Living with multiple sclerosis (MS) presents its own set of challenges, from managing symptoms to maintaining overall well-being. But what if there’s another condition complicating matters? It is normal to feel tired when you are dealing with MS, the condition itself makes you tired, but what if another disorder is contributing to your fatigue?  Up to 60% of patients with MS experience poor sleep.  Insomnia, restless legs syndrome, sleep apnea and other sleep disruptors happen more often in people with MS. If we look at the American statistics, sleep apnea affects about 3% of the population overall, but in patients with MS, up to 50% may suffer from OSA; and most are undiagnosed and untreated.


Understanding Multiple Sclerosis:

First, let’s grasp the fundamentals of MS. It’s a chronic autoimmune disease where the immune system mistakenly attacks the protective covering of nerve fibers (myelin), disrupting communication between the brain and the rest of the body. This can lead to a wide range of symptoms, including fatigue, muscle weakness, cognitive impairment, and mood disturbances.  


Unravelling Obstructive Sleep Apnea:

This sleep disorder occurs when the muscles in the throat relax and collapse during sleep, causing partial or complete blockage of the airway. The result? Breathing pauses, known as apneas, disrupt normal sleep patterns and lead to oxygen desaturation and intermittent hypoxia. Common symptoms include loud snoring, daytime sleepiness, morning headaches, and difficulty concentrating.


The Intersection of MS and OSA:

Both conditions share overlapping symptoms such as fatigue, cognitive impairment, and mood disturbances. Additionally, certain risk factors like obesity and smoking are associated with increased incidence of both MS and OSA. Moreover, the immune system dysfunction observed in MS may play a role in the development or worsening of OSA.  For reasons not yet fully understood, those with MS are at a higher risk for sleep apnea than those without MS.


One of the reasons that we see a correlation between MS and OSA is that the damage to myelin leaves scars or lesions on the brain and spinal cord making it harder for your brain to control your breathing while you sleep.


Treating Patients with Both MS and OSA:

Managing patients with co-existing MS and OSA requires a comprehensive approach tailored to individual needs. 


  1. Diagnosis: Accurate diagnosis is a critical first step. Patients presenting with symptoms suggestive of either MS or OSA should undergo thorough evaluation, including clinical assessment, neuroimaging for MS diagnosis, and a sleep study for OSA diagnosis.


  1. Collaborative Care: A care team consisting of neurologists, sleep specialists, respiratory therapists, and other healthcare professionals can provide holistic care for patients living with both conditions.


  1. Continuous Positive Airway Pressure (CPAP) Therapy: CPAP is the gold standard treatment for OSA. It involves wearing a mask during sleep connected to a machine that delivers a continuous flow of air that keeps the airway open. CPAP therapy can alleviate OSA symptoms, improve sleep quality, and reduce daytime fatigue in patients with MS and OSA.


  1. Lifestyle Modifications:  Lifestyle changes such as weight loss, smoking cessation, and regular exercise can benefit patients with both MS and OSA. These modifications can help alleviate OSA severity and improve overall health outcomes.


  1. Symptom Management: Addressing MS symptoms such as fatigue, pain, and mood disturbances is essential for enhancing quality of life. Healthcare providers can prescribe medications, physical therapy, and psychological support to manage these symptoms effectively. 


  1. Monitoring and Follow-Up: Regular monitoring and follow-up appointments are crucial for assessing treatment efficacy, adjusting treatments as needed, and addressing any new concerns or complications.


In conclusion, navigating life with multiple sclerosis is challenging enough, but when obstructive sleep apnea enters the picture, the journey becomes even more complex. If you or a loved one is struggling with MS and suspect OSA, don’t hesitate to seek help.   Our dedicated Care Team is available when you are ready to take the first step to better health.


Contact us today to schedule a consultation or to learn more about at-home sleep studies


May is MS Awareness Month, a time dedicated to raising awareness about multiple sclerosis and ways to help the over 90,000 Canadians who live with this condition.  Please visit the MS Canada website for more information.  


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