Lesion locations affecting sleep cycle?

[aspen2]

I'm a limbo-lander who has never posted before.  Amongst many other symptoms, my sleep cycle has gone crazy.  I wake up, for the day, at all hours of the night.  Last night I didn't sleep all night -- usually I manage 3 hours, sometimes 4.

My first mri showed a lesion in the left internal capsule, anterior limb.  Since axons from the thalamus run through this section, I'm wondering if that is causing/contributing to my inability to maintain some semblance of a sleep pattern.

Any guesses out there?  :-P.  Please help me keep my mind occupied :-).

Presented initially with TN (left side) in January.  Now have moved into right-sided weakness (initially hand, now extending into arm and occasionally leg).  Still have twinges in TN area that proceed sudden right side coldness, then weakness.  During events -- NO short term memory at all, mixing up words and if things escalate I present a little like I'm having a stroke, although at this point strokes have been ruled out.  First MRI was a TN protocol, but showed the internal capsule lesion plus more than nine other areas of demyelinization.  Not sure why they care about 9.

[aspen2]

Thanks, Deb.  Yes, the sleep issues were rather trying when I couldn't lay my head on the pillow ... but, like you, once I was down, the TN settled down and I still usually managed a decent night's sleep (7ish hours).  Now, 4 months later, I'm ranging from 0-4 hours a night, without much actual pain.  My doctor as recommended I try a small dose of melatonin -- but I'm so hyper-sensitive to medication right now I'm not sure this will be a good thing :-P.

Definitely the lack of sleep is contributing to my lack of function -- I've always been very good at sleep, and very obviously out of whack if I missed out on it.  Sigh.  4 hours last night -- better than none but I've slept for 10 hours over the last 4 days ... zzzzzz.

[Deb61]

I meant, I COULDN'T get to sleep very fast because of the spasticity in my
legs. . .

[Deb61]

I think there is a connection between sleep problems and MS for several reasons.  However, I do not know anything about lesion location and sleep disorders.  There are many reasons, though for having sleep disorders if you have a neurological disease like MS.  

One of the best things my new neurologist did was referring me to a sleep specialist.  I was not getting deep sleep which added to my fatigue, focus, and memory issues.  For me, it had to do with pain I had at night.  I could get to sleep very fast because of the spasticity in my legs.  This is probably very common in people with MS.  I take a generic of Provigil which also helps with the fatigue and focusing issues.  I also take a seizure medicine (low dose).  

I've had bouts of TN.  I can guarantee that I wasn't getting to sleep when it felt like an ice pick was stabbing me in the side of my head.  Once I was asleep, though, the TN was at rest, too, though.  It was getting to sleep that was difficult.  

I don't know why nine is an important number either.  I had less than that when I was first diagnosed.  Maybe they're keeping a count of the lesions to see what changes, if any, in future lesion load.  Perhaps nine is the number of significant lesions you had plus some other tinier ones . . . Just speculating, though.

[aspen2]

I was being treated for TN pain (tried gabapentin then Lyrica).  Couldn't tolerate the meds at all.  They made me fall over, amongst other things. (They didn't seem to affect my sleep, though).   I read some things about statins and neuropathic pain, and convinced my doctor to let me drop my statin.  "Coincidentally" the facial pain moved from 12/10 during the events to an occasional 2/10 -- now it normally feels like occasional twinges or pulling in my face, that PRECEDES (sorry for the spelling mistake earlier) the other symptoms.  I had the extreme pain January 25 through to middle of beginning of April, since then it's been a background thing (for which I am truly grateful!)

At this point, after two months of med cocktail, I can't take anything without side effects -- I ended up with rebound headaches from Tylenol.

It's funny ... I don't "feel" stressed about it ... although I would welcome a diagnosis of something.  Anything LOL.  I have no problem going to sleep (until last night).  And when I wake up, it's not like when you are worried about something.  My system feels like it's morning, even if it's still only 10:45 p.m., and I don't get back to sleep.  It feels bright.  I have had a few episodes of sparkles in one eye ... and I suppose that could be waking me up, but I don't think it would KEEP me up.

I had a second MRI yesterday; hopefully that will shed some more light on things ... (stroke/ms protocol this time).

[Poppy7402]

Welcome to the forum.    I don't know whether there is any relationship between lesion location and sleep issues but there are quite a number of things that can cause these problems.  

You mention that you have trigeminal neuralgia.  Is this being treated?  The reason I ask is that some of the drugs used to treat nerve pain play absolute havoc with sleep.  When I tried Nortriptyline for nerve pain, it kept me awake for a whole week and I believe other drugs can also do this in susceptible people.

Another thing that seemed to cause me the sleep issues you describe, was the whole issue of being in limbo land.  It is one of the most awful places to be and it's all but impossible to avoid being upset/stressed about it.  Believe it or not, now I've got a diagnosis I sleep much better.

The number nine in terms of lesions is probably significant if someone is going off the old McDonald criteria (someone please correct me if I've got this wrong).  If you look at this website http://en.wikipedia.org/wiki/McDonald_criteria or one like it, you'll get a run down of the criteria they use.  For example, in my case, I've got numerous lesions involving the periventricular white matter and infratentorially, plus I've had more than two relapses so I'd come under either of the first two revised criteria.

Hope this helps somewhat.


Poppy