Getting a good night sleep is challenging for everyone, but many patients with neurologic disorders will find it even more of a struggle. Sleep disturbances affect about 60 percent of people with multiple sclerosis (MS), about 70 percent of people with Alzheimer’s Disease (AD), up to 90 percent of people with Parkinson’s disease (PD), and about 70 percent of people with migraines. This is compared with closer to 10 percent in the general population.
There are multiple reasons why neurologic patients suffer from more sleep disturbances than the general population. First of all, there may be damage or disruption of brain regions that control the sleep-wake cycle (such as the hypothalamus, brainstem or basal ganglia). Disorders like PD are characterized by changes in the chemicals in the brain (like serotonin, melatonin and dopamine) which regulate sleep. Neurologic patients are also at greater risk for conditions associated with sleep disorders, such as restless leg syndrome, sleep apnea and REM sleep behavior disorder). Additionally the anxiety and depression associated with or caused by neurologic disorders can worsen sleep function. Also, increased nocturnal urination, pain, seizures and tremors may interrupt sleep. Finally, the drugs often used in neurologic disorders (antidepressants, dopaminergic meds, anticonvulsants and steroids) can disrupt sleep.
The downside of not addressing sleep disturbances include worsened fatigue, cognition, walking ability and mental health.
Some tips for managing sleep disturbances in neurologic patients include:
- Seek out a formal diagnosis at a sleep center. The different causes may require different solutions. For example, sleep apnea is treated very differently than medication effect.
- Exercise even if you are tired (but not too close to bedtime)
- Establish a healthy sleep routine. Try to fall asleep and wake up at the same time each day
- Avoid devices like phones, computers and TV at least an hour before bedtime.
- Do not stay in bed to read or watch TV. You need to condition your mind that getting into bed is a signal to go to sleep. If you have not fallen asleep within 15 minutes of getting in bed, get out of bed and try again when you feel sleepier.
- Talk to your physician about if any of the medications you take or their timing might be a problem.
- Talk to your physician about supplements or other medications that may help.
- Avoid alcohol, a big meal or caffeine after around 6 pm.
- Be attentive to any bladder issues-if you are getting out of bed 5 times at night to urinate, go to the appropriate specialist for evaluation
- Keep a sleep journal to track your sleep.
BeCare Link can help you navigate your neurologic health journey by monitoring your neurologic function, your mood and your lifestyle. Become empowered and be a driver in your own health care.