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Day and Night

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.

Daytime with RA

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.

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!

Nighttime with RA

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.

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.  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.  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.

Nan

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • kikikk
    3 years ago

    This article describes my life too! My pain is always worse at night. I’m going to try your recommendation about taking a hot bath before bed. I’m also trying a new extended release pain medication, but I’m not sure if that’s really working or not. Thanks for the suggestions to help those with RA sleep better!

  • renee77
    3 years ago

    My sleeping patterns were just like yours UNTIL I started sleeping on my hammock. I have a double rope hammock that I sleep very well on. I am assumming maybe because there’s no pressure points. It looks silly in my bedroom and takes up alot of space but…I’m worth it.

  • seroinflammatory
    3 years ago

    I have sero inflammatory arthritis which mirrors almost all of the rheumatoid symptoms it just doesn’t test positive in the blood work for RA. I too had difficulty at night but am doing better since my rheumatologist told me to take my prednisone at bedtime.

  • suann
    3 years ago

    I think before my Ra went into severe I could manage in day time vs nite time, Now for me, anytime I get up or set down is a chore. At nite I could not sleep and if I did fall asleep it was for minutes at a time, I spoke with several people with RA,Lupus,etc. etc. I did learn most of these people went to their family doctor and ask for something to help with sleep,already taking pain meds that barely touch the pain I ask for an anti-depressant as well.He did comply with my request, I know a lot of people do not like taking medications but for health reason I feel it a must for me, before the anti depressant I suffered terribe with high blood pressure and now, I function better than ever and my bp is where it needs to be, my mind is not foggy, well as foggy as it has been and Im happy.. I also found for nite sleep if u keep a heating pad on low under u it will also help with stiffness of a morning, I know what works for one may not work for another, never say never and never give up hope on a cure…

  • Nan Hart author
    3 years ago

    I think you are so right to have gone to your physician to help sort our what would work best for you. Too often we try to just tough it out and more times than not that just makes matters worse. I am happy to hear your BP is better and you are getting some sleep. Sounds like you made some really beneficial adjustments and that is exactly how we manage a chronic disease like RA! All the best, Nan

  • Jennifer Birchell
    3 years ago

    I suffer from this problem frequently. I work full time and by the time I get home my joints are on fire and I’m in exhaustion mode. I literally crawl into bed the minute I walk in and put things away or tidy up for a brief moment. I’m lucky to have support at home for meals, etc. What helps me is my hot pad, a heated blanket, raised legs (on pillows), and sometimes a warm bath if I can get help in and out of the tub- I can’t do it myself. My Dr. has prescribed a sleep aid so that I can rest- he said it’s much harder on my body to not have sleep. Also- I’ve made myself a music playlist. I’m a board certified music therapist and, of course, I feel music is most important to your body. Start with music that is a little more upbeat at 1st, then, with each song, bring the speed down slowly. Your body will entrain to the speed of the music- your heart rate will match the beat of the music, your respiration rate will match as well, slowing you down, along with your mind too. Use music with no words so you’re not processing words in your mind while trying to rest. Try it! I promise it works!! I use this technique daily with my patients and it works every time! Good luck everyone!

  • Kelly Dabel moderator
    3 years ago

    Hello Jennifer, Thank you so much for sharing your story and for the great reminder to incorporate music as therapy. I love your suggestions and I know others in our community will find this helpful and inspiring. Sorry that you are exhausted after work. It’s wonderful that you have support. We’re glad you’re here. Thank you for being part of our community! Best, Kelly Dabel, RD – RheumatoidArthritis.net Team

  • gnb2975
    3 years ago

    I have the same problem, never the classic RA stiffness in a.m. but at night, feel like my joints are on fire and my muscles are screaming. I end up pacing around in the dark and get more worked up as time goes by. I used to read all the time but never pick up a book any more since i can’t really focus on it. (sigh) I’m so fortunate to not work full time so i can sleep in occasionally. Thanks for sharing, now i feel less alone.

  • Nan Hart author
    3 years ago

    Judy I have come to believe there is no “classic” RA anymore. The more folks I meet with RA the more individual is the way it manifests. I often find nighttime to be the worst. My shoulders have been flaring lately and by the end of the day I can hardly lift a glass of water! I do find that a hot Epsom salts bath and some guided imagery help. Healing hugs and thanks for sharing your journey. Nan

  • Margie
    3 years ago

    This is me too! Sleeping is impossible. By 5pm I just want to lay on the couch. I force myself to get dinner and finish the day.

  • Kelly Dabel moderator
    3 years ago

    Hi Margie, So glad this article resonated with you. You are not alone here. I admire your tenacity. It’s okay to stop and get the rest you need. Thank you for being part of our community!

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