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Insomnia + RA - A Vicious Cycle

Last updated: April 2021

I used to think I couldn’t sleep because I had too much on my mind.

Then, I thought I couldn’t sleep because of how much my knees hurt.

To confuse things even further, I’ve definitely been told that my knees might hurt because I’m too tired.

Here’s what it’s like to live with both insomnia and RA: Fatigue is a symptom, a sign, and a rule of thumb. Exhaustion is the only thing I know.

Living with insomnia and RA

Let me rewind. I’ve lived with a sleep disorder since childhood, basically as long as I can remember. For me, insomnia has meant struggling to fall asleep, struggling to stay asleep, struggling to sleep through the night, never feeling rested in the morning, and struggling to make it through the day awake.

Additionally, I’ve dealt with joint pain for about as long. Labeled as growing pains in my childhood, and misdiagnosed as fibromyalgia in my early twenties, I wasn’t correctly diagnosed with (or put on an adequate treatment plan for) rheumatoid arthritis until the year I turned 30.

How it all started

As you can imagine, the vicious cycle started somewhere near the beginning. At night, I’d take baths or drink warm tea, trying to relax my body and my mind. I’d get cozy into bed and then fixate on how much pain I was feeling in my knees, or my ankles, or my wrists.

The pain would prevent me from finding a comfortable position, which would prevent me from falling asleep - or would I fail to fall asleep because I was also living with insomnia and I couldn’t turn my brain off?


Managing multiple conditions

Here’s how I manage as best as I can: Taking care of my body and managing the physical symptoms of RA is a full-time job. This means taking my treatment plan seriously, not missing infusions or medication doses, attending routine appointments with my rheumatologist, and getting routine lab work completed.

Moving everyday

It means doing the right amount of movement during each day for my body - I’ve learned over time that not moving enough and pushing myself too hard both have separate and equally undesirable outcomes. It also means fueling and hydrating as best as I can, taking into account the other chronic illnesses I live with.

Preparing my body for sleep

Preparing my body for bed has become a routine of sorts as well. Soft, warm clothes and bedding are a must. A heating pad, or heated blanket, along with some topical cream (Arnicare, Tiger Balm, BioFreeze, etc) all help to manage my pain and support my body as I unwind from the day and try to fall asleep.

Trying to get decent sleep with insomnia

As any condition does, managing my insomnia involves additional medical providers, medication, and specific routine. But here are the most important things I've found to help my chances of decent sleep:

  • Consistency in bedtime and morning rising
  • Consistency in sleep environment (temperature, noise, light, etc)
  • Journaling for insomnia - I have found over time that completing a brain dump of sorts before bed allows my mind to "let go" of as much as possible

If you struggle with sleep or live with a sleep disorder in addition to your RA, what has been helpful for you to manage both conditions?

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