Dealing with Sleep Troubles and Rheumatoid Arthritis

When your rheumatoid arthritis is affecting your sleep, increase your chances of getting some quality shut-eye with these healthy sleep hygiene hacks.

When you’re living with rheumatoid arthritis (RA) there’s a good chance that you have experienced some difficulties in falling asleep, staying asleep, or feeling rested even after getting some sleep.

When you have RA, your immune system is erroneously attacking healthy tissues. This can lead to inflammation, pain, and decreased range of motion. The discomfort of these symptoms of RA can keep you awake at night or disrupt whatever sleep you are getting.

In addition to the physical symptoms, living with RA can take an emotional toll. This can also contribute to your sleepless nights.

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Why is sleep important when you have RA?

There’s no doubt that medical professionals focus a lot of attention on sleep and its benefit for your overall health. Sleep affects nearly every single system in the body. Sleep is when you heal, reset, and recover. Deep sleep is when the immune system replenishes itself and inflammatory factors are reduced.

Sleep becomes even more essential when you have RA because your immune system works in overdrive. Your body needs that time to heal and recover from the additional inflammation that has built up throughout the waking hours.

It’s not always easy to get enough sleep, though. A study from 2018 which surveyed 95 people diagnosed with RA found that those with moderate to severe disease activity also reported shorter than optimal sleep duration. The researchers also noted that increased pain intensity correlated with increased sleep disturbances.

A 2017 study noted both short and long-term results of sleep disruption. In healthy adults, even short-term sleep disruption contributes to “increased stress responsivity, somatic pain, reduced quality of life, emotional distress and mood disorders, and cognitive, memory, and performance deficits.”

For those with underlying conditions and long-term sleep disruptions, researchers noted the bidirectional way they may interact. In other words, each may affect the other, creating a circle wherein sleep disruptions worsen chronic conditions and lead to increased sleep disruptions, or the other way around, with chronic conditions negatively affecting sleep.

Why do so many of us find getting quality sleep challenging?

How much sleep is enough? 7 to 8 hours a night, for most adults, is recommended in this handy guide from the Centers for Disease Control and Prevention (CDC). This can be a hard goal to hit when you’re tossing and turning.

When it comes to getting enough rest, there are several elements to consider.

• duration (how long you’re able to sleep)
• continuity (whether your sleep is solid or interrupted by periods of wakefulness)
• quality (whether you’re left feeling rested after sleep)
• other factors (conditions like sleep apnea or restless leg syndrome which may interrupt or otherwise affect sleep)

The pain and anxiety caused by RA symptoms can make it difficult to fall asleep or to stay asleep.

Medications you take for your RA can impact sleep too. You may use steroids, prednisone, or methylprednisolone, for inflammation and flare management. These medications can make it harder to fall asleep at night. You can talk with your doctor about whether taking your dosage early in the day may help.

Where does sleep hygiene fit in?

How do you get enough high quality sleep when you have RA? One way to work toward better sleep is to focus on your sleep hygiene.

When you look at the big picture, where you sleep, what you do to prepare for sleep, and even how you spend your day can impact the quality of your rest. If you’re interested in boosting your sleep hygiene, here are some great tips to get you started!

1. Prioritize sleep: Getting quality sleep is just as important as drinking enough water and eating a varied diet. Take some time to think about your challenges and work on improving your sleep. Seek support from your doctor and family members.
2. Clear your mind: Anxiety can make settling into sleep challenging. If you’re dealing with stress and a racing mind each time your head hits the pillow, consider counseling, a coaching program, or support groups to provide you with social support and tools to help you cope.
3. Manage your pain: Knowing your body and working with your doctor can help keep pain in check. This may mean doing things earlier in the day or spreading out challenging tasks that may cause discomfort. This may also mean discussing pain management options with your healthcare professional if what you’re doing isn’t working as well as you’d like.
4. Establish a regular sleep schedule: Make an effort to go to sleep and wake up around the same time every day. This will train your body to rest during certain times, making going to sleep, and staying asleep, easier over time.
5. Establish a regular pre-sleep routine: Take time to brush your teeth and wash your face, but also think about incorporating things like journaling, stretching, or meditating. This will start to signal your body that it’s time for rest.
6. Create a space for sleep: Make your sleep space a haven. If possible, invest in a mattress, bedding, and pillows that offer comfort. Use air conditioning or fans to adjust the temperature. Experiment with lighting or try blackout curtains that allow you to darken your room at any time. This is especially helpful if you work odd shifts or have long periods of daylight where you live.
7. Avoid screens before bed: Television can be very stimulating with varying lights and sounds. The same goes for your cell phone. Try to allow at least 30 minutes of screen-free time before bedtime.
8. Exercise daily: According to a review from 2017, for middle-aged and elderly adults, exercise can improve sleep efficiency and duration, especially in those with chronic conditions. Scheduling time for movement each day can improve sleep.
9. Limit caffeine to about 1 serving a day: You may also want to avoid energy drinks or other beverages or foods with stimulating properties.
10. Talk with your healthcare professional about your sleep challenges: They may be able to offer tips specific to your needs. They may be able to suggest over-the-counter options, like melatonin, diphenhydramine, or other options. There are also many prescription options available if sleep quality continues to be an issue.

Sleep is an essential part of your quality of life. Taking the time to think about your challenges and improve your sleep hygiene can have daily benefits.