Overview: A Framework for the Discussion of Sleep in Multiple Sclerosis

This review will focus on the causes, consequences, workup, and treatment of sleep disordered breathing, insomnia, and restless legs syndrome in patients with MS. An approach to the discussion of sleep problems and associated symptoms with MS patients, to facilitate timely and accurate diagnosis, is emphasized.

Recent research suggests that sleep disordered breathing, insomnia, and restless legs syndrome disproportionately affect patients with MS, and contribute to substantial morbidity in this population.

Sleep disordered breathing, insomnia, and restless legs syndrome are common but frequently under-recognized conditions in patients with MS. Additional efforts are needed to incorporate discussions about sleep into the clinical evaluation of MS patients. Neuroanatomical features, concomitant comorbidities, and medications associated with MS may partially explain the high prevalence of these disorders in MS. Prompt identification and treatment of sleep disorders may reduce fatigue, and a thorough discussion with the MS patient about their sleep will facilitate fatigue management. Research that further characterizes recently identified relationships between sleep disturbances and other chronic symptoms in MS such as pain, depression and cognitive dysfunction could identify new pathways to improve some of the most debilitating symptoms of MS.