a bladder assessment can improve not only bladder function but sleep too.
  • Do you have restless legs? Talk to your team.
  • Do you have neuropathic/nerve pain – often more noticeable at bedtime when the noise of the day is less and we’re more in tune with our bodies. If so please discuss this, as treatments available and this again can improve sleep.
  • Do you have signs of sleep apnoea? StopBang questionnaire sleep apnoea assessments are no longer a hassle with sleep clinic attendance required. Your sleep can be monitored from home and in the event you do need treatment CPAP machines are smaller, way more comfortable and no longer make you sound like Darth Vader.

Practical things you can do.

  • Create a sleep habit diary (fortnight) there are lots online to download
  • Discuss melatonin with your GP or MS team. This is a natural medicine. Cannabis products also deserve a mention here – there are many private providers and some preparations are linked to improved sleep.
  • sleepcalculator.com is a great tool if you know when you need to wake/or get to sleep by as it calculates your REM sleep and when you should set your alarm for the most refreshing sleep
  • Do a sleep hygiene check list (see below)
  • Have a listen to Dr Matthew Walker’s TED talk/podcast or read his book ‘Why we sleep’. His interview with Joe Rogan is excellent. The Joe Rogan Experience Episode #1109 on Spotify
  • We have an NZ expert Bernice Tuffery https://www.sleephaven.co.nz
  • The late great Michael Mosley has written a book Fast Asleep, there’s an audio book, 4 weeks to better sleep as well as a sleep series https://www.bbc.co.uk that’s free online.

Good Sleep Hygiene

Maintain a regular bedtime and awakening time schedule including weekends. Get up about the same time every day, regardless of what time you fell asleep.
Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime many include a warm bath or shower, aroma therapy, reading, or listening to soothing music.
Sleep in a room that is dark, quiet, comfortable, and cool; sleep on comfortable mattress and pillows.
Use your bedroom only for sleep and sex. Have work materials, computers, and TVs in another room.
Finish eating at least 2-3 hours prior to your regular bedtime.
Avoid caffeine within 6 hours; alcohol & smoking within 2 hours of bedtime.
Exercise regularly; finish a few hours before bedtime.
Go to bed only when sleepy. Lay in bed only for sleeping, not for work or watching TV.
Avoid naps
Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime.
After 10-15 minutes of not being able to get to sleep, go to another room to read or watch TV until sleepy.

This webinar series is made possible thanks to our friends at Care on Call

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Sleep Webinar Slides by Fiona d’Young
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