What is it with MS and sleep apnea?

 

Sleep can be a common concern among those with multiple sclerosis. Possibly up to 60 percent of MSers struggle with some sort of sleep disturbance. Sleep apnea is a frequent contributor to this issue.

 

What is sleep apnea?

 This is a condition that causes a person’s breathing to stop and start unpredictably during sleep. During those intervals (which may last for several seconds or more), the body is deprived of ample oxygen. An individual may gasp and awaken, or slightly stir and resume breathing. Each time this happens, it’s called an apnea, and it can occur many times each hour throughout the night.

 Experts say approximately one in five American adults may suffer from sleep apnea, although many may not be aware they have it. (Often, it's identified after a sleeping partner complains enough about intense and sudden spurts of snoring that a person seeks medical advice for it.)

 

What are the symptoms of sleep apnea?

 People with sleep apnea find themselves extra tired during the day. They might wake up with frequent dry mouths and nagging morning headaches.

 

What are the risks of sleep apnea?

 Untreated sleep apnea can be deadly, or at least add to potentially fatal conditions. Some researchers claim it can take as much as 10 years off a person’s life, largely because it increases a person’s vulnerability to high blood pressure, strokes, and heart attacks. (This has something to do with decreased blood oxygen levels that occur during each apnea episode.)

 

How does sleep apnea play into MS?

 Specialists have identified two types of apnea.

1.  Obstructive apnea occurs when the muscles in a person’s throat and nose relax (usually during sleep), blocking the airway and stopping breathing momentarily. This is the type that is commonly associated with loud, sputtering snoring and most often with obesity. Smoking is a risk factor as well.
2. Central apnea occurs when the brain fails to direct the body to breathe for a short interval. This may be more of a neurological issue. (That concept sounds familiar to anyone with MS and how it can pay tricks on all sorts of body part and functions.)

 MSers are widely regarded to be at higher risk for both kinds of apnea. Neuroscientists have pointed to reduced brainstem function issues as possible reasons for this, such as may be caused by demyelinating lesions that may be caused by MS over time.

 Whether obstructive apnea, central apnea, or some combination of both, this sleep disorder wreaks havoc when it strikes someone living with MS. Even without MS, sleep apnea tends to make people extremely sleepy all day long, due to the diminishing of quality sleep overnight. MSers already face bouts of (or ongoing struggles with) a crushing fatigue that is nearly indescribable.

 When sleep apnea prevents quality sleep, it considerably complicates this battle. The lack of rest can also aggravate memory loss, increase accident risks, lead to depression, and worsen diabetic symptoms (for MSers with that comorbidity).

 Certain medications frequently used to alleviate MS symptoms may make sleep apnea worse. These include those prescribed for insomnia, pain, spasticity, and more.

 

What can be done about sleep apnea?

 Once sleep apnea has been diagnosed (usually through an at-home of in-lab overnight sleep study, ordered by a neurologist or other physician), the patient will likely be prescribed treatment using a CPAP (continuous positive airway pressure) machine. This regulates breathing during sleep, piping humidified air into the person’s airway via a special mask. In many cases, sleep apnea may also be lessened somewhat when a person stops sleeping on his or her back.

 It can take time and practice to adjust to CPAP treatment, especially the wearing and breathing through the mask while sleeping. (Trust me. It can take weeks or even months to get used to it!) But this adaptation has been shown to reduce sleep apnea episodes (as well as their duration), and eventually to improve restorative sleep and rest.

 That’s worth plenty to an MSer.

 

 Related items:

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• Got up. Got dressed. And got back in bed.
• Learning to plan down-days
• MS comorbidities: Welcome to the party!
• MS has made me more body-conscious.
• The perfect storm can bring on an MS maelstrom
• Thermostat wars and MS

 

Image/s:  Public domain photo

 

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MS comorbidities: Welcome to the party!

 Multiple sclerosis is a wacky disease. Ask anyone battling it. The constellation of possible MS symptoms is baffling to contemplate. Experientially, MS brings a host of surprises, as the MSer’s body seems to betray him or her in all sorts of surprising (and seemingly unrelated) ways. 

 

 Vision disturbances can crop up. A limb may go numb for a while or longer. Incontinence may sink in. Spasticity might strike. Walking can become difficult. Vertigo could stop by for a spin. Fatigue might suddenly become overwhelming.

Once diagnosed, we find it’s easy to blame all sorts of health complaints on MS. On the other hand, MSers can be prone to several other illnesses and complications. That’s called comorbidity.

 

What are the most frequently found comorbidities with MS?

Here’s a garden variety:

• anxiety
• arthritis
• asthmatic bronchitis
• cardiovascular disease
• chronic lung disease
• cognitive/memory issues
• deep vein thrombosis
• depression
• diabetes
• high cholesterol
• inflammatory bowel disease
• migraines
  
• obesity
• psoriasis
• sleep issues
• stroke
• thyroid disorders
• urinary tract infections
• and more.

