Long Nights and Rheumatoid Arthritis: The Problem of Chronic Insomnia 

“Have you stopped drinking coffee? You need to exercise every day and that will help you sleep.” It had been awhile since I’d slept a full night and I figured it was time to talk to my rheumatologist. Unfortunately, after our conversation I realized that a quick google search gave me more tips than he did.

Sleep problems with rheumatoid arthritis

Sleep is an enigma, and treating sleep issues is not an area that modern medicine thrives at. After the less than helpful visit to my rheumatologist, I went to a Sleep Disorder Center. They had me fill out a form that asked about my sleep hygiene, basically habits that help create an environment that is conducive to sleep, and then ruled out sleep apnea, which is a common cause of impaired sleep.

I was sent home with homework to track my sleep. This second try was still not helpful and I decided that my struggle to sleep was one I’d have to figure out on my own.

Figuring out my sleep issues on my own

Over the years, I’ve turned off all lights after eight pm to help my circadian rhythm, I’ve taken almost every herbal supplement known to help sleep, I’ve religiously followed all the sleep hygiene techniques I learned, and learned relaxation techniques to calm my body and mind. All of these things have helped me, but just like treating RA, at times nothing seems to work very well.

Insomnia related to RA pain

For years, I’ve had a very strong inkling that most of my problems with insomnia were related to pain. A body in pain is not a relaxed body and, after I got an Apple watch last year, my suspicions were confirmed. It takes me at least an hour to fall asleep most nights, and my sleep quality is laughable - if I get an hour of deep sleep at night, I’m lucky. My Apple watch often shows that I was awake for hours in the middle of the night, even though I thought I was sleeping, so I must move around a lot.

Taking pain medicine at night

Armed with this information, I decided, with reluctance, to take a pain medicine at night, and my results were better than I thought. Unless my JRA is flaring, the pain medicine allows me to get at least double the amount of deep and quality sleep that I used to get. But the idea of taking daily pain medication is one that I’m still getting used to - to me, this seems like a big step. I’ve decided to use it for now and hope that, once my JRA is well controlled, I won’t need it every night.

Chronic insomnia and living with RA

Chronic insomnia is something I wouldn’t wish on anyone; after all, sleep deprivation is a form of torture. But many of us find ourselves in this position because many of the things that contribute to the problem of insomnia are the very things that come hand-in-hand with living with RA. Pain, anxiety, depression, stress are inevitable results of RA but also sleep killers. 

There isn’t much good news in this story, and I don’t have a way to wrap it up in a neat bow. What I can do is pass on some of the things, other than pain medication, that have helped me sleep over the years. So, stay tuned. In my next article, I’ll try to help you get a better night's sleep!

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