The Importance of Zzzzzzzzz
When living with rheumatoid arthritis, there are many ways to overdo it. Too much activity can cause a flare, too much rest can lead to muscle weakness and greater fatigue, too much sitting can cause an increase in joint pain, just as standing for too long can. In treating these symptoms, too high a dosage or duration of some medications can cause intolerable side effects and additional health problems. It’s hard to find balance with so many factors to address. However, there is one thing I’ve found that both benefits my RA and never turns into too much of a good thing. This precious commodity is sleep.
A good night’s sleep is beneficial in so many ways. It improves mood, concentration, and memory. Adequate sleep may even help with maintaining a healthy weight, as researchers have linked sleep deprivation with weight gain.1 For those of us with rheumatoid arthritis, sleep can be even more critical, as getting enough rest has been shown to increase immune function2 and even decrease pain sensitivity.3 While I’ve always noticed that my RA symptoms decrease at least a little bit with a good night’s sleep, I never would have guessed that I may have actually decreased my sensitivity to the pain in my joints while I slumbered.
It’s all well and good that adequate sleep is important for everyone, and that it’s critical for those of us with RA, but obtaining it is no easy matter. Joint pain can make it extremely difficult to fall asleep and to stay asleep. While I’ve had insomnia off and on since adolescence, when I add joint pain to the mix, a night full of tossing and turning is not only infuriating, but full of physical suffering. Yet, there are some things that I’ve found help me get a good night’s rest.
Prioritizing rest. Sleep experts recommend establishing a nightly routine, with a similar bed time each night and some relaxing activities (warm bath, reading a book, etc.) before going to sleep to cue your body that sleep is coming soon. I always had a hard time with this one, as I’ve always been a night owl, and often feel like I can be most productive in the evenings. However, I have to be at work at 7:45 every morning, and my young children wake up by 6:30am even on the weekends. When I tried to keep the schedule I preferred, I just didn’t get enough sleep every night, and I felt the toll this was taking on both my emotions and on my RA symptoms.
About a year ago, I decided to truly make sleep a priority, so now I go ahead and brush my teeth and get on my pajamas right alongside my kids. We have story time together, and then we all go to sleep around 8:30pm. If you would have told me a few years ago that I would have an 8:30 bedtime, I would have thought you were crazy. Yet going to bed this early allows me to get nine hours of sleep before my 5:30am alarm goes off. If I stay up after the kids go to bed, it’s too tempting to try to get more items crossed off the to-do list, and I end up going to bed around 11:00. However, when I go to bed so early with my children, I wake up after nine hours of sleep and am able to tackle just a few tasks before getting myself and the kids ready for the day. In the long run, I find that I’m just as productive with this schedule as I am when I only sleep six or seven hours a night, as I feel better and am able to accomplish tasks more quickly when I’m well-rested.
Pillows. Having enough pillows is essential to getting comfortable, which is why both my bed and my daughter’s bed, where we have nightly story time, are absolutely covered in pillows. I have pillows of different sizes and thicknesses so that I can adjust them depending on what each joint needs on a particular night.
Staying away from the screen. In this ever-connected technology age, where most of us keep our cell phones within arm’s reach at any given moment, the lure of the screen can be powerful. When we’re having trouble falling asleep or falling back asleep, it can be extremely tempting to check email, social media, or surf the web. I often feel that diverting my mind from the frustration of having trouble falling asleep will help me relax. Yet, studies are showing that the blue light emitted from televisions, tablets, and smartphones makes our brains more alert and suppress the production of melatonin.4 Therefore, the worst thing to do when trying to go to sleep is to look at a screen. Since I’ve learned about the negative impact of blue light on sleep patterns, I no longer check my phone or turn on the tv when I’m having trouble sleeping. Instead, I spend a stretch of time in bed in the dark, and if I still can’t fall asleep, I read a book (in the old-fashioned format). In the months since I’ve resisted the urge to look at a screen, I’ve found that I’ve cut the amount of time it takes me to fall asleep after the lights go out by about half.
Medication. I’d be lost without some prescription assistance in falling asleep. If I’m having a good day, with minimal joint pain and low anxiety, I can fall asleep on my own. However, if I’m in pain and/or am stressed out, I require the help of medication to fall asleep and stay asleep. Depending on how I’m feeling, I either take Trazadone or Flexeril at night. The first medication was originally an anti-depressant, but is commonly used for sleep problems, and Flexeril is a muscle relaxer. I often find that when I have a lot of joint pain, taking a Flexeril at night not only helps me get some rest, but also decreases my level of pain by allowing my muscles to stop tugging on my joints while I slumber.
While getting a good night’s sleep can feel like finding the holy grail to an RA patient, I’ve found that making some changes in my habits has gone a long way in achieving better rest.