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Sleep – Oh, Elusive Sleep

Insomnia creates elusive sleep for many RA patients.

Those of us who find regular sleep habits hard to come by shake our heads in wonder at our partners and others who snooze away for a solid 8 hours or more.  Once upon a lifetime ago, sleep came easy for me.  But as my rheumatoid arthritis progressed, I found it increasingly difficult to fall asleep and stay asleep for the length of time my body needed to recover.  Elusive sleep plays with your mind and drags you down.

Over the last 15 years, I have tried numerous over-the-counter sleep aids.  Few of them worked and if they did, it wasn’t for long.

My primary care doctor prescribed Ambien, and it was wonderful.  I slept so well for about 3 months.  And then the rash began…and spread…and spread.  Both legs and forearms looked like a measles rash.  One doctor thought it must be rheumatoid vasculitis, but my rheumatologist shot that down.  He sent me to a dermatologist.  During the 3 months I waited for that appointment, I experimented myself.  Ambien was the only change in medications or diet over several months, so I stopped taking it.  Sleep again became elusive. 

However, a few days after ceasing the Ambien, the rash disappeared.  I took that little pill once more, and the rash returned.  One problem solved, but I still could not fall asleep until the wee hours of the night and awoke several times before giving up.

While an exact percentage of RA patients with sleep issues would be difficult to discern, reports say that 80% do suffer from fatigue.  It stands to reason such fatigue would figure into sleep disorders.  A lack of sleep can aggravate stress hormones and cause flares, more pain and more sleeplessness.

The RA Connection to Insomnia

We all know the importance of getting enough sleep.  It improves both physical and mental health. According to one source, 50 to 75% of RA patients deal with sleep disorders. When you suffer from swollen and/or painful joints, sleep becomes elusive.  The search for a comfortable position makes it difficult to relax enough to fall asleep. 

How Medication Affects Your Sleep

Certain drugs used to treat rheumatoid arthritis may interfere with your sleep rhythms.  Prednisone might be one of those medications.  For some RA patients, hydroxychloroquine creates sleep problems.  Talk to your rheumatologist about the drugs you take if sleep eludes you.  He or she might change your meds or the time of day you should take them.  At any rate, your doctor should know if you have difficulty sleeping.

Suggestions to Help You Sleep

What works for one person may not help another.  You may need to try multiple tips to find one that helps you but hopefully, one or more of the following tips will work.

Turn Off All Electronics before You Go to Bed

That means no television, no cell phone!  Just silence and cool air to promote relaxation and total rest. Exposure to artificial light late in the evening disrupts your circadian rhythm and melatonin levels

Establish a Regular Pre-Bedtime Routine

Do you go to bed and wake up at the same time each day?  A routine gets your body expecting the same time of sleep each day.  Allow time at the end of your day to mentally slow down and relax before sleeping.

Regular Exercise Promotes Good Sleep.

Along with helping your RA pain and swelling, regular exercise may contribute to better sleep.  Include both aerobic exercise, like swimming or walking, and muscle-strengthening exercises in your workout routine. Try to get 30 minutes of exercise daily, even if you need to break it up into segments.

Watch What You Eat.

It makes sense to avoid caffeine in any form at night, if sleep is elusive.  Alcohol will also interfere with regular sleep.  Try to eat a light dinner.  If you feel you need a bedtime snack, keep it light.

Rethink Your Mattress.

One of my issues for many years was back pain when lying in bed.  We tried several different types of mattresses and used a waterbed for several years.  But when we bought a Sleep Number mattress, my life changed for the better.  I still struggle with sleeping, but I don’t have back pain.

Think about your pain and how your bed affects it.  Could be a change of mattress would help.

Hot Baths Are Heavenly!

A hot, relaxing bath before you go to bed might provide the key to a good night’s sleep.  Everyone is different but it’s certainly worth trying.

Pain & Insomnia Create a Vicious Cycle.

According to an article in “Arthritis Care & Research,” RA patients with sleep disorders experience more intense pain than those who sleep well.  This suggests that the lack of sleep determines how the brain interprets pain. So, it pays to do what you can to relieve pain and encourage good sleep habits. 

Make sure you establish a regular routine before going to bed; exercise regularly, watch what you eat and when, and lose the electronics before bedtime.   Choose bedding that provides the most comfort for you.  If pain and insomnia create a vicious cycle that feed each other, it makes sense to do what you can to address both.

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