b'Symptom ManagementSSlleeeeppDDiissoorrddeerrssaannddCChhrroonniiccMMSSSSyymmppttoommssCCoommmmoonnpprroobblleemmssccaanniinncclluuddeeffaattiigguuee,,rreessttlleesssslleeggssssyynnddrroommeeBy Tiffany J. BraleySleep disorders and disturbances areAs obstructive sleep apnea is associated common among people with MS, and havewith serious health problems (in addition the potential to exacerbate symptoms andto other symptoms), early evaluation and disease processes associated with MS. Astreatment by a sleep specialist is recommended. most sleep disorders are treatable, a keenPositive airway pressure therapy is considered knowledge of their causes and consequencesthe primary treatment, though other treatments provides an opportunity to optimize healthmay be considered. Signs that an evaluation and function. This article focuses on sleepfor sleep apnea may be necessary include disorders that are most frequently encounteredsnoring, excessive daytime sleepiness, and in MS, and their link to some of the mostfragmented sleep. Fatigue, while more commonly important MS symptoms, including cognitivelinked to MS itself, may also be a presenting impairment, fatigue, and pain.symptom of sleep apnea. C Insomniasymptomswhichinclude CoommmmoonnsslleeeeppddiissoorrddeerrssiinnMMSSObstructive sleep apnea is characterized bytroublefallingasleep,stayingasleep,and repeated episodes of upper airway collapsewaking earlier than desiredare also commonly during sleep. Nighttime airway obstructionexperiencedbypeople withMS.Upto40 leads to fragmented sleep and decreasedpercent of people with MS (or more in some oxygen levels throughout the night. Althoughstudies) exhibit symptoms of insomnia. People obstructive sleep apnea is common in thewho experience insomnia symptoms three or general population, research suggests it maymore times per week for at least three months be more common in people with MS. Themay suffer from chronic insomnia disorder. presence of brainstem lesions may be a riskAlthough certain symptoms that are commonly factor for more severe forms of obstructiveencounteredinMS(includingdepression, sleep apnea, and a different type of apneapain, spasticity, and bladder problems) may known as central sleep apnea.increase the risk of insomnia, many non-MS msfocusmagazine.org 14'