Living with multiple sclerosis (MS) requires a delicate balance of routine, rest, and self-compassion. While much attention is given to managing symptoms throughout the day, what happens in the evening can be just as important. My evening rituals have become an anchor—quiet, dependable, and oddly empowering. They provide structure, help me wind down, and most importantly, prepare my body and mind for restorative sleep. In this post, I’ll walk you through the evening rituals that bring calm to the chaos and offer a few reflections on how MS has shaped them over the years.

Why Evening Rituals Matter More with MS

For people living with MS, evening routines aren’t just about comfort—they’re about survival. Fatigue, pain, and cognitive dysfunction often crescendo as the day draws to a close. Without well-established evening rituals, the transition to rest can become erratic, even distressing. These routines help mitigate overstimulation, promote sleep hygiene, and reduce the likelihood of nighttime symptom flares.

In my own case, having consistent evening rituals gives me a sense of control over a body that often defies logic. Rituals create a boundary between the day’s demands and the calm that precedes sleep. It’s not just a routine—it’s a signal to my nervous system: “You’ve done enough. Now, it’s time to rest.”

My Evening Rituals: A Step-by-Step Look

1. Winding Down Begins with the Clock

Around 8:30 pm, my body tells me it’s time to slow down. This isn’t a discipline—it’s a necessity. If I ignore that signal, I pay the price in fatigue and stiffness. So I respond by reducing light levels and turning off unnecessary noise. These quiet cues are the first phase of my evening rituals.

To conserve energy in the evenings, I start winding down as soon as the clock signals it’s time to slow the pace.

I’ve also learned not to eat too late. Evening meals are light and early—supper before 7 p.m. if possible. A heavy meal too close to bedtime affects digestion, which in turn disrupts sleep. MS taught me this the hard way.

2. A Warm Drink and Some Light Reflection

A warm cup of herbal tea or a malted milk drink is often my evening companion. Nothing with caffeine, of course. This pause gives me time to reflect on the day—not in a journalistic way, but mentally: What did I achieve? What needs carrying over to tomorrow?

This reflective pause is one of the gentlest but most powerful parts of my evening rituals. It’s not about productivity; it’s about closure.

Savouring a warm drink while reflecting on the day helps reinforce healthy habits and a sense of calm.

3. Quiet Entertainment: TV or a Book

Evenings used to mean Kindle reading for me. I powered through the complete works of Charles Dickens. But I’ve come to realise that electronic devices, even those designed to mimic paper, can interfere with sleep. These days, I often read a traditional paperback book or, more commonly, watch something calming on TV with my wife.

When I do read, it’s sometimes to improve my language skills. I might play Spanish or Portuguese lessons through speakers, hoping some of it sinks in as I drift off. As a method of learning, subliminal listening has had mixed results—but as part of my evening rituals, it adds gentle structure to bedtime.

4. Evening Medications and MS Management

Evening medications are non-negotiable. Despite a lifelong aversion to pills, my evening rituals now include the careful management of a small arsenal of prescriptions that help keep MS symptoms in check. For most of my life, I prided myself on avoiding medications wherever possible. I saw them as a last resort—a sign of weakness, perhaps, or an invitation to side effects that might be worse than the original problem.

But MS doesn’t give you the luxury of idealism forever, if ever.

Over the years, I came to see medication not as surrender, but as strategy. Fatigue, spasticity, pain, bladder urgency, and low mood—each has a specific remedy, and together they make up the chemical scaffolding that helps support my daily life. I don’t take anything casually. Each tablet, capsule, or spray has earned its place.

Prescription Drugs

Each evening, I take three medications as part of my winding-down routine. First, tamsulosin—a drug prescribed to limit the growth of my enlarged prostate gland. Then mirabegron, which helps ease the pain and urgency associated with my spastic bladder—a common and frustrating symptom of MS. And finally, amitriptyline. This one deserves a brief explanation.

Amitriptyline is technically an antidepressant, but that’s not why I take it. I am not depressed. I’m a generally easy-going sort of fellow, and I prefer to focus on the positives in life. But amitriptyline has another purpose: in low doses, it helps improve sleep quality and reduce nerve pain—both of which are welcome gifts in my MS toolkit. For me, it’s a night-time ally, not a mood stabiliser.

