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Since there is no cure for ALS, it’s really important to look for treatable problems and symptoms that can improve the life of people with Amyotrophic lateral sclerosis. Sleep disturbances are common in patients with ALS and can make their lives that much more difficult. Different things can cause sleep issues in these patients. Sleep can be disrupted by mucus retention, pain, discomfort from muscle spasticity and reduced mobility. For example, patients can’t turn around in bed or they have pain from being immobilized. Many people with ALS have trouble falling or staying asleep because of muscle cramps and restless legs. Weakness of their respiratory muscles can cause shallow breathing during the night and the accumulation of carbon dioxide in the blood. If that’s happening, the way to improve the life span of someone with ALS is by starting noninvasive ventilation using a facial mask. Depression and anxiety can lead to insomnia. Managing mental health issues is of extreme importance in patients with ALS. In a small subset of patients, rapid eye movement sleep behavioral disorders can be present because of the degeneration of neural pathways that are involved in REM sleep regulation. With regard to overall prognosis, sleep disorder breathing and nocturnal hyperventilation are particularly important because they precede respiratory failure. The use of sleep medications should be used only in the last phase of the disease prior to death, or when there’s intractable insomnia. Patients with ALS need regular followup in a sleep lab to help ensure optimal home ventilation. A multidisciplinary team taking care of someone with ALS should include a sleep specialist.
