Relief From Multiple Sclerosis Sleep Disorders Is a Dream

Among the sleep disorders this columnist deals with is confusion arousal

Benjamin Hofmeister avatar

by Benjamin Hofmeister |

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Multiple sclerosis (MS) and a good night’s sleep seem to be mutually exclusive. I seriously doubt that anyone with MS will reply in the comments that the disease has blessed them with the best sleep of their lives. Yet I used the word “seem” because when writing about any symptom of a consistently inconsistent disease, it’s unwise to deal in absolutes.

What’s safe to say is that the majority of people with MS report problems with sleep. This feels tragically ironic, because rest is one of the things we need most. My fatigue, especially the sleepiness and cognitive aspects, otherwise known as brain fog, would most likely benefit from, or perhaps even improve with, proper sleep.

I should be perfectly aware of this, because in Army Ranger school, we were deliberately deprived of sleep to induce mental and physical stress. But I didn’t immediately make the connection. I’m going to blame insomnia for that.

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Even just sticking with my nonprofessional musings, I could easily write a year’s worth of columns about MS-related insomnia. Obstructive sleep apnea, spasticity, medication side effects, and pain are some of the likely causes for our lack of sleep, or sleep interruptions. A few of the results are the fatigue and cognitive issues I mentioned above, plus memory problems, emotional instability, depression, and another parasomnia I’ve occasionally dealt with.

What is confusion arousal?

Have you ever awakened confused, perhaps experiencing uncoordinated movements? Did you wonder, where am I? Who am I? How did I get here? Why am I dressed like this? Am I late for work? Do I even have a job? Is it worth getting up for? If so, this particular condition is known as confusional arousal, a documented type of sleep disorder.

The American Academy of Sleep Medicine (AASM) notes that the disorder usually occurs within the first three hours of sleep or sometimes after a nap. It lists a number of risk factors, including other sleep disorders, not enough sleep, and stress. The AASM also names likely causes, two of which are sleep apnea and periodic limb movement disorders.

People with MS who sleep in short bursts interrupted by symptoms could have nights made up of nothing but three-hour periods of sleep. That might lead to frequent naps in different locations where you’re not accustomed to waking up. Add in one or more of the risk factors, and it feels like MS and this sleep disorder go hand in confused hand.

It was worse when my spasticity was uncontrolled. With spasms, stiffness, and hyper-reflexivity responding to every brush of a bedsheet, only the changing numbers of a clock were proof that I’d slept at all. When every 24 hours consists of six or more naps in different places with different activities going on around you, you’re bound to wake up confused sometimes.

‘Dream weaver’

With a baclofen pump to treat my spasticity came initial immobility, but blissful relaxation. I talked about myself like you would an infant: “I slept through the night two times in a row. Isn’t that wonderful?”

I also started dreaming again, or at least remembering dreams instead of feeling like I was sometimes waking in the middle of one. Like seeing that first robin and knowing that spring has arrived, the return of dreams seemed to signal a thawing of insomnia.

It’s multiple sclerosis, so it can’t be all wine and roses. Though suppressed, the sleep-interrupting spasticity is still there and wakes me sometimes. When this happens, getting back to sleep can be difficult. I also had an incident of waking up confused in my recliner recently, which led me to read about confusional arousal.

Still, those incidents are exceptions now rather than rules, and having an occasional bad night instead of an occasional good one is a better place to be. Further improvement might be just a dream — but since I can do that now, I think I will.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Ruth Hoham avatar

Ruth Hoham

Your writing ability is quite remarkable - well done! Keep at it! I’m enjoying it.

Benjamin Hofmeister avatar

Benjamin Hofmeister

Thank you so much Ruth!

Honestly though, if you saw my draft before the editors cleaned it up, you probably wouldn't say that.

B. CARR avatar


My secret to more sleep is a cocktail of things, daily exercise, wear sleep pants/shirt if cold, plus earplugs. Helps to sleepin temperatures < 70 degrees F or colder, but not colder than the low 60's.

I've tried just about everything, this is the only way I get more sleep these days. Not saying this works for everyone, but I take Flexeril, Evening Cannabis, then Indica Edibile prior to bed, plus silicone earplugs to block out any noises accidentally waking me.
Also, Imperative to empty the bladder before HS.
I waste more time trying to urinate before bedtime.

My sleep duration lately is 7 to 9 hours.

Be proud of your writing, majority have editor's as well, most wouldn't get this far, keep up the effort, its timely, thank you.

Happy Holiday's.

Benjamin Hofmeister avatar

Benjamin Hofmeister

Yes, yes, yes, and especially yes to emptying your bladder before bed! Who knew that was so important?

As far as the writing, that was a little tongue in cheek and a cheap shot at the editors. I am proud, but they really do an incredible job. I have no real experience other than writing the world's most boring SOAP notes and later, the world's longest and most boring operation's briefings. Getting to write to inform and entertain is amazing.

Stephen De Marzo avatar

Stephen De Marzo

Yes, sleep was an elusive luxury. the spasticity drive me nuts! I just started Medical Marijuana gummies. Yes they work!! Shut my legs and foot down completely. If they're available to you I recommend trying it.

Benjamin Hofmeister avatar

Benjamin Hofmeister

Thanks Stephen! Remember when we were kids and going to bed early/taking a nap seemed like a punishment?


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