43 msfocusmagazine.org But if you are regularly getting less sleep than needed, the eﬀects will build and may be more diﬃcult to manage. Sleep quality self-assessment Next,you need to take the time and evaluate your current sleep quality. According to Dr. Abby Jean Hughes, assistant professor of Physical Medicine and Rehabilitation at Johns Hopkins, “assessing your sleep is the ﬁrst step to identifying sleep-related problems and/or clinically signiﬁcant sleep disorders.” Dr. Hughes recommends a self-assessment that you can use to evaluate your quality of sleep. Using your previous month of sleep, answer these questions: 1. How long, on average, has it taken you to fall asleep? 2. How many hours of sleep, on average, did you get per night? 3. How many times, on average, did you wake up per night? 4. Howmanyminutes pernight, on average, did you spend in bed awake, unable to fall back asleep? 5. How rested, on average, did you feel upon waking in the morning? 6. How often, on average, did you take naps during the day? 7. How often did pain interfere with your sleep? 8. How often did spasticity/restless legs/ limbs/body interfere with your sleep? 9. How often did urinary/bowel symptoms interfere with your sleep? 10. How often did you take medication (prescription or over-the-counter) to help with sleep? 11. How often did you snore or experience shortness of breath upon waking? 12. Howdiﬃcultwas it to maintain alertness and energy during the day? Discussthesequestions,andyourresponses, with your healthcare provider. If you face any sleep-related issues, or have diﬃculty falling or staying asleep, a doctor may recommend that you take part in a sleep study. During a sleep study, your sleep is monitored by professionals using special equipment. Treating sleep disorders Once you have an understanding of how much sleep you need, and you have identiﬁed any problems aﬀecting your quality of sleep, the next step will be correcting those poor sleep behaviors, treating sleep-related issues, and achieving a better sleep routine. Dr. Hughes said, “Treating sleep disturbance in MS can be quite challenging due to its many potential causes, as well as potential side eﬀects of some treatments.” Treatment options will depend on where your symptoms stem from: • Are they the result of personal habits? • Are they caused by MS symptoms? • Are they the result of some other issue, like insomnia, restless leg syndrome, or sleep apnea?