 In many instances, medical experts aren’t altogether sure whether MS causes a certain comorbidity or vice-versa. For example, MS can cause a person to live a more sedentary lifestyle, which could lead to (or aggravate) blood pressure issues, diabetes, heart or lung disease, obesity, and other ailments.

 Additionally, comorbidities may arise together, perhaps randomly. And lots of medical conditions share symptoms, so it may be difficult to pinpoint whether a symptom stems from MS or from an existing comorbidity. 

Comorbidities can also delay and complicate a person’s initial diagnosis of MS, as symptoms of other conditions may mask MS’ appearance. They can also make MS treatment more difficult to manage and may even set the stage for MS to progress faster in some patients.

 It’s a crazy world out there, especially with the less-than-pleasant bonus of comorbidities with MS.

Related items:

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• Maybe MS has taught me something, after all.
• MS is like the cancellation disease.

 

Image/s: Public domain photo and user-created word-graphic

Feel free to follow on Twitter. Please visit my Amazon author page as well. You are invited to join the Kicking MS to the Curb page on Facebook and the Making the Most of MS board on Pinterest.

Dizziness isn't always all-ears

 

Whirling vertigo often begins in the ears … but not always. Ask anyone with multiple sclerosis or migraines. Better yet, ask anyone with the double bonus of both. The combination abounds!

 Vertigo can be a symptom of migraine. And it’s extra special when it comes from an MS migraine, which is an entity (or agony?) all its own.

The American Speech-Language-Hearing Association put it this way:

 Specifically, vertigo, which is the sensation of perceived motion without actually moving, is reported by up to one third of people who have migraine, and general dizziness or unsteadiness is reported by up to three quarters of all patients with migraine.

The folks at Johns Hopkins Medicine point to vestibular migraine as a frequent source of vertigo and related symptoms:

 Migraine headaches are a common neurological condition. Although common migraines are characterized by a moderate to severe pounding or throbbing headache, vestibular migraine may or may not involve headaches in combination with vestibular symptoms such as vertigo, imbalance, nausea and vomiting.

Stanford Medicine agrees:

 Unlike the classic migraine, which is described as severe, throbbing headache, vestibular migraine has no pain associated with it 50% of the time. Vestibular migraine causes episodes of dizziness described as rocking, spinning, floating, swaying, internal motion and lightheadedness. They most often occur spontaneously, but can be triggered by stress, sleep problems, skipping meals, dehydration, other illnesses.

 Wow. So it’s possible (and not even unlikely) to have a migraine without suffering a severe headache.

Finally, someone’s talking my language!

 After years of going around and around (See what I did there?) with my primary care physician, in which he insisted that my frequent and severe vertigo / lightheadedness / dizzy / off-balance symptoms were caused by inner-ear crystals (including multiple physical therapy sessions for this diagnosis, which proved unfruitful and actually aggravated my symptoms, I found this migraine-related information to be a complete game changer.

OK, for the vast majority of vertigo sufferers, a simple physical therapy maneuver can work miracles. (Got vertigo? Try this first!)  But for the MSer (or anyone with central vertigo, rather than benign positional vertigo) or the migraineur, it generally proves a bust.

 I’ve had migraines since my Junior High years. But they always used to include major headaches. And apparently vestibular migraines (and the frequently associated vertigo) are most common among those who were particularly susceptible to motion sickness, especially as children. Bingo! That was me.

 Enter MS. Within the past few years (especially since hormonal changes kicked in with a vengeance), my migraines have evolved. Sure, I occasionally have the head-in-a-vise pounding variety. But more often, I battle a dull headache behind the agonizing whirling and unsteadiness of vertigo.

 Thankfully, my MS doctor affirmed my description of symptoms and flat-out said the frequent (sometimes daily) vertigo I face is related to migraines, which are common with MS. As such, she recommended avoiding food-related migraine triggers (as I already do), getting much-needed rest, drinking plenty of water, and taking travel-sickness medication when vertigo strikes. (See Simple OTC product helps vertigo?)

 That means no more neck twisting, which only aggravated some of my existing MS demyelination and didn’t fix the lightheaded spinning problem anyway.

 

Related items:

• Ain't nothin' pseudo about a pseudo-exacerbation.
• I bucked the system and skipped the spinal tap.
• MS and vision: How many types of glasses do I need?
• MS is like the cancellation disease.
• MS makes me clumsy sometimes.
• Not all nose-dives are MS' fault.
• Self-advocacy: When therapy is not therapeutic
• Simple OTC product helps vertigo?

 

 Image/s: Excruciating Headache, M. Egerton, 1827, public domain

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