Circadian variation

[1eye]

I have a theory regarding level of disability in MS. It changes depending on the time of day. I believe if you ran an experiment using the 9-hole peg test, 50m walk, PASAT, or other less coarse measures which give a more accurate reading of fine motor skills, sensory abilities, proprioception, weakness, etc., you would find that in MS there is a definite deterioration from the time of awakening, through the day, and as bed time approaches.

It is my belief that there is definite improvement when endorphin is at its peak. I think the production of melatonin as we approach our nadir after sundown is not a binary thing. I think the sun triggers the melatonin/endorphin cycle, but that as with the sun in winter, its chemical cycle can be very gradual.

It may be that the biochemical state which produces disability in MS is ameliorated by endorphin, and/or worsened by melatonin. There may be something about MS which amplifies these biochemical cycles/changes. I think this whole area needs further investigation. There is a definite circadian element to this disease.

If you percieve this effect in your own case, chime in...

[ElliotB]

"there is a definite deterioration from the time of awakening, through the day, and as bed time approaches"

I fully agree yet I find a short afternoon nap can often negate the effect.

[1eye]

"there is a definite deterioration from the time of awakening, through the day, and as bed time approaches"

I fully agree yet I find a short afternoon nap can often negate the effect.

Maybe the nap is restoring your endorphin production. That matches my experience, and I have times when I wake up in the middle of the night and I'm thinking more clearly. I have also heard of pwMS being able to walk "after midnight". I think the endorphin production may depend on achieving REM sleep, and being able to run the garbage backwash cycle. This may or may not be happeningb during a nap.