Painsomnia: Physical and Emotional

Last updated: June 2022

"If pain must come, may it come quickly. Because I have a life to live, and I need to live it in the best way possible." --Paulo Coelho

Struggling to sleep with RA

It's 12:30 AM as I write this, while I lie in bed restless, anxious, in pain, and unable to sleep. I have to work at my physically and mentally demanding job early tomorrow morning, making this insomnia, or "painsomnia," even worse. My right ankle burns and throbs right now, and I can feel that my fingers are swollen and painfully tender as I type on my laptop. The bursitis in my hips, which has been flaring for weeks, is still throbbing and aching even though I'm not even moving.

My RA is flaring up again, and I know I need to restart Humira. I've been off it since I got COVID-19 (Delta) right before Thanksgiving and was sick for over a month (despite being triple vaccinated, plus receiving the monoclonal antibody treatment). I plan to take it tomorrow, even though I'm scared of going back on it with COVID-19 still lurking out there. However, I did recently get another booster shot, so I hope I'll have enough protection if I get it again.

What is "painsomnia"

Painsomnia, while not an official diagnosis, is something that often afflicts those of us with RA and chronic pain. Understandably, pain could keep a person from being able to relax and fall asleep at night. Pain also becomes more pronounced and noticeable at night when you're lying in bed without the noisy busyness of the day to distract you. You're all alone with your pain and your thoughts, and if your thoughts are also emotionally painful or troubled, sleeping can seem almost impossible.

This is what's happening to me right now as my body and brain churn restlessly while pain is shooting through my joints, and anxiety, sadness, and grief are piercing my heart. How can I fall asleep? I pray for drowsiness to fall upon me, but the tight knot in my chest that's twisted in worries keeps me maddeningly awake. I long for the relief of sleep.

Emotional pain also keeps me up at night

There are a lot of very stressful and emotional things going on in my life right now. Everything feels uncertain and out of control, and I have some agonizingly big decisions to make. What are these things? I'm not going to be too specific, but it's relationship, job, housing, financial, health, and family stuff. Basically, everything in my life right now is up in the air, and I feel like I'm barely keeping my head above water.

I would argue that emotional and mental pain, especially anxiety, can be worse than just dealing with the physical pain of RA. Having RA for over 20 years, I'm used to its unpredictable random assaults on my body. I've learned how to adapt, for the most part, but when emotional pain takes over, it often feels unbearable, and I don't know how to deal with it. I see a therapist, which helps some, and I try to talk to family and friends (which helps some), but I often can't stop the worries attacking my brain.

Emotional and mental distress, of course, directly affects my RA and will often bring on a flare-up. I know this, and it's a vicious circle because the physical and emotional pain often feed into each other. Dealing with the mental health side of RA and chronic pain is often extremely hard to do. So many negative and hurtful feelings can engulf you due to living with this disease: depression, anxiety, guilt, grief, anger, frustration, insecurity, fear, regret, defeat, poor self-image, and others.

Are there any solutions out there?

So, how do I deal with this painsomnia that's comprised of both physical and emotional pain? Knock myself out with medications? I don't really want to do that. Meditate? I've tried, and I'm terrible at it. Reading a book? I can't even focus enough to read right now, which is sad, as I love reading. Falling asleep watching mindless T.V.? Maybe.

I don't know, but I welcome any helpful suggestions that actually work. Not sleeping enough also has its own significant consequences: RA flare-ups, increased anxiety, increased depression, and mood instability.

What do you do to help your physical and emotional painsomnia? Please tell me because I'm desperate for a night (or more!) of deep, sound, peaceful sleep. I haven't had it in a while.

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