Sleep and RA (rheumatoid arthritis)

Dia duit agus fáilte – that’s Irish for hello and welcome – to my thriving with Rheumatoid Arthritis (RA) and autoimmune disease blog. The title says it all…keep reading to learn about sleep and RA.

This post is all about sleep – how rheumatoid arthritis/RA affects sleep, what you can do about RA pain at night and how to get more sleep while living with RA. I use my own experiences with rheumatoid arthritis to inform much of what I write but research and conversations with fellow autoimmune disease and chronic pain warriors leads me to believe that we are all part of a large group of fighters trying to figure out how to do this thing called life with a few more challenges that some others.

You probably already know that sleep is especially important when you have an overactive, or compromised, immune system and you may have already experienced that sleep is hard to come if your pain at night is such that you cannot get comfortable. You may even have heard the term “painsomnia” to describe to nightly battles many of us face.

For decades, I joked about how much I love my bed, that it was one of my favorite places in the world to be. When you are raising 4 kidlets, any time spent in bed is relished and appreciated. And I was always grateful that sleep came so easily. I never suffered jet lag when I traveled home to Dublin, rarely felt the need for a nap and could sleep anywhere (as long as the bed was comfy.)

And then, as I got older and was diagnosed with RA, all those years of great sleep went out the window. (I became jealous of my dog!) Continue reading below to learn how to sleep when you have RA even if your rheumatoid arthritis pain is worse at night.

Getting back to sleep with rheumatoid arthritis

My journey back to healthy sleep was as convoluted and challenging as my journey back to health; I hope this “Sleep and RA” article helps you quickly and easily improve your sleep while coping with RA pain at night.

With the gradual increase of my pain symptoms, I began to find it really difficult to fall asleep as the pain pulsed in my joints. If I woke in the middle of the night, my body ached so badly that I often chose to get up in the hopes that a new position would ease the discomfort. I soon found myself staying in bed until 10am simply to try and get 8 hours of sleep. RA and sleep make terrible bed fellows (couldn’t resist, sorry!)

The good news is that the more I adjusted my other habits – changing my diet, reducing stress and toxins, finding support – and reduced my pain and other RA symptoms, the more my sleep improved. But it didn’t return to the same quality as before my diagnosis and I knew I would have to do even more in order to rediscover my love of sleep and my bed.

The science of sleep

As I’ve said before, I am not a doctor and any of the science-y type of info on this site is very basic and in terms that I understand and feel comfortable telling others. I encourage you to talk to your physician if you have any questions.

Have you ever wished you didn’t need to sleep because you have so much to do and could really use those 8 hours much more productively? Surely, I am not the only one with this crazy idea. And yet, I will spend between 1/4 and 1/3 of my life asleep, just like every other human which begs the question: Why?

Why do we need sleep?

Thanks for asking! The body needs sleep to “reenergize its cells, clear waste from the brain, and support learning and memory. It even plays vital roles in regulating mood, appetite and libido.” Read more. That’s quite a to-do list to be completed in the 7-9 hours of nightly sleep the average human adult needs. And to be honest, it sounds much more important than what’s on my to-do list.

Okay, so I’m convinced. I need sleep but do I really need 7-9 hours?

Sleep deprivation is a real thing. (Did you know they use sleep deprivation as a form of torture? Terrible, but true.) In just the first night or two without enough sleep, our brain function decreases, compromising our decision-making skills, and we might feel more emotional or light-headed.

The good news is that we can catch up on sleep (like on the weekends when we snore until 11am!) The bad news is we cannot bank it in advance of a particularly busy/stressful week.

Chronic sleep deprivation by itself can lead to:

But what we’re more concerned about in this article is when lack of sleep and RA combine forces, resulting in more pain, more frustration and for me, worse depression (post) and lower libido (post.) The above list, when added to rheumatoid arthritis symptoms, create a much more difficult path to healing and a return to our active, live-out-loud life.

But the good news is (and this site is full of great news for anyone dealing with the chronic pain of RA or another autoimmune disease) that our habits and behaviors have the potential to improve our sleep and therefore our lives. Keep reading.

