Sleep Hygiene as a Defense Against RA Painsomnia

People with rheumatoid arthritis have more than a passing acquaintance with painsomnia—the sleep-disrupting pain caused by RA. In fact, more than half suffer from suboptimal sleep, thanks to pain.

Throbbing, swelling tissues and stiffness are bad enough during the day, but become intolerable while trying to fall asleep at night.

RA pain can lead to rude awakenings with its searing, stabbing neuropathy, leaving you with nothing to focus on but the pain… and the fact you’re not sleeping through it.

The underrated relief of sleep hygiene

Practicing sleep hygiene might be quickly rejected as a solution by those with acute or chronic pain. People want immediate relief, and who can blame them? Long-term, intolerable pain is seriously disabling, both day and night. Treating one’s RA pain is important, especially at night.

But sometimes, simple self-care practices like sleep hygiene do bring some relief. Even if it’s only temporary, it’s still better than nothing.

Sleep hygiene, by itself, isn’t a cure-all for anything. Instead, it’s a supportive practice in self-care. It may not mask RA pain directly, but it can give the body support for pain management and may even lead to its prevention.

At the very least, sleep hygiene can support more and better sleep, which is well known to reduce one’s sensitivity and tolerance to pain.

The following sleep hygiene best practices can be a part of a healthy overall pain management protocol.

5 sleep hygiene best practices

1. Keep things cool

This may seem counterintuitive for people with RA, but an overwarm sleeping space will disrupt nighttime sleep. The circadian system needs the body’s core temperature to slowly drop overnight as part of a healthy sleep-wake process. If you’re too warm, sleep may be elusive, or you may awaken and find it difficult to reclaim sleep. There isn’t a magic thermostat reading that works for everyone, but try a range between 60 and 67 degrees.
Meanwhile, swap your heavy comforter for multiple layers of sheets and blankets to add and subtract throughout the night to keep you comfortably warm. When practical, sleep with a window open, or use a fan or air conditioning. Also, a bedtime glass of cold water can reduce your body’s core temperature.

2. And speaking of water…

Unless you have problems with nighttime urination (nocturia), reconsider that bedtime glass of water. Not only does cool water regulate core body temperature, it keeps you hydrated, which naturally reduces inflammation. Flavorful ways to hydrate include sleep-inducing chamomile tea or a glass of anti-inflammatory tart cherry juice. The latter offers naturally occurring melatonin, which is the same substance your brain generates to induce sleep. Don’t forget about warm Epsom salt baths! At bedtime, these are relaxing, can draw inflammatory toxins from the body, and allow your skin to absorb natural magnesium, which loosens muscles around stiff arthritic joints.

3. Trick yourself to sleep

Relaxation through distraction can trick the body into falling asleep. Some calm distractions include listening to soft music or podcasts, reading, or light massage. Absorbing projects like jigsaw puzzles, sudoku challenges, or adult coloring books can help you wind down. So can using lavender essential oil, as sleep-friendly aromatherapy, in a diffuser, pillow spray, or Epsom salt bath.

4. Can I get an Om?

The breathing and stretching benefits of yoga are well known for reducing inflammation. Fortunately, some of the easiest yoga poses (child’s pose, corpse pose) are also the most effective. Consider a two-fold yoga practice: a morning series of energizing poses (such as the sun salutation series) and an evening series to calm both mind and body. Keep your focus on even, easy breathing. Already doing yoga? Consider graduating to meditation. Yoga is meant to prepare the body for meditation. Learning simple techniques may further relax your mind so you can sleep.

5. Timing is everything

If you can cleave to a consistent and adequate sleep-wake schedule, you’ll find it easier to rebound from RA flareups. This means a consistent daily bedtime and rise time schedule. Disrupted sleep schedules leave our bodies vulnerable to immune system dysfunction, pain, and inflammation. Also, consider this: We all know that inadequate sleep is unhealthy, but did you know that too much sleep is also unhealthy? Adults should stick to getting between 7 and 9 hours of sleep a night for best results.

Remember, these sleep hygiene efforts may not directly relieve your pain. However, sleep loss due to pain creates a vicious cycle of sleeplessness that leads to more pain sensitivity, which further compromises sleep quality. Treating RA with medications and other therapies, while practicing sleep hygiene, may be all you need to prevent RA flares and reclaim healing sleep.