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Elusive Sleep

Elusive Sleep

I want to get a good night’s sleep.  I occasionally do but not regularly and not tonight. It is 4:30 AM, Pink Floyd, and Lou Reed are playing on my radio, and like most nights I have slept about 3 hours. I will be exhausted later and will need a mid-morning nap to sustain myself. This is my usual sleeping pattern, and it is so frustrating for both Sheryl and me.

The question is why I cannot get sustained sleep?

I suggest two factors, and neither is likely to change anytime soon. The first is a built-in alarm clock that rings around 4:00 AM. I call it the blood sugar clock. It seems that my mind is programmed to get up around this time to check my blood sugar. Even with modern technology to detect low blood sugar episodes; I still feel the need (mainly habit) to get up and test my blood sugar. It is a long-standing practice that I have done for years to make sure I did not have dangerous low or high blood sugar during the night.  Tonight, when I got up my blood sugar, was 228, or about 100 points higher than normal, so a correction was called for, and now I am waiting to be sure my correction worked.

Once awake, RA seems to take over and drive the whole sleep process. The effort to get out of bed after 3 hours of sleep is extraordinary. The stretching, morning stiffness and the energy it takes to get out of bed, leads to a small ritual of sitting on the side of the bed for a few minutes before standing.  I usually do this with my head down to equalize my blood pressure. I have always known this was a good idea, but when my cardiologist diagnosed orthostatic hypotension, it became a necessity.

Just as I must get up, I also know that a lack of sleep can make everything in my body angry.  It is like the fatigue of RA is magnified and amplified several times over. Yet this nightly ritual of wakefulness (listening to music, reading, having a sugar free popsicle and wishing I was back in bed) continues.

According to the American Academy of Sleep Science, there are 14 things that can be done to improve sleep hygiene:

  1. Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
  2.  Set a bedtime that is early enough for you to get at least 7 hours of sleep.
  3. Don’t go to bed unless you are sleepy.
  4. If you don’t fall asleep after 20 minutes, get out of bed.
  5. Establish a relaxing bedtime routine.
  6. Use your bed only for sleep and sex.
  7. Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
  8. Limit exposure to bright light in the evenings.
  9. Turn off electronic devices at least 30 minutes before bedtime.
  10. Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
  11. Exercise regularly and maintain a healthy diet.
  12. Avoid consuming caffeine in the late afternoon or evening.
  13. Avoid consuming alcohol before bedtime.
  14. Reduce your fluid intake before bedtime.1

I believe I practice about half of these useful suggestions. My biggest issue is clearly the electronic devices. I am not ready to give that part of my life up yet. But I believe this list helps me identify the biggest issues, and that is at least a good start.

If you find sleep difficult, I suggest looking over the list. Perhaps there are changes you can make to help things along. If these suggestions do not work and you find yourself awake around 4:30 AM, first try Pink Floyd then give me a call, chances are good I will be awake, and we can listen to Pink Floyd together.

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

  1. Healthy Sleep Habits. Secondary Healthy Sleep Habits  2017.


  • Lawrence 'rick' Phillips moderator author
    1 year ago

    I am sorry i am just catching up on comments after vacation. We might need to arrange a conference call?

    I wish a restful night tonight and every night for all of us.

  • lees
    1 year ago

    If it’s legal in your state, I would suggest cannabis.

  • Colourfull
    1 year ago

    Hi Emma,

    I dont sleep very well @t all these days i was awake for hours last night then i had to be up this morning for my grandson.


  • Monica Y. Sengupta moderator
    1 year ago

    Hey Colorfull, I am so sorry you deal with insomnia. Personally, I think it’s one of the worst symptoms we deal with (no matter what chronic illnesses we deal with).

    I thought this article might be interesting to you: Though, if you consider adding either of these supplements to your regime, I strongly recommend you speak to your doctor to make sure it doesn’t react with any of your current medications or they are safe given any medical history.

    All the best, and I hope you find some relief soon! ~Monica

  • EmmaCB
    1 year ago

    Me too – re the 4am wakefulness, I can’t put it down to years of blood testing at that time, but I wonder if it is to do with circadian rhythms as well? I think we poor diabetics also suffer rotten sleep as yet another side effect…

  • Larry Sawyer
    1 year ago

    I have been trying to get a good nights sleep for 37 years. This is my strategy. Dinner is small, early and light on carbohydrates. I use small doses of valium and cyclobenzaprine to take the edge off pain. read late into the evening. try to avoid serious pain meds in the evening. goal is to hold off sleep until 10:30, 11pm. good luck. Larry

  • jdaph
    1 year ago

    Ive tried everyting I can think of over the last two decades to sleep longer, but nothing has worked,, Ive just accepted the fact that I am going to wake up before 2:00 a.m. every morning, and I use that time for Bible study and prayer, this is life with R.A. I recently started using essential oils and I use one for sleep that helps me get better sleep even though I don’t sleep long.

  • Monica Y. Sengupta moderator
    1 year ago

    I’m always more thirsty before bed and can easily down two or three glasses of water (even though I stay pretty well hydrated during the day!)

    At least now with my lower dose of steroids I don’t have to wake up in the middle of the night to pee. I just wake up because I can’t sleep on my joints for too long. Ugh.

    Awesome article, Rick!!

  • Lawrence 'rick' Phillips moderator author
    1 year ago

    Thank you Monica. I hope you find much good sleep with the reduction of steroids. Ugh sterioids !!

  • Carla Kienast
    1 year ago

    Rick: Sleep is that one natural remedy that seems to calm all our ills. Unfortunately for many of us, RA attacks our sleep patterns much like it attacks our joints — relentlessly.

  • Lawrence 'rick' Phillips moderator author
    1 year ago

    Carla, it was the first and most persistent causality of my RA diagnosis.

    I do have to amend one thing in my little article. After I posted it Sheryl said, if any one calls her house at 3:00 AM they and I will be in lots of trouble. So maybe a text is better and I will call you.

    The Pink Floyd part, that stays. After all with Joints in quesiton it is a matter of Us and Them.

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