b'3. Depression and anxiety: These psychologicallikelyadifferenceinperceptionofsleep conditionsarecommoninMSandcanquality compared to objective measures of contribute to sleep disturbances.sleep efficiency. 4. Spasticity: Muscle stiffness and spasticityInterferoncan make it difficult to nding a comfortableInterferon beta can sleeping position.affect sleep continuity 5. Medications: Some medications used toor cause frequent awakenings while sleeping, manage MS symptoms can affect your sleepespecially during the beginning phases of patterns,resultingindisruptionof yourtreatment. More research is needed to determine sleep cycle.the exact cause of this effect, but it is believed Disease-modifying therapies and sleep to be related to an increased production of Disease-modifying therapies can helpinterleukin-6. Smaller trials have shown that to prevent MS relapses and delay disabilityinterferon beta can increase restlessness and worsening. Certain disease-modifying therapiescause difficulty in awakening for patients. In have been reported to worsen sleep, whilecontrast, some studies showed interferon beta other medications taken by MS patients havemayimprovesleepquality. Thisvariation been reported to help improve sleep. Still, therecan be explained by differences in the type is some research reporting disease-modifyingor severity of MS for patients enrolled in the therapies do not affect sleep. There is conictingtrials, medications used in conjunction with research on this topic, but we will highlightinterferon,administrationtimes,andthe several medications that have been widelytypes of assessments used to measure sleep researched with respect to their effect on sleep.(e.g., objective measures versus self-reported Steroids questionnaires). Some studies have shown improved sleep Methylprednisolone is aefficacy and reduced u-like symptoms when steroid that can be given to treatswitching from evening to morning injections. relapses or quickly reduce anAny changes in medication administration active inammatory response.times should always be discussed with your It decreases REM sleep, withprescriber before you make those adjustments.insomnia being a well-knownGlatiramer acetateside effect that can occur after only a few doses. Approximately 25 percentTreatment with glatiramer to 44 percent of MS patients taking methyl- acetate is linked to frequent prednisolone reported insomnia as their mostawakenings and daytime frequentsideeffect.Interestingly,anothersleepiness. Anxiety is a studydemonstratedthatdespitepatientscommon side effect of complaining of sleep disturbances while onglatiramer acetate and treatment with methylprednisolone, a wear- can lead to restlessness. This has an indirect, able watch that measures actual sleep cyclesnegative effect on sleep. Overall, there is not showed the patients had a high sleep quality.enoughevidencetoconcludeglatiramer These discrepant ndings suggest there isacetate directly causes insomnia. 11 msfocusmagazine.org'