Back to Journals » Nature and Science of Sleep » Volume 13

Therapeutic Approaches to Insomnia and Fatigue in Patients with Multiple Sclerosis

Authors Drerup M, Roth A, Kane A, Sullivan AB

Received 7 October 2020

Accepted for publication 15 January 2021

Published 16 February 2021 Volume 2021:13 Pages 201—207


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Steven A Shea

Michelle Drerup,1 Alicia Roth,1 Alexa Kane,2 Amy B Sullivan2

1Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, USA; 2Mellen Center for MS, Cleveland Clinic, Cleveland, OH, USA

Correspondence: Michelle Drerup
Cleveland Clinic, 9500 Euclid Ave S-73, Cleveland, OH, 44195, USA
Tel +1 216 445 9251
Fax +1 216 636 0090

Abstract: The prevalence of sleep disorders in individuals with multiple sclerosis (MS) is 3– 5 times higher compared to the general population. Insomnia Disorder, defined as difficulty falling asleep, maintaining sleep or waking up too early, can lead to significant fatigue, the most common and disabling symptom of MS. In addition, fatigue and insomnia in patients with MS also can overlap with and exacerbate other psychological and physical symptoms. Cognitive behavioral therapy for insomnia (CBT-I) has been shown as an effective treatment for chronic insomnia and burgeoning research has demonstrated the effectiveness of this treatment for insomnia in individuals with a variety of comorbid medical conditions including MS. The purpose of the current review will explore the literature surrounding the prevalence and impact of sleep disorders and fatigue in MS. Additionally, this review will address practical ways to help individuals with MS manage fatigue as well as how to modify typical standard behavioral treatments for insomnia to take into account special considerations for individuals with MS based on the level of disability and other comorbid issues that impact sleep.

Keywords: CBT-I, sleep, comorbidity, neurological disorder, multiple sclerosis

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]