So every evening, without fail, I open my weekly pill organiser and go through the motions. I check that I’ve taken the right tablets for that day and prepare the next day’s doses. I do this at the same time each night, not just for consistency, but because skipping or mistiming doses always has consequences.

This part of my evening rituals is also when I run a mental check-in: Have I noticed any changes today? Any new muscle spasms, tingling, unusual fatigue, or signs of infection? Anything that might signal a flare or something brewing under the surface?

It’s a clinical, almost methodical ritual—but not without emotion. There’s a strange comfort in knowing I’ve done what I can to support myself. And a strange irony, too: the man who once avoided paracetamol now has a nightly medication checklist.

Evening medications may not be a glamorous part of my routine, but they’re a powerful reminder that managing MS means making peace with compromise —and taking care of future me, one tablet at a time.

5. Bathroom Prep and the Pee-Bottle Routine

Bathroom rituals are not glamorous, but they are essential. I brush my teeth, check the bedroom for trip hazards, and empty my trusty pee-bottle if it was used overnight. This humble item—a nod to the chamber pots of old—saves me painful middle-of-the-night bathroom treks.

But this wasn’t always part of my evening rituals. I resisted it for a long time, clinging to a sense of normalcy. Then came the night when nature called around 3 a.m. I rose groggily from bed, half-asleep, and tottered off toward the bathroom. As soon as I reached the loo, a wave of nausea swept over me and I blacked out—collapsing unceremoniously onto the cold bathroom floor.

It wasn’t just undignified—it was dangerous. I could have broken a bone or suffered a head injury. That was the turning point. I realised that pride wasn’t worth the risk. So I gave in to practicality and stationed a pee-bottle beside the bed.

Now, part of my evening rituals is a simple check: is the pee-bottle there? Is it empty? It’s one of those small acts that protects my independence and keeps me safer. It may not be glamorous, but it’s essential—and oddly reassuring.

The Emotional Comfort of Evening Rituals

One might expect evening rituals to be functional, even clinical—but for me, they’re deeply emotional. They represent self-care and dignity. I used to thrive on stress and abhorred routine. MS turned that on its head. I now understand that stress is the enemy and routine is my ally.

Each step in my evening rituals is a kind of self-respect—a way to say, “You made it through today. Let’s make tomorrow a bit easier.” This mental reframe didn’t come easily, but it’s become essential.

Evening Rituals and Brain Fog

Cognitive fog is a frequent visitor in the evening hours. I counteract this by keeping my evening rituals consistent and visual. I have checklists, gentle reminders, and even timers to nudge me through the process. If I skip steps, I notice. If I stick to them, I sleep better and wake up clearer.

My rituals also reduce decision fatigue. By making the last few hours of the day predictable, I save precious cognitive energy. It’s not automation—it’s compassion in the form of habit.

By easing brain fog with structured evening rituals, I set the stage for smoother, more focused morning routines.

When My Evening Rituals Go Awry

No routine is perfect. There are evenings when pain flares up, or emotional exhaustion overtakes me. Sometimes, I do nothing right—skip meds, leave lights on, fall asleep with the TV blaring. The result is predictable: poor sleep, more pain, more brain fog.

These off-nights remind me why my evening rituals matter. They aren’t optional; they’re part of my survival strategy.

Final Thoughts: Routine as a Form of Resistance

Living with MS often feels like a battle of attrition. But my evening rituals are a form of resistance—a soft rebellion against chaos. They are about showing up for myself, night after night, even when I’m tired, sore, or scared.

MS may have robbed me of many things—spontaneity, speed, certainty—but it’s also given me the value of mindful structure. My evening rituals are not just tasks. They’re a quiet anthem of resilience.

Outro: A Quiet Mind, A Well-Fed Soul

And so, each night, I finish the day with a mix of gratitude and fatigue. I watch a show, read a few pages, sip a warm drink, and do my best to make peace with whatever the day brought.

Sometimes, I still fall asleep listening to language tapes, imagining myself fluent by morning. It hasn’t worked yet, but it’s part of the dream. And isn’t that what evening rituals are really for? Not just sleep—but rest. Not just habits—but hope.

Establishing consistent bedtime rituals and nighttime routines can greatly improve sleep quality and overall wellbeing. Whether you’re winding down with calming music, journaling, or gentle stretches, these evening routine ideas help signal to your body that it’s time to rest. By adopting simple yet effective end of day habits, you create a sense of calm that carries into the next morning.