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Why Are My MS Symptoms Worse at Night?
What Can You Do to Help Yourself?

  • Shaky hands.
  • Numbness.
  • Pain and Tingling.

Sound familiar? An MS diagnosis might throw all kinds of obstacles your way and drastically change your life, but it doesn’t need to be the end of your health, happiness, or good sleep. In fact, sleep is now more important than ever. But you probably don’t need us to tell you that. 

We know your journey will require patience, dedication, hard work, and lots of effort, and we want to help you understand how sleep can help alleviate MS symptoms and in some cases aid in slowing the progression of the disease. While we don’t know the details of your daily life, we can imagine that an autoimmune disease takes its toll on both energy and stress levels, which can lead to aggravation of MS. Thankfully, some research shows sleep can help. 

We’ll do our best to answer your sleep-related questions, but if you want some ideas on a few changes that might help you manage, click here.

Facts about Multiple Sclerosis

MS is a neurological auto-immune disease that leads to the breakdown of tissues protecting the central nervous system. This can affect the brain, eyes, spinal cord, and many basic body functions. MS is rare, affecting well under 1 percent of the U.S. population, but the disease is much more common among middle-aged women in the northern hemisphere. 

While some research suggests MS incidence is increasing, there is no known cause for the disease, though in many cases risk factors seem to be genetic. When it comes to rest, the Multiple Sclerosis Foundation reports that a variety of disorders including narcolepsy, restless leg syndrome, and sleep apnea go hand in hand with MS. These issues often lead to increased fatigue and poor sleep. 

There is no known cure for MS, but there are a variety of treatments that can slow the progression of the disease and improve the quality of life.The methods of treating MS may vary but when it comes to medications, the side effects have a lot in common. An Italian study found that many of these medications may seriously interfere with your sleep.

MS-related Fatigue

Over 80 percent of patients with MS report high rates of fatigue according to the National Multiple Sclerosis Society (NMSS). This fatigue can be a result of exhaustion from poor sleep, muscle pain, and even from the daily effort it takes to care for such a complicated condition. This fatigue can make it difficult to work, exercise, eat, and even to get out of bed, closely mimicking symptoms of depression. In many cases, depression and fatigue can have a cyclical relationship, with one worsening the other.

While there is no specific cause for MS-related fatigue, doctors at the NMSS have identified some common sleep inhibiting factors, such as caffeine intake, nightmares, overactive bladders, and muscle spasms. Each of these problems can keep you up at night, sometimes compounding fatigue the next day.

Effect of Poor Sleep on MS Symptoms

Poor sleep can affect more than your energy levels, however. In many cases not getting enough sleep can affect your general outlook on life. We’re not here to tell you a happy attitude will fix everything, but we know that sometimes it can be hard to take care of yourself when you don’t feel like your results are worth the effort. A lack of sleep can amplify these feelings, which is why we want to help you rest. 

While some types of MS can go into remission with treatment, this usually requires a fair amount of resilience, patience, and sometimes hope. MS treatment plans vary from lifestyle changes to even cancer drugs. To endure the lengthy process of a treatment cycle, you’ll probably need rest and the ability to keep moving forward despite setbacks. That’s where we think sleep can help.

Worsening Symptoms at Night

However, no matter how much you want to sleep, it rarely comes easily to those with MS, and sometimes the general symptoms of MS can get worse at night. We’ll go over some common symptoms associated with MS, and then get to the ways you can combat the effects. 

Spasticity Pain

Spasticity in MS is like dealing with the after-effects of running a marathon without the pleasure of receiving the medal or sleeping like a rock after. Characterized by extreme muscle stiffness, spasticity can be painful, cause uncontrollable spasms in the arms and legs, or muscle jerks that keep you awake. 

In some patients, these symptoms could worsen in the evening because the long periods without movement can increase muscle stiffness according to MS Trust


This neurological type of pain can be difficult to pinpoint and comes from nerve sensitivity according to the National MS Society. As they can be related to pressure and temperature, these pains could become more bothersome at night. 

