Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 6427 msfocusmagazine.org blood pressure, heart attack, and stroke), depression, diabetes, motorvehicle accidents, decreased work productivity, and diminished quality of life. Obstructive sleep apnea can profoundlyaffect dailyfunction and exacerbate chronic symptoms experienced by persons with MS. Chief among them? Fatigue. This highly debilitating symptom imposes significant socioeconomic consequences, and is a leading cause of diminished quality of life. Recent studies suggest that several sleep disorders, including OSA, contribute to fatigue in MS. Early data also suggest that successful treatment of OSA and other sleep disorders mayimprove fatigue and sleepiness; yet these sleep disorders remain significantly under-recognized in the MS population. Cognitive impairment – difficulties with thinking, information processing, memory, andverbal expression – affect up to 70 percent of people with MS. Interestingly, many of these symptoms have also been linked to OSA. Recent studies have shown that OSA is associated with subjective and objective cognitive problems in both MS and non-MS patients. Treatment options Given the effect of OSA on health and well-being, all individuals with MS should discuss symptoms of sleep apnea with their healthcare provider. Symptoms of sleep apnea include: • Snoring • Pauses in breathing • Gasping or choking upon awakening • Nonrestorative sleep • Excessive daytime sleepiness or fatigue • Cognitive disturbances • Nighttime awakenings Difficulty with swallowing or speech production (which may be signs that MS has affected your brainstem), or the presence of brainstem lesions on your MRI, may also signal higher risk for OSA or CSA. An overnight sleep study is needed to diagnose sleep apnea. This is typically done in a sleep laboratory, so that your sleep and breathing can be measured throughout the night. In some cases, sleep studies can be done with equipment that you take home. The sleep study should not be painful and generally has few complications. Fortunately, sleep apnea is a treatable condition. The most effective treatment for OSA, known as positive airway pressure therapy, uses a mask to blow air into the upper airway, splinting it open during sleep. The air pressure may be constant (continuous positive airway pressure, or CPAP), may use different pressures when you inhale and exhale (bilevel positive airway pressure therapy, or BiPAP), or might be self-adjusting to your breathing within a set range of pressures (AutoPAP). There are multiple choices and sizes of sleep masks, and your healthcare provider will work with you to find the most comfortable mask for you. Healthy sleep is an essential part of physical and mental well-being. Discussions about sleep should be a routine part of your comprehensive MS care. Although MS is associated with many chronic symptoms, some of these symptoms may be, at least in part, exacerbated by sleep disturbances, and may improve when the sleep disturbances are treated.