Sleeping Well: Wren's 5 Ways
I’m writing this at 1:54 a.m. because, well, I can’t sleep. I figured I might as well use this unexpected and unwanted time productively. And while it might seem sort of ironic that an insomniac is offering advice on how to sleep better, it’s not like I don’t have some experience in the matter.
RA joint pain hinders our sleep
Let’s face it: sleeping is sometimes tough as nails for those of us who live with rheumatoid disease. Joint pain, which runs the gamut from mild-but-annoying to oh-man-just-shoot-me-now severe, can totally ruin a good night’s sleep. And then there’s the drugs we take to treat the disease and its symptoms. Many of them—I’m looking at you, Evil Prednisone—can interrupt and throw chaos into an otherwise peaceful sleep cycle.
So what can we do? I hate to say it, but sometimes, not much. Sometimes, like tonight, we just have to suck it up and make the best of it. My joint pain is fairly mild tonight, but I’m adjusting to an increase in my gabapentin dose. It’s helping the pain, which is nice, but as a drowsy-making sleep-aid, it sucks.
Patience, Wren. Breathe. Seek your joy, even if it is oh-dark-thirty.
5 ways to practice sleep hygiene
But hey, back to sleep hygiene. Practicing it helps, most of the time. Here’s what I’ve learned over the years.
1. Set your sleep hours—and stick to them.
I get up and go to bed at roughly the same time every single day, day in and day out. I get up at 6:00 each morning and I crawl into bed at 10:00 each night. These hours aren’t set in stone: now and then I’ll sleep in a little or wake up earlier. But you get my drift.
The reason I’m so dedicated to these hours? Our bodies will follow a natural sleep and wake cycle—the circadian rhythm—if we let them. This rhythm wakes us with the sun if we’re not forcing ourselves into some other pattern. We feel almost relentlessly drowsy in the mid-day, between 1 and 3 p.m., because that natural rhythm is telling us to rest for a while. And once the sun sets and darkness falls, our bodies yearn for sleep. Why fight it?
2. Your sleep environment matters.
Sleep in a cool, dark, quiet room. The bedroom is for sleeping only (except for sex). There’s no watching TV there. No using the computer or checking your phone. Leave them in the other room. You’re crawling into bed to sleep, not to keep your mind stimulated, occupied, and wide awake.
I know how hard this can be. But turning off, shutting down, and settling down into the cool, gentle quiet of the night is essential for a decent sleep. Sure, RD tosses a rude wrench into the works now and then, but this helps most of the time.
3. Stop eating and drinking by 7 p.m.
I’ve found that this is really important. Here’s why: Most of us eat our evening meal by 7 p.m. or so. For several hours afterward, our bodies are working to digest and absorb the meal. By bedtime, our bodies can relax and start the process of renewal.
Drinking stimulants, like coffee or tea with caffeine, can keep anyone wide awake. Avoid them. Shun them! And don’t drink anything else, either. No soda—even sugar-free and decaffeinated—and no water. Nada. The reason? Liquids in, liquids out. Stop drinking by 7 p.m. or resign yourself to waking up for at least one middle-of-the-night shuffle to the loo.
4. Put yourself to sleep with meditation.
I know, this sounds nuts, but it works! Try this: to quiet your mind, pay attention to your breath. Notice how it feels to breathe in and breathe out. You don’t have to take big, deep, slow breaths. Just breathe normally. Concentrate on how the air feels flowing into your nose, cool and good, and feel it inflate your lungs and raise your chest and tummy.
Notice how it feels when you breathe out. Do it again: inhale, exhale. As you focus on it, you’ll naturally start to breathe more deeply, fully oxygenating all the cells in your body. Your muscles will loosen and relax. Just stay focused on your breath, bringing yourself back to it gently and without judgment if your mind wanders. Breathe … and you’ll drift off to sleep.
5. Accept insomnia when it happens.
Yep, this is tough, too. We get upset when we can’t fall asleep or stay asleep. We know we have things to do in the morning. There’s work; we have responsibilities! How can we manage them if we’re too tired? We’re already stiff and achy!
Well, I don’t know about you, but somehow, I always do manage to get through the day anyway. Even at my most sleep-deprived, I always muddle through. Stressing out over it just makes it harder, you know?
So, I try to accept that I can’t sleep. I use the time. I get up, go into the living room, and read a good book. Or maybe, like tonight, I’ll go ahead and work on a project, like writing or maybe drawing. I’ll do that until I start to feel sleepy, and then I’ll go back to bed in my dark, cool, quiet room. I’ll focus on breathing and, if I’m lucky, I’ll fall back to sleep. If I’m not … well, I’ll manage. Like always.
And now, I’m finally getting sleepy. Nighters, all!
After the past 2+ years, how do you feel about telehealth appointments to manage your RA?