A woman lying in bed laying there awake due to her inflamed and painful knees.

Insomnia and Rheumatoid Arthritis (RA)

I have been "lucky" enough to struggle with multiple health conditions over the years, 2 of which have affected me since childhood.

Insomnia - or struggling to sleep - is something that I vividly remember my parents explaining to the pediatrician at my routine appointments.

Insomnia and pain radiating from my knees

They were concerned that it could take me forever to fall asleep at night, or that I'd wake up several times during the night, or that I'd cry out or speak in my sleep but have no recollection of that in the morning.

They were worried about me - about if I was truly resting - and how a lack of sleep would impact my growth.

Were the two related?

At the same time, I was experiencing significant knee pains - like to the point where I'd be screaming and crying and hitting my thighs to try to relieve the pain radiating from my knees.

My parents asked the doctor, more than once, if these things (my joint pains and my inability to sleep) could be related. And the answer was always a shocking "No."

Looking at this from an adult's perspective - I don't understand.

If my knee pain was keeping me awake or if being awake was cluing me into the depths of my pain, then of course they walked hand in hand.

How could they not go together? How could they not be two parts of a bigger whole?

An RA diagnosis later in life

My joint pain came and went and I often wasn't taken seriously by the doctors assessing my pain symptoms (more on that journey here and here).

Because of this, I wasn't diagnosed with rheumatoid arthritis until I was 30 years old, shortly after I was diagnosed with Crohn's disease. But, I was diagnosed with insomnia in high school.

Now, in my mid 30's, I have learned that managing my health conditions can't be one by one, and instead has to be a whole-body approach.

A better understanding of insomnia and RA

How do I know when insomnia is affecting my RA, or when RA is affecting my insomnia? To be honest, it's not hard for me to tell.

There are sometimes when I'm plagued with symptoms of insomnia brought about by seemingly no reason or because of stress, a life event, or a number of other considerations.

This, for me, is one type of insomnia - when I'm awake but not uncomfortable, inconvenienced but not distressed. My sleep disorder responds to a number of things - unfortunately only one of which is pain.

Then, there are the times when I can't sleep because my joints hurt too much to lay still. When the ache in my knees or my hips or my ankles seems to be trying to scream through my skin, and no amount of pain reliever or joint support can reduce it, it's impossible to doze off.

Relief is hard to come by

The irony is that during those times, sleep is the only escape. The only time that there isn't pain is when I'm unconscious and, in those moments, being unconscious feels impossible. It feels elusive, like a state I'm not lucky enough to reach.

This. This is the battle of living with both RA and insomnia. They feed off one another. They make it so when one is loud, the other is louder.

Relief for both is incredibly hard to come by and sometimes feels like existing inside a vicious circle.

Do you live with other conditions besides RA? How do they impact each other?

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