RD "Sundowning"

You may have heard of the term “sundowning.” Generally, it refers to how some Alzheimer’s and dementia patients’ symptoms seem to grow worse late in the day and evening.

But recently, a Twitter friend of mine used the term “sundowning” to describe the way her rheumatoid diseasesymptoms ramped up in the latter part of the day.

"Sundowning" to describe rheumatoid arthritis symptoms?

Not a comparison between RA and dementia

Now, I don’t mean to compare RD to dementia in any way. They're very different diseases and conditions. But I immediately understood what my Twitter friend was talking about because I frequently have the same experience. I start hurting more after about 3 p.m. most days. By the time I go to bed at night, I’d like to chop the offending limb off and have it over with once and for all.

RA symptoms and time of day

I’ve looked and looked, but I can’t find any references or research on this odd phenomenon in regard to rheumatoid disease. But I know that my Twitter friend and I aren’t the only ones whose RD joints often start feeling worse later in the day. Like those of us whose joints hurt more when the barometric pressure is high, low, or changing, or when it’s cold, hot, or humid outside, the time of day is something that seems to affect RD symptoms for many of us but doesn’t have any definitive scientific explanation to back it up.

So, please allow me to do a bit of unscientific conjecturing.

Explaining "sundowning" of RA symptoms

Sensitivity to pain and the day progresses

Maybe our joints hurt more because our bodies are tiring out as the sun heads west in the sky. Coping with pain — even low-grade pain — on a frequent basis is, let’s face it, tiring. When the pain is moderate or severe, it’s more than that — it’s exhausting. Is it any wonder that we just hurt more — or perhaps are more sensitive to pain — as the day wears on?

The rise and fall of the barometric pressure

Because the rise and fall of barometric pressure has always had an effect on my RD pain, I’ve become a barometer-watcher. I want to know why I hurt, dang it! Recently, I noticed that the barometer tends to rise and fall throughout the day. Maybe that’s why I tend to hurt more after lunchtime on some days and not others.

Maybe RA symptoms are just worse in the evening?

Or maybe RD acts like some acute illnesses do in the afternoon and evening. Who hasn’t had their cold or flu symptoms feel worse as the day becomes night? Your nose clogs up worse or runs more. Your cough gets more frequent. If you’re running a fever, it goes up some as the sun goes down. You just plain feel more miserable.

Our circadian rhythm

Maybe it has something to do with our circadian rhythm—our body’s internal clock, which is tuned naturally and instinctively into the rise and set of the sun. That rhythm governs all sorts of biological processes, including when we wake up, when we get sleepy at night, our hormone levels, and etc. Why shouldn’t it also influence our perception of pain, of fatigue, and of illness?

Sundowning helps me explain my RA symptoms

Whatever the reason it happens, I sort of like the term “RD sundowning” to describe that inexorable increase in RD discomfort as the day wears on. Do you experience this, too? Any thoughts on what might cause it? Tell what you think!

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