b"approach with your healthcare providers can ensures a safe and effective integration of exercise into your overall care plan. Consultation with healthcare professionals Before embarking on any exercise regimen, individuals with MS should consult with their healthcare professionals. Each person's condition is unique, and tailored exercise plans can address specic needs and potential limitations. A collaborative approach with your healthcare providers can ensures a safe and effective integration of exercise into your overall care plan .Sleep Disorders and Chronic MS Symptoms Adapted from an article by Tiffany Braley, for MS Focus Magazine Sleep disorders and disturbances are common among people with MS, and have the potential to exacerbate symptoms and disease processes associated with MS. As most sleep disorders are treatable, a keen knowledge of their causes and consequences provides an opportunity to optimize health and function. This article focuses on sleep disorders that are most frequently encountered in MS, and their link to some of the most important MS symptoms, including cognitive impairment, fatigue, and pain. Common sleep disorders in MS Obstructive sleep apnea is characterized by repeated episodes of upper airway collapse during sleep. Nighttime airway obstruction leads to fragmented sleep and decreased oxygen levels throughout the night. Although obstructive sleep apnea is common in the general population, research suggests it may be more common in people with MS. The presence of brainstem lesions may be a risk factor for more severe forms of obstructive sleep apnea, and a different type of apnea known as central sleep apnea.As obstructive sleep apnea is associated with serious health problems (in addition to other symptoms), early evaluation and treatment by a sleep specialist is recommended. Positive airway pressure therapy is considered the primary treatment, though other treatments may be considered. Signs that an evaluation for sleep apnea may be necessary include snoring, excessive daytime sleepiness, and fragmented sleep. Fatigue, while more commonly linked to MS itself, may also be a presenting symptom of sleep apnea.Insomnia symptomswhich include trouble falling asleep, staying asleep, and waking earlier than desiredare also commonly experienced by people with MS. Up to 40 percent of people with MS (or more in some studies) exhibit symptoms of insomnia. 5"