I have a vague recollection of a time in my life when sleep came easily and could be counted on to give me the necessary energy and refreshment to function fully the next day. With the advent of RA those days have now become mostly a distant memory with the occasional night of blessed, blessed sound sleep thrown in to keep me hopeful of a more consistent sleep pattern.
We all are well aware of the need for sleep and how it impacts our physical and mental well- being so I will not go into that in this piece. I have found it interesting/annoying that along with all of the other challenges RA presents us with, difficulty getting a good night’s sleep can be added to that very long list. Thanks, in part, to the very nature of RA sleep can consistently elude us. When we are in the midst of a flare our joints tend to be at their worst at night, with pain, stiffness and swelling our constant nighttime companions. Add to that the fact that the non-movement associated with sleep can exacerbate the discomfort and the stage is set for sleeplessness. Even when I am not in a flare my body has now gotten in the “habit” of waking me up every couple of hours (or more often) as a reminder to get up and move to prevent the discomfort that goes along with extended periods of sedentary behavior like sleeping.
Of course medication side effects have their place in this scenario as well. Corticosteroids often make one restless and even agitated. Thus the reason it is often suggested by our doctors to take it in the AM to avoid the sleeplessness that can be a side effect if taken later in the day. It really is a good idea to check on the side effects of any of your medications to ensure that you will be still be able to get a good night’s sleep if you take the medications earlier in the day.
There are a few strategies we can use to try to enhance our sleep. One thing I do is to move a bit before bed. That is not to say I run or exercise vigorously late in the day. I just mean move a bit, walk around, take the dog out, enjoy a view of the stars while strolling around your yard, etc. By moving a bit, you keep those joints from stiffening up to soon. This summer I enjoyed a late evening Tai Chi practice which was a welcome meditative movement that helped prepare me for sleep. In addition, I often fold my laundry (nice and hot from the dryer), put away the dishes, etc. These chores keep me moving and I feel great in the morning when I realize these chores are done!
Another good tip is to take a nice warm/hot bath or if you have access a hot tub soak. This not only feels great on our joints, but also relaxes our entire body, “preparing” our minds as well as our bodies for some shut eye. Add to that some relaxing music and/or some scented candles and you have created the perfect “mood” for sleep.
Speaking of mood, I have a “soundscapes” machine I listen to every night. I have it set on the ocean sounds because I find it very relaxing. It takes my mind off of whatever thoughts or distractions have invaded my sleep mode and “places” me on a warm, sunny, sandy beach! Perfect place to sleep. Another tool is Guided Imagery or something of that sort. It almost always puts me to sleep, relaxing my mind and body.
Sometimes I like to read at bedtime as this once again takes me to a place other than reality often leading me to fall asleep before I get more than a few pages read! One thing I try not to do is watch TV in bed. I find it gets me “wired” and I don’t fall asleep or if I do, I don’t stay asleep.
Of course if you still cannot get a good night’s sleep you may want to share this with your physician and be very clear about how it is impacting your health and well-being. He/she may have some medical suggestions that might want to consider.
Getting quality sleep is a tool that is as important as any other treatment in the management of RA so don’t let it keep you awake at night. There are solutions out there and they do work!
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