Emotional Reaction to Pain

With MS, many patients live in a constant state of fear. Fear of their disease worsening, fear of every symptom meaning something greater, and other similar anxieties. Pain is often related to the emotions in a way that’s unique to MS. 

According to a study in Portland, Oregon, emotional stress and anxiety are often associated with MS flare ups. So the fear of getting worse could spike more MS pain, further worsening sleep.

Associated Sleep Disorders

If these symptoms weren’t enough to deal with, there is also a long list of sleep disorders commonly associated with MS, as the nervous system is one thing every vital function has in common. 


Whether it’s related to pain, anxiety, depression, or a combination, insomnia is common among MS patients and often snowballs into daytime fatigue or nighttime anxiety. Rather than giving in to the frustrating reality of it all, some find solace in humor, like this blogger, while others simply ride the waves of MS. 

However you choose to cope, we commend you for still trying, and a little later we’ll get to some practices that might make a difference.

If you are having trouble with insomnia, take a look at our list of best mattresses for insomnia.

Sleep Apnea

Because Multiple Sclerosis affects neural pathways, in some patients this manifests as periods of not breathing while asleep. Sleep apnea goes hand in hand with many chronic illnesses but with MS it is more likely to result in needing a CPAP mask or a breathing machine to keep oxygen flowing during sleep.  

Circadian Rhythm Disorder

Circadian rhythm disorder is more common among those with MS than the general population. According to one Iranian study, this could be related to the increased fatigue among subjects with MS. The study suggests circadian rhythm disorder likely develops because of chronic sleep deprivation, exhaustion, and irregular sleep and waking phases. 


While insomnia is characteristic of the disease, hypersomnia or oversleeping is also a common symptom of MS, and is probably also related to chronic fatigue. See where we’re going here? Worsened sleep leads to fatigue which leads to irregular sleep in a cyclical pattern. While oversleeping might sound like heaven to some with MS, it may not be as blissful as it sounds.  

In some cases, hypersomnia is related to narcolepsy and episodes of cataplexy, meaning sudden bouts of muscle weakness and/or losing consciousness.


A better name for having to get up to pee every few hours, this can be one of the more frustrating elements of MS. In most people, the body produces lower amounts of denser urine to allow us to sleep through the night, but in those with MS, the nerves that tell you when your bladder is full may not work as well as you’d like. This means you may have less time to get to a restroom than you’d like. 

To treat this, some doctors recommend drinking less water in the evening, but in some cases, nocturia can occur even when you’re dehydrated. 


While some might think this disorder means comically falling asleep in the middle of sentences, it could also mean insomnia, chronic fatigue, and episodes of extreme muscle weakness that could cause injury. This is a neurological condition that can result from low levels of hypocretin, the hormone that regulates wakefulness. 

While there is no current cure for narcolepsy, some medications like antidepressants have been shown to help combat some of the symptoms, according to the Mayo Clinic.

Night Sweats

While many of us rejoice the end of hot and sticky evenings, not everyone sleeps cooler in the fall. For those with MS, cold temperatures can be extra tricky because you may go to bed bundled up and then wake up in a hot flash later. Night sweats are not only uncomfortable, but they can also be a sign of underlying medical concerns. 

In those with MS, it could mean a few things. While keeping in mind that menopause, use of different stimulants like caffeine, and anxiety can all cause night sweats and should be ruled out first, one American study shows MS lesions can form on the part of the brain that regulates temperature.

When this happens, some experience heat-related fatigue as well as increased heat sensitivity. The good news is, however, that after cooling down the body the symptoms should go away quickly.

Restless Leg Syndrome

If you’re constantly driving yourself and your partner crazy by shaking your legs at night, you’re not alone. According to a study conducted in Washington, RLS is extremely common among MS patients, but highly underrecognized by doctors in the MS community. 

So if you’ve noticed an uncomfortable sensation or increased restlessness in your limbs in the evening, we recommend consulting your doctor and asking about the condition.

Related: Best Mattress for Restless Leg Syndrome

Will a Better Bedroom Help?

