Reasons for not sleeping...is it the MS?

Here is My Question:
I am currently working for a man with MS and trying to help. He is having a real hard time sleeping at night and is taking medications that are not working and really can't function or focus the next day and is not able to do much like go outside and get sun, think, etc. and is very unhappy. He also has restless leg syndrome and is on a medication for that as well. He is struggling...can you help please?

Answer:
There are lots of reasons for not sleeping, all of which require different treatments. If we assume his only problem is restless legs syndrome, then he either needs the dose of his current medication adjusted or he needs a different medication. He should discuss this with his doctor. Common additional reasons for not sleeping in MS patients include the following:
1. Leg spasms and nocturnal leg movements
2. Sleep apnea
3. Pain
4. Depression
5. Anxiety
6. Waking up to urinate frequently
Good luck with helping him. Have him start by contacting his MS specialist and ask for a visit visit to discuss only his sleep problems. I often find that people with MS do not establish clear goals for their visits and this lack of preparation means the doctor does his or her thing and never gets around to addressing the most important problem.  Have him write out the reasons he believes his sleep is disrupted before the visit and have him specifically ask for a visit to address this issue alone.

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