13 Habits that improve sleep

My sleep got so bad that I finally went to a sleep specialist and ended up doing an overnight sleep study which came back with a no-sleep-apnea result. That was great news. But the biggest takeaway from the whole experience was what the doctor told me to do and what not to do.

I like a good, no-nonsense to-do list, even if I didn’t create it and the list my sleep doc gave me was short, sweet and simple to follow. I say simple rather than easy because breaking some of my “bad” sleep habits took incredible will power. (Complete disclosure; I still read in bed.)

Here’s my doctor’s list:

• The bed is for sleep and sex, that’s it. No reading (big problem for me), no TV, phone, computer in bed (not hard.)
• Avoid alcohol in the evening. (So when exactly am I supposed to have a glass of wine? Breakfast?)
• No caffeine after 2pm. (Damn, I like that afternoon pick-me-up-cuppa-tea)
• Exercise regularly but not within 3 hours of bedtime. No problem here.
• Don’t nap. (No biggie)
• Learn yoga and/or meditation to reduce stress. Done. See post)
• Keep the bedroom temperature around 65*F (Okie doke. Just ask the kidlets; they moan about the house being freezing at night!))
• Go to bed and rise at the same time every day. (This can be tough for me, especially when Im awake for three hours and my body needs that sleep even if it is 9am.)

And I’d like to add the extra few habits that helped me deal with the RA pain at night that often kept me from getting a full night of restful, rejuvenating sleep:

• Take 15-20 minutes each evening before bed to do a relaxing yoga and meditation.
• Turn off the TV (and all electronics) at least 30 minutes before bed.
• Take supplements that aid in sleep – Melatonin, Magnesium and Vitamin D.
• Drink herbal teas with lavender, valerian root or passionflower before bed.
• Take an Epsom salts bath when possible, at least one hour before bedtime (to allow the body to cool slightly.) Use my Sleepy Time blend. Recipe here.

Sleep and RA pain at night

Even when we change our diet, reduce or remove toxins from our life, practice meditation and spend time on self-care, we might still find ourselves dealing with RA flare-ups more often than we would like and that pain often makes its presence known very loudly once we crawl into bed, exhausted and ready to sleep.

Suddenly, your wrist begins a low thrum that you try to ignore as you feel yourself drift off. Sometime later that night, maybe you need to run to the loo or the pain wakes you up, and now, toes and wrists are throbbing enough to classify as pain and you can’t seem to pull your brain away. What do you do when you just can’t sleep because your RA pain is keeping you awake?

Getting back to sleep when RA pain is keeping you up:

• Focus on your breath with some deep relaxation breathing. It helps to learn and then regularly practice some breathing techniques to train your mind and reduce stress.
• Depending on where the pain is, I find a full body pillow helps. Not only does it support my hips, legs, knees and feet but it can also give my arm a place to rest above my heart which reduces swelling.
• Go for a short walk, to the kitchen for a glass of room temperature water (don’t turn on the bright lights) or stand at the window of a darkened room and look up at the stars. I know this sounds woo-woo and perhaps even silly but it has worked for me and who knows, it might work for you. Maybe it’s the change of scenery or allowing my achy joints to move a little; who knows?
• Orgasms are wonderful soporifics; solo or partner-assisted, whatever works.

Other resources for sleep and RA

I spent lots of time researching sleep and RA and, while it was fascinating and I learned loads, you might not feel inclined to spend your time the same way. But just in case, I found “Why We Sleep” particularly helpful.

Final thoughts

RA pain causes poor sleep; poor sleep causes RA pain. That’s not good news. Except now we know how to use diet to reduce our RA pain, how to remove toxins that exacerbate our symptoms and how to sleep when you have RA.

When we change our lifestyle and clean up our sleep habits, we can return to a full night of rejuvenating and refreshing sleep. After all, we need all the energy we can find in order to live the life of an RA Warrior.

I would love your feedback; either comment below or email me your thoughts and story.