While some might tell you that these symptoms are just characteristics of your disease, this doesn’t have to mean there is no way to improve your situation. As you know a few tips and tricks won’t cure you, but we think some of them may help you cope, and at least help you get better rest. 

A Turning or Rotating Bed

If you haven’t heard of rotating beds before, they’ve become an interesting way to help some patients with MS get in and out of bed without causing too much strain on the body, and in some cases, you can do it without help. Before you get dizzy thinking about it, these beds don’t spin in circles, they lift the frame and mattress into a seated position and then rotate and recline to help you lay down.

This could be a good option for those with dizziness and instability, as well as those who are wheelchair-bound. If you’re wondering how this could help you sleep better, a rotating bed could make nighttime disruptions less of an ordeal, helping you to rest easier knowing it won’t take you forever to get up and get back to sleep.

An Adjustable Base

Similar to a rotating bed, those with adjustable bases can lift you into a sitting position, helping those with muscle weakness and dizziness to get up on their terms and when they’re ready. These beds can be remote-controlled and can change shape in a variety of ways, lifting the feet, the head, or allowing you to sleep in a customizable position for ultimate comfort and pain relief. 

Waterproof Mattress Protector

For those who struggle with incontinence at night, having a waterproof mattress protector can be a great way to cut down on the time you spend cleaning up messes when you’d rather be asleep. This way all you would need to do is wipe down the pad, replace your sheets, and you’re good to go. Some even recommend layering the bed with mattress protectors and sheets so you can just peel off a layer and throw it in the wash when you need to replace your bedding. 

Silkier Sheets

If you experience frequent night sweats, silky sheets can be a great way to stay cool. As it tends to breathe well, silky material mixed with an absorbent viscose or microfiber could help absorb excess moisture, helping you sleep cooler. As an added benefit, these lightweight sheets are great for dry skin as they glide across without absorbing too much moisture or causing irritations. 

Responsive Mattress With Pressure Relief

While this may sound too good to be true, mattress science has come a long way in the past few years and what used to sound like a unicorn mattress has become available in beds like Purple. For MS, pressure relief is important to promote spinal alignment and reduce pain points, but if you find yourself needing to reposition frequently, memory foam is probably not the right option. 

By choosing a top mattress of 2024, you could find better pain relief, and fall asleep quicker.

Bed Rails or Grab Ropes

While this may sound too good to be true, mattress science has come a long way in the past few years and what used to sound like a unicorn mattress has become available in beds like Purple. For MS, pressure relief is important to promote spinal alignment and reduce pain points, but if you find yourself needing to reposition frequently, memory foam is probably not the right option. 

By choosing a bed with the best of both worlds, you could find better pain relief, and fall asleep quicker.

Questions for Your Specialist

While there are many great medical resources online, some questions are better answered by a specialist who knows your case and your history. To avoid worrying more than necessary, or worse, brushing off serious concerns, here are some questions you should bring to your next appointment. 

Is my disease progressing or am I sleep deprived?

With MS, the thought of your disease progressing can be terrifying, and sometimes every pain or change can be a source of worry or fear. We know it can be a frightening and often lonely experience, but not every change needs to be a cause for concern, and according to the research, sleep has a lot to do with how we function. 

If you find yourself struggling with sleep issues and notice a change in your symptoms, we’d encourage you to talk to your doctor about your options for improving your rest before succumbing to your fears.

Read More: Sleep Deprivation

How much should I be sleeping?

It can be hard to measure how much you should be resting when you have Multiple Sclerosis, especially when you are dealing with chronic fatigue. This is a question best answered by your doctor, but keep in mind that sleeping too much or too little can make it hard for you to sleep at the right time or to function properly. 

While it’s recommended that the average person get seven to eight hours of sleep per night, this may need to be altered by your specialist.

What are the side effects of my medication?

Most medications have a variety of side effects that vary from person to person, and MS drugs are no exception. What works for one, may not work for all and if your meds are affecting your ability to rest, you may want to ask your doctor about other options or consider the benefits vs the side effects for your best health. 

Are sleeping pills right for me?

