My neuro wants me to get off the lorazepam I've been taking for sleep every night for the past 5 years. I started before I found him, partially because of anxiety due to the diagnosis. Yikes. I was at 1.5 mg. Now I've dropped to 1 mg plus 5 mg of Ambien. Then it's on to .5 mg of lorazepam and 10 mg of Ambien. Then ultimately it's off all lorazepam.

He told me benzodiazepines are the absolute WORST for sleep because they don't allow you to go into a deep REM sleep. He said that's not a problem with Ambien and when he gets people off benzodiazepines they come back and say I'm now dreaming all the time. And his response is "well that's normal because now you are getting deep sleep!" Benzodiazepines don't contribute to healthy sleep and they can exacerbate depression and cause cog fog and memory issues apparently.

He really believes sleep is almost more important than diet or exercise. He found that what many people thought was MS fatigue was actually bad sleep. When they started getting good uninterrupted sleep the fatigue improved significantly.

So that's my #1 goal -- fix my sleep. I also got a lecture about how the sleep you get during daylight hours is not as good as the sleep you get during the time the sun is down. I was told to stop going to bed so late and getting up so late.

In general my neuro's goal is to find medication that helps with bladder problems at night to minimize interruptions, advise drinking less water before bed, and keep pets from bothering your sleep and even snoring spouses! And the bedroom is only supposed to be for sleep or sex, nothing else.

All of this is referred to as sleep hygiene.