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Why Are MS Muscle Spasms Worse at Night?

Medically reviewed by Joseph V. Campellone, M.D.
Written by Emily Brown
Updated on February 1, 2024

“I couldn’t sleep because of spasms,” one MyMSTeam member shared.

Muscle spasms are common among people with multiple sclerosis (MS), and they can feel worse at night. As many as 80 percent of people with MS experience muscle spasms or stiffness. Spasms can be painful and make parts of the body jerk uncontrollably. Leg spasms often happen during sleep, which can make it hard to get a good night’s rest.

Reduced movement, body positioning, and temperature may play a role in making muscle spasms feel worse at night. Learn more about nighttime muscle spasms and tips for managing them.

Why Do MS Muscle Spasms Happen at Night?

According to the National Multiple Sclerosis Society, spasticity is one of the most common symptoms of MS. MS-related nerve damage in the brain and spinal cord can disrupt normal muscle contractions, causing muscles to jerk. MS spasticity, which makes for stiff or tight muscles, can cause muscles to spasm when the muscle is stretched, such as when you move your legs.

Muscle spasms can be worse at night because spasticity is worse when you move less, such as when you’re sleeping. Your body positioning in your bed also matters — unsupported joints can cause extra tension and tightness in your muscles. In addition, tight muscles and pain associated with MS can make it hard to relax, which not only makes it harder to sleep but can also lead to muscle stiffness associated with spasms.

Muscle spasms can be worse at night because spasticity is worse when you move less, such as when you’re sleeping.

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Fatigue is a common trigger for spasticity, so addressing fatigue is an important part of managing spasticity and spasms. However, managing fatigue can be much easier said than done. Other triggers of spasticity include temperature changes, stress, and anxiety.

How Do Muscle Spasms at Night Affect People With MS?

Muscle spasms at night may cause you to lose sleep and become more fatigued. Having insomnia is hard enough, let alone managing symptoms of MS while you’re trying to sleep. Sometimes, just knowing you are not alone can help. Many MyMSTeam members express the pain and frustration of dealing with muscle spasms at night:

  • “I get them every day — sometimes, even in the middle of the night. I was just drifting off to sleep last night when the arch of my left foot decided to do something.”
  • “Had a horrible foot spasm last night, and my hip was hurting for days too.”
  • “Bad night with left and right shoulder and arm spasm.”
  • “Last night kinda sucked … not much sleep due to left leg spasms.”


I get them every day — sometimes, even in the middle of the night. I was just drifting off to sleep last night when the arch of my left foot decided to do something.

— A MyMSTeam member

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Tips for Managing MS Muscle Spasms at Night

MS muscle spasms are common, but they can be managed. Managing spasticity, in general, can help reduce spasms at night. There are several treatment options for muscle spasms and stiffness, such as:

  • Physical therapy and occupational therapy
  • Muscle relaxants and medications such as baclofen (Lioresal), tizanidine (Zanaflex), dantrolene (Dantrium), gabapentin (Lyrica), diazepam (Valium), clonazepam (Klonopin), or onabotulinumtoxin A (Botox)
  • Equipment like braces or splints for stretching stiff muscles
  • Electrical stimulation therapy

Exercise for Muscle Spasms

Exercise can also help with spasms, as it increases flexibility and muscle tone. Gentle exercises like yoga, gardening, and range-of-motion exercises can be good places to start. Check with your health care provider or a physical therapist before beginning any new exercise routine to make sure it works for you and doesn’t aggravate your MS symptoms.

You can try to manage your muscle spasms at home. Consider some tips for preventing MS spasms that you can start tonight:

  • Make sure your mattress is supportive enough and you have plenty of pillows.
  • Ensure good positioning when you lie down, with support for your neck and back to reduce strain.
  • Avoid sleeping in tight pajamas or other garments.
  • Keep a comfortable temperature where you sleep, using air conditioning, a fan, heating, or more or less bedding as necessary.

If you find yourself with spasms in the middle of the night, try some stretching exercises in bed. For example, pull your knees into your chest and let one knee fall to the opposite side, and repeat on the other side. You can also try flexing your feet and pointing your toes.

If you find yourself with spasms in the middle of the night, try some stretching exercises in bed — pull your knees into your chest and let one knee fall to the opposite side, and repeat on the other side.

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MyMSTeam Members Share Tips

Members of MyMSTeam often share tips on what works for them, apart from prescribed medication, to reduce muscle spasms at night. One popular solution is to add weight. Members report using weighted blankets and even sacks of rice on their legs to calm down the spasms. “My dog lays on mine,” wrote one member.

Each person with MS is different, but here are a few more tips from members of MyMSTeam:

  • “The only thing that seemed to help was putting on multiple layers of socks to create counterpressure in my foot. It made the twitching less disruptive to my sleep.”
  • “I cut sugar out of my diet and muscle spasms at night stopped. I miss sugar but like sleeping better.”
  • “Have your potassium levels checked. In the meantime, maybe a banana before you go to sleep might help.”
  • “I have to make myself get up and walk it off when I have leg spasms at night.”

Tips for Getting Better Sleep

It’s no secret that getting enough sleep is important for quality of life. But with MS, it’s not always easy. Not only can MS muscle spasms make you lose sleep, but increased fatigue from lost sleep can increase stress and spasticity, which can lead to spasms. Hence, it can turn into a cycle.

Managing spasticity and spasms is critical to getting better sleep. There are many ways to reduce sleep disturbances specific to MS to reduce fatigue. Remedies like melatonin, changing up your pillows, and even therapy are helpful for some people. If you’re losing sleep because of MS, talk with your health care professional or neurologist about ways to get the sleep you need and deserve.

Talk With Others Who Understand

MyMSTeam is the online social network for people with MS and their loved ones. On MyMSTeam, more than 207,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you noticed your muscle spasms worsening at night or negatively affecting your daily life? What other symptoms of multiple sclerosis are you living with? Share in the comments below, or start a conversation by posting on your Activities page.

Updated on February 1, 2024
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Joseph V. Campellone, M.D. is board-certified in neurology, neuromuscular disease, and electrodiagnostic medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Emily Brown is a freelance writer and editor, specializing in health communication and public health. Learn more about her here.

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