While sleeping pills may help you get some shut-eye, some may seriously affect the quality of rest. They can contribute to reduced REM and slow-wave sleep, cause increased fatigue in the mornings and make it harder to wake up when you need to use the restroom.

However, not every sleeping pill is created equal and in some cases, these risks may be worth some extra rest. To figure out what’s best for you, it’s a good idea to ask your specialist.

Is there a way to treat my overactive bladder?

We get it. Waterproof mattress protectors, incontinence pads, and other methods can get old, so you may be wondering if there is another more permanent option for you. From medications to exercises, there are a variety of ways doctors treat an overactive bladder, but not all are the right option for everyone. 

MS is an individual disease and no two cases are the same. To help you determine the right course of action, talk to your doctor about your options.

What exercise do you recommend?

Many doctors like those at the University of Pennsylvania recommend aerobic exercise for increased quality of life with MS. From increasing muscle strength and stamina to improving muscle control, it can be a great way to stay healthy, but it’s not for everyone. 

In some cases, too much of the wrong exercise can exacerbate symptoms, so before launching a new routine, it’s probably a good idea to talk to the experts or get a second opinion.

Improved Sleep for Decreased Symptoms

The studies don’t lie, better sleep can help manage many MS symptoms, but it can be extremely hard to attain. According to doctors from the National MS Society, better sleep can mean less irritability and fatigue, better work, and better cognitive function. Conversely, poor sleep has a variety of negative outcomes, which is why we made this list of some practices that can help. 

Bedtime Routine

Creating a bedtime routine can mean anything from brushing your teeth to a ritual listening of Africa by Toto and an evening bowl of cereal as long as it’s relaxing and you do it every night. It’s as simple as that. Creating a routine can help tell your body when it’s time to rest, and after you form these habits they can even help you wind down and prepare for sleep. 

Reduce Naps

One of the more notorious symptoms of MS is fatigue, which means so much more than feeling a little tired. In the middle of the day after a long night, when your bed or couch, or let’s be honest, desk is starting to look real comfy, try to take a break in a way that doesn’t require sleep. Turning on a TV show, sitting down, or asking your partner for a shoulder rub could all be little ways to recharge that won’t mess up your sleep schedule.

While it might be difficult, it could pay off when you save all those sleepy vibes for bedtime when you need them. However, keep in mind that the right amount of sleep for those with MS varies, so it’s probably a good idea to verify with your doctor that limiting naps is a good idea.

Avoid Alcohol at Night

While this is good advice for anyone trying to sleep better, with MS it’s probably even more important that you limit your alcohol consumption in the evenings. It’s true that some studies show that the occasional drink can help with MS, but it can also combat the effects of medications, reduce muscle control and balance, and will almost certainly make bladder concerns worse, according to the National Association for Continence

So if you’re going to drink you’re probably better off in the early or late afternoon, so long as you make it won’t interfere with the effects of your medication.

Consider a Weighted Blanket

These newer products have changed the way some deal with insomnia, especially when it comes to mental health concerns and Autism. However, recently they’ve been making waves in the Multiple Sclerosis community as well.

According to Psychology Today, these blankets can help increase our natural levels of happy hormones like serotonin and oxytocin, while lowering the stress hormone cortisol and decreasing our blood pressure. 

Learn more about these blankets here : Weighted Blankets Benefits for Adults with Anxiety & Insomnia


When it comes to Multiple Sclerosis, no two cases are the same, and what works for one, may not be right for another. One thing is for sure, and it’s that everyone with MS is fighting their own battle, and we applaud every one of you. Dealing with an auto-immune disease is never easy, but it doesn’t have to be hopeless. 

That’s why we put together this article to help clear up why sleep is so important for both the management of MS and overall health. While we can’t answer all the questions about MS and sleep, we hope this has guided you in the right direction to get help and better rest.

Julia Forbes

Julia Forbes

Lead Product Tester

About Author

Julia is the Lead Reviewer at Sleep Advisor, specializing in testing out mattresses and sleep accessories – she’s in the right line of work, because she loves to sleep.

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