Day and Night
It struck me recently how much different RA is during the day versus at night for me. I wonder if this true for others of just one of those quirky things I seem to experience that others may not.
My daytime RA joint symptoms
Day RA is more manageable for me. During the day, I am so busy with work, social and other commitments, etc., that I can, to some degree but not always, push through the RA "stuff" and keep going.
Beyond that, the fact is that once we get our joints moving and past that horrible morning stiffness phase, we can move around however tentatively for some time. Now, this is all thrown out the window if I am having a nasty flare in which case DAY and NIGHT are really one horrific blended experience. But for purposes of this article, I want to talk about the differences sans an ongoing flare.
Worse RA joint pain at night
As sure as night follows day so does the transition of day RA versus night RA. Once I get home at the end of my day, I am tired. I would actually say fatigued is a better word. It is so much more descriptive than tired. At that point in my day, my mind and body are exhausted. I often don't even care if I eat because all I can think about is getting in my pajamas and collapsing on the couch.
But the dilemma is that despite wanting to rest and later sleep, NOW my joints decide to "speak" to me, even if they have been relatively "quiet" all day long! After a day of movement my joints are achy, stiff and sometimes swollen. That is not helped by my desire to sit or lay down. I have to fight my compulsion to collapse and summon up every inch of will power to continue to move, even a little bit. It is so hard!
Sleeping difficulties and joint pain
Night RA is much more difficult for me. Sleeping is like competing in an Olympic event. I am not skillful enough to do it despite my best efforts. Even in the unlikely event I can find a position comfortable enough to accommodate the various joints that are screaming at me, it does not last more than a very brief (like 20 minutes on most nights) period of time.
I can fall asleep for short periods but, inevitably, I am awoken with pain in one or more joints and simply have to GET UP to relieve the discomfort. While up, I then usually take one of several nightly trips to the bathroom (now that I am post-menopausal, they are even more common) which means that getting back to sleep is now going to take some time.
Managing RA symptom changes between day and night
I have found a few ways to offset some of these issues. One is that when I get home at the end of the day, I try to ease into my evening. I often take my dog for a brief walk to clear my head and gently move those joints before settling in for the night.
Easing into my evening
I have also found that taking a hot bath in the evening helps me to relax both mentally and physically so that I can get to sleep more easily. I also love guided imagery and doing some of that (or any other type of mediation) can be really useful for getting your mind where it needs to be to invite sleep and even maintain it.
Avoiding certain beverages before sleep
I also avoid caffeine for at least 6 hours before bedtime and alcohol as well since both will make you restless - the last thing we need!
Finding ways to transition from day RA to night RA is not easy but you can discover what works for you and make both your day times and night times a lot more comfortable.
After the past 2+ years, how do you feel about telehealth appointments to manage your RA?