How can I get more sleep and energy. Help!

Here is My Question:
I'm a working female in my late 30s with RRMS. I am doing ok with it, but it is the secondary stuff I am trying to learn to live with.

What is the priority to handle: sleep cycle disturbance or daytime fatigue? They're both negatively affecting one another.

I'm dragging myself to bed between 10 and 11pm nightly (can't go any earlier). I am up between 3:30 and 4am for a variety of reasons (not often MS symptom related...I'm a light sleeper), and I can't go back to sleep. Once I'm up, that's it! By mid-day, I'm a walking zombie. I can't function without caffeine around 2 or 3pm. Wash. Rinse. Repeat. 

I am already on 100mg Amantadine in the morning and 50mg before 1pm, but it hasn't really done much. Sleeping pills make daytime drowsiness so horrible.

How can I get more sleep and more energy? Help!

Answer:
Managing daytime fatigue and sleepiness  must begin with a thorough evaluation of altered or disrupted sleep. You can only beat the proverbial, “dead horse” so much with caffeine and stimulants . It sounds like you have longstanding problems as a light sleeper but were able to compensate in the past. Common problems to address include the following:

1. Altered sleep cycles: Doesn’t seem to be an issue with you
   
2. Poor sleep hygiene: This includes no caffeine or stimulants past afternoon, no alcohol, taking time to meditate or practice mindfulness before bed; sleeping in a dark quiet room (no TV) and getting out of the bed (and room) if not asleep in a reasonable amount of time
   
3. Frequent awakenings: These have many causes including anxiety with rumination, depression, urination frequency, discomfort or spasms, noisy sleeping partner, problems with your sleep environment or sleep disorders (sleep apnea for instance). Your doctor should be able to help with this assessment or you may need an evaluation in a sleep clinic

Good luck
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego