Tackling Rheumatoid Arthritis Sleep Problems

Moon and clouds

The irony of Rheumatoid Arthritis sleep issues

Rheumatoid Arthritis (RA) patients need quantity and quality sleep to in order to fight debilitating pain and fatigue. Rest is one of the only things that can enable those living with RA to function in a somewhat normal manner. In my opinion, it is second in importance only to RA disease fighting medicine.

Sleep can also be the only refuge from persistent pain. However, for those with RA, getting enough sleep can be a problem as we discussed yesterday. Rheumatoid arthritis patients frequently complain that restful or adequate sleep is elusive.

Promoting sleep with RA

Priority 1 is falling asleep: Falling asleep with RA may require special preparation. We may need to confront things head on which can interfere with the rest we really need. This way, we do everything in our power to promote sleep.

Tips to confront things which interfere with RA’ers sleep:

  • Pursue physical comfort. Deal with pain and discomfort as much as possible ahead of bedtime. This not only includes pain medicine, but also could include heat patches or creams. An example of addressing problems ahead of time might be taking a heartburn preventative if you need it. Look for your ultimate mattress, pillow, and cover as if it’s your Holy Grail.
  • Attempt to relax. Release the intense stress of another day living with RA. Things that might help include gentle massage, warm bath, chamomile tea, a brief conversation w/ a loved one, fragrance, music, light or boring reading, and soft loose clothing.
  • Watch out for medicine. Some drugs or meds interfere with sleep. These may include various vitamins, cold medications, prednisone, and blood pressure medicines. Check with your pharmacist. Some can take methotrexate at bedtime successfully, but it if bothers you, you can back it up a few hours.
  • Be careful about food and drink: Some foods and drinks promote sleep and some interfere. Caffeine is the obvious one, but watch to see what bothers you, such as sugar. A typical safe snack is a banana or a turkey sandwich with milk – full of L-tryptophan and potassium to fight leg cramps. Alcohol and nicotine are usually no-no.
  • Take hormones earlier in the day. Many hormones such as estrogen or thyroid supplements can interfere with sleep if taken near bedtime.
  • Treat illness. It is not known which aspects of the RA disease process may cause sleep problems, so treating RA adequately may help sleep. Other medical issues may include sleep apnea or endocrine problems which can affect circadian rhythm.

Priority 2: Finishing strong by getting back to sleep

Going back to sleep can be a separate problem. The most important thing is to plan ahead. Set out whatever you may need when you awaken: medicine or pain cream, fresh dry clothes or pillowcase, extra blanket, a drink. Hopefully, you can get back into bed within a few moments without ever turning on the light. (Some of the Resources below include tips about this.)

My personal favorite sleep tips

Okay, a bonus: my personal tips. No footnotes – just what works for me:

  • A combination latex-rubber mattress with a thick feather bed on top. Very lightweight feather comforter and duvet which are easier on my fragile fingers.
  • A bath with menthol-infused salts.
  • Turn the clock away from your face. Don’t look at a clock if you wake up.
  • Slow, deep breathing.
  • A dim blue LED nightlight.

Finish this post with your own favorite tips. How do you promote good sleep?

Some Really Helpful Sleep Resources:

Related posts:

Kelly Young

Kelly Young is an advocate providing ways for patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. Through her writing, speaking, and use of social media, she is building a more accurate awareness of Rheumatoid disease aka Rheumatoid Arthritis (RA) geared toward the public and medical community; creating ways to empower patients to advocate for improved diagnosis and treatment; and bringing recognition and visibility to the Rheumatoid patient journey. In 2009, Kelly created Rheumatoid Arthritis Warrior, a comprehensive website about RA of about 950 pages and writes periodically for other newsletters and websites. Kelly served on the Mayo Clinic Center for Social Media Advisory Board. There are over 42,000 connections of her highly interactive Facebook Fan page. She created the hashtag: #rheum. Kelly is the mother of five, a home-schooler, Bible teacher, NASA enthusiast, and NFL fan. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She has lived over nine years with unrelenting Rheumatoid disease. See also http://www.rawarrior.com/kelly-young-press/

56 thoughts on “Tackling Rheumatoid Arthritis Sleep Problems

  • February 3, 2010 at 7:45 am
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    something that i’m sure won’t work for everyone, but seems to help me is a sound machine,, i like light sounds, rippling stream etc, seems to help me,,sometimes.

    Reply
  • February 3, 2010 at 7:56 am
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    I ahve been thinking about getting a feather bed matress topper to go over our 4in memory foam topper. I think however we will have to replace our mattress (its about 6yrs old I believe) with a better quality one. Usually I end up just getting up for the day when the pain/temperature issues drive me outa bed so that I dont wake my husband up (he has problems sleeping as well-worked nights and funeral home oncall for to long). I was able to get some sleep last nite so feel a bit better today 🙂
    Thanks for the tips!

    Reply
    • February 3, 2010 at 8:12 am
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      Danielle, for me, the mattress change was “night and day.” Haha. Seriously, I can’t say enough about how much better it is to be as comfortable as possible. No pressure points at all.

      Reply
  • February 3, 2010 at 8:56 am
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    An electric blanket works well for me. The heat feels so good and can help you relax.

    Reply
  • February 3, 2010 at 9:18 am
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    Caffeine – remember that chocolate contains both caffeine and theobromine, and therefore also interferes with sleep.
    Also chili might interfere with sleep.
    CU Lothar

    Reply
  • February 3, 2010 at 11:08 am
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    I also find that some kind of ambient noise is helpful. My biggest issue is that when left alone I tend to sleep for 12 hours at a clip and am really at my best when I can do that. But it’s not that condusive to having a job. :p

    Reply
  • February 3, 2010 at 12:22 pm
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    Ah, sleep! Why is it so much easier to sleep in the daytime?

    Here are some of the things I do to help me fall asleep:

    1. A foam mattress topper – this has really helped me
    2. Ambient sounds – my Ipod and a thunderstorm!
    3. Relaxing Yoga or stretching right before bed
    4. My heating blanket – Since I am always frozen, this is a must!
    5. Yogi Bedtime Tea (It has peppermint which helps with relaxation)
    6. Backrubs if I can get my hubby to comply!

    Reply
    • February 3, 2010 at 11:31 pm
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      Tea is wonderful! You can get antioxidants or helpful herbs instantaneously & it’s warm & comforting… I use the peppermint a lot too. And the Chamomile at bedtime. Not original, but effective.

      Reply
  • February 3, 2010 at 1:27 pm
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    A couple of years ago I went to the dollar store and bought a really cheap box fan that is noisy (I work nights so trying to sleep during the day adds an additional challenge) in an attempt to drown out all noise while I try to sleep. This has worked well for me. If my pain is elevated, I will jump in the hot tub for 20 minutes or so right before going to bed.

    Reply
    • February 3, 2010 at 11:31 pm
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      Yep. I run a “loud” bathroom fan when I need “noise.”

      Reply
  • February 3, 2010 at 4:59 pm
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    I agree a good back rub hits the spot

    Reply
  • February 3, 2010 at 8:33 pm
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    I know this is so 80’s but a water bed has been a lifesaver for me. It doesn’t matter how you sleep or which way you turn, there is no pressure on the body.

    Reply
    • August 10, 2011 at 9:53 am
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      Water bed has made a huge diffrence!!! I highly suggest this….

      Reply
  • February 4, 2010 at 12:49 am
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    Pain keeps me awake every night. For me to get enough sleep to function during the day, I need to stay in bed about 12 hours. I still don’t feel “rested”, but 12 hours gets me to my “new normal” to start the day.

    I have two suggestions:

    1) One thing that helps me is to distract myself, to get my mind off the pain, by listening to an audiobook from the library. I set up a CD ready to go before I go to bed. Then if I have difficulty going to sleep, or when I wake up in the middle of the night in pain and can’t sleep, I hit the button to start the audiobook. It gets my mind off the pain somewhat and, instead of just lying there wide awake, frustrated, tossing and turning, I can at least enjoy some good fiction. And usually I drift back to sleep for awhile longer.

    2) I’ve tried numerous pillows, and the one that works best for me (at least right now) is a long body pillow. The length of the pillow makes it very versatile and easy to adjust, from sleeping with my head on a thin section, to doubling it up to whatever thickness is most comfortable at the time. And sometimes I use the extra length to support my back when I’m lying on my side, etc.

    Reply
  • February 4, 2010 at 4:29 am
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    I LOVE my Sealy Posturepedic mattress with pillow top
    AND a heated mattress pad
    temperpedic pillow
    down feather pillow between my legs
    heated blanket especially for the winter time
    Celestile Seasonings Sleepytime tea with a splash of milk in it
    Hot bath with lavender Epsom Salts
    Stretch
    Deep breathing
    Snuggling with my doggies
    I always keep a spill proof water bottle by the bed because I get thirst in the night and it wakes me and I keep meds next to it in case I wake in pain
    humidifier in the winter
    If worse comes to worse and nothing else will do I take a benadryl

    I also switch out my pillows when in extra pain with the snoogie which is a maternity pillow that looks like a body pillow with a hook at either end, it supports your back, neck, legs and keeps your body in alignment 🙂

    There are also ambiance dvds available that have soothing colors and sounds to promote sleep. I’ve always wanted to buy one but because I don’t work much I can’t bring myself to spend money on myself. One day I’ll try it and let you all know how it is 🙂

    SWEET DREAMS!

    Reply
  • Pingback: Most Tweeted Articles by arthritis Experts: MrTweet

  • February 4, 2010 at 10:05 am
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    i sleep with three pillows also body pillows are great

    Reply
  • February 4, 2010 at 10:14 am
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    I have a wonderful pillow top mattress. Earplugs help too. I find that even the smallest noise wakes me. I also have a CD that was given to me by a friend. He is a Hypnotherapist and it is a cd on pain reduction. I listen to this and it is very soothing. I still have my nights when I wake up and just can not get back to sleep, no matter what I try.

    Reply
    • January 2, 2011 at 9:20 pm
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      Hi, can you tell me who makes the cd? I have lots of relaxation and meditation, but none specific to pain. Thanks!

      Reply
  • February 10, 2010 at 9:14 am
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    No advice I slept for 24 hours and last night not at all. I have a tempurpedic which is absolutely awesome. So much so my four kids all want to jump in too.

    I do have a question. I noticed someone had a change of clothes nearby. I have been sweating at night and get really hot on the side I lay down on. It is not the mattress, because I have had it for quite some time now and this is a recent occurence. Any thoughts? is it my RA?

    Reply
    • February 10, 2010 at 9:27 am
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      Yes, a change of clothes set out is helpful if sweating is a problem. I have heard the night sweating blamed on mattress material or mattress age. But, I’ve also read that prednisone is too blame or hormone fluctuations such as cortisol (our natural steroid). Women are forced to blame estrogen, but that won’t fly in this case, huh?

      Reply
  • February 10, 2010 at 12:31 pm
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    My favorite sleep helpers

    3mg melatonin tablet
    Magnesium supplement

    and…if pain had gotten me super tense…my primary care doc prescribed Flexaril (a muscle relaxer). It really helps on those tough days when chronic pain has taken its toll. I have chronic bursitis in my hip so finding a way to sleep on my good side is an issue solved with a couple pillows. Nagging wrist pain is another struggle and I am open to suggestions. NSAIDs and tylenol only seem to work to a point.

    Sweet dreams,
    Lee Ann

    Reply
  • February 14, 2010 at 11:24 am
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    I just had to comment about this…it was too funny. I was checking out your bonus sleep tips, and I realized, we had the EXACT same ones. I too use the featherbed, down comforter, epson salts and chamomile tea! HA!

    This was a great series. Sleep is a HUGE issue for me and other RAers!!!

    Good one, Kelly!!!

    – RA SB

    Reply
  • May 11, 2010 at 3:06 pm
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    Despite Amebien and xanax at bed time, I was still in too much pain for good sleep. My doc prescribed muscle relaxers.
    Too many Rx’s!

    I’ve gotten some locally grown marijuana, what a positive difference! I am off all three of the drugs I mentioned. One hit before bed and I am sound asleep for at least 5 hours!

    I wish it lasted longer!

    Reply
  • September 13, 2010 at 10:50 am
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    I have not found anything that works consistently to get a good night sleep. I have used classical music, healing and hypnosis CDs with varying degrees of success. However, oftentimes I will sleep for 2 hours and be wide awake throughout the night. I have used most of the suggestion except using a smoothing blue light bulb. Which I will try. Can not afford the massage anymore on SSI, the income is too low. Thank you, Thom

    Reply
    • September 14, 2010 at 11:45 am
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      Sorry it’s so hard Thom. Sleep is so VERY helpful w/ RA. Many patients take a sleep medicine. Maybe ask your doctor if that would be safe for you.

      Reply
  • September 27, 2010 at 9:12 pm
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    I am recently diagnosed with RA and definitely find that I am having the same troubles with sleeping as everyone else here. My husband and I have discussed getting a new mattress. I am interested in any feedback from fellow-RA sufferers on good mattresses that have made a positive difference. I am trying to conduct as much research as possible before spending the money. However, if it makes a big difference, I am willing to spend the money in order to try to get a good-night’s sleep! Thanks in advance for your tips!

    Reply
    • September 28, 2010 at 3:35 pm
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      Rachel, I do talk about my mattress I think – It’s a latex mattress (rubber) with a feather bed over. I do think that a comfortable bed makes a tremendous difference with RA. I sleep like a rock most of the time since I got it. It is a relief. Whatever you decide is best for you, I hope you can get it.

      Reply
      • December 27, 2010 at 12:21 pm
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        I love my memory foam mattress. Good support but very soft on the surface. It really makes staying in a restful position easier. Hope that helps.

        Reply
  • December 27, 2010 at 12:12 pm
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    Love my memory foam mattress! Always a soft spot wherever I need it:) Plan ahead for the mid-night awakening. Not getting up to meet your needs is the best. Keep the meds and water at arms reach (ouch!) And I’ve learned not to stress about it when I do wake up. That always made it worse for me. I guess we can always dream about a long uninterrupted sleep:)

    Reply
  • January 25, 2011 at 2:49 am
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    WOW! Without even discussing it with anyone else I have:
    –bought two 2″ thick memory foam toppers from EBay that I’ve layered over my (decrepit) mattress. A LOT cheaper than a whole Tempurpedic mattress (I think they were $42 with free shipping!)
    –bought two feather beds in succession. The baffle box one seems much better and easier to fluff than the old channel one.
    –switched from piles of quilts to one down blanket plus a thin quilt in the winter so my aching toe joints get a break when I’m on my back
    –given away my heavy flannel sheets and just discovered INCREDIBLE Polar Fleece sheets at QVC. (I use the cotton jersey ones in summer they’re great, too.)
    –gotten my primary to give me a referral for a sleep test at a hospital sleep lab….I’ve had my CPAP machine for over a year. It’s made a huge difference in my rest. My only complaint is that there is no truly comfortable head gear for it and I wake up with marks on my face that don’t fade for at least two hours.
    –had my rheumatologist write me a prescription for Sonata so I can get at least five hours of meaningful sleep on rough nights.
    –been able to retire with my sanity intact (I think) from teaching in an inner city middle school….how on earth did I do that? Another whole tirade….

    I’m so happy to be able to post and read about our “dreadful disease”….thanks so much.

    Reply
      • January 28, 2011 at 1:59 am
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        Thanks for the comment, Kelly. It’s hard for me to believe that you take the time to read all the responses. I am soo soooooo glad I’ve found you. I tear up when I write that: I have felt so in-valid and old and useless and guilty and alone that it’s good to find people who are getting a grip and doing what they can, and not dwelling on what they can’t. But first we have to admit what we can’t do and then search for what we can. When I was younger, I taught myself to sew and knit. Now, I have an embroidery machine and have been knitting things to give away and to sell. I get a great deal of pleasure out of being able to be creative again…for however long I can be. (my hands seem to be getting worse since I had to switch from NSAIDs to prednisone (in addition to the plaquenil, tramadol, zanaflex and elavil I take for my RA and fibro…oy…)
        Anyway, I have loved reading your old blogs and trying to “catch up.” When I pray, you will be in my prayers.
        Thanks again,
        Judy

        Reply
    • March 19, 2011 at 12:04 am
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      As somebody with arthritis and inflammation (exact kind unknown)… and sleep apnea… check out padacheeks for your mask/strap marks.

      Reply
  • August 10, 2011 at 9:48 am
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    Sleep is one of my number one priorities. I try to get at least 8 hours/per night. Med wise – I have managed to work myself down to just a couple rx’s..I am “currently” blessed that way. However, I have not been able to step away from LYRICA at bedtime. I truly am so uncomfortable without it that i don’t sleep and feel sick all night – all over. I have a hard time explaining the nerve pain that hits me to others…”The worst body ache flu you have ever had?? Along with ithcing and not being able to think clearly…” Anyhoo, as long as I have my Lyrica…and I take one Valerian and one Passion Flower…I sleep pretty well. I was also diagnosed with sleep apnea…however, it wasn’t linked to my RA at the time. Interesting article you had on the connection. thank you.

    Reply
  • September 6, 2011 at 10:54 am
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    I think I have tried just about everything to improve the quality and quantity of my sleep. Here is my latest find, which is helping with my current hot spots-ankle hip and lower back (the perennial favorites!) I have recently aquired one of those body size pillows i used when i was pregnant. If I lay on my side next to it and drape my arm and leg over it, i can releave the stress on the shoulder, hip and lower back that come from side sleeping. Get’s watrm though, so i often throw off the covers, but will be even nicer come chilly winter nights! My husband even prefers this to what he used to refer to as my ‘pillow fort’.

    Reply
  • September 6, 2011 at 4:16 pm
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    Hi Kelly, Thanks for this Article. It was very timely for me. I was awaken last night with horrible muscle and joint pain in my arms. This is not common for me, but it took over 2 hours for me to get back to sleep, so appreciate the times on getting back to sleep.

    Reply
    • September 6, 2011 at 6:42 pm
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      Hopefully it will not become a regular thing! If it continues, I guess you can ask your doc about whether a muscle relaxer for those emergencies would be a good idea. I have avoided them (for my back) due to sleepiness but recently the PA said, “If you are in bed anyway, you might as well…” convincing me to keep them for just in case.

      Reply
  • December 16, 2011 at 8:34 am
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    simmons beauty rest with an featherbed topping and thick mattress pads. feather pillows that i position around to sore joints. sleep with a mask to darken all of the leds and misc lights – saves money and tme fooling with those details! lightweight covers so the blankets don’t sit heavy on the joints – goodby wool blankets. i have cotton or feather comforters and lightweight fleece for additional warmth.

    Reply
  • May 29, 2012 at 6:32 pm
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    My sleep problem is that I am so bothered by any little wrinkle in my sheets and/or pajamas. I twist and turn all over the place before I get to sleep; is this something with my RA?

    Reply
  • August 30, 2012 at 2:24 pm
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    So I got the exquisitely comfortable, pillow-top mattress. Perfect. And I got six pillows, small to large, rigid to waddable, for my neck. Great. But my TOES were still screaming with pain and keeping me awake. Just the weight of a sheet was excruciating.

    Here’s what I devised: Take three foam pool noodles (you know, long, floaty things that kids have for swimming). Pile them up length-wise– two on the base and one on top– and tape them together. Place this at the foot of the bed under the sheet and blanket. The foam keeps the contraption from sliding and the height keeps the covers off of your feet.

    Voila, an effective “medical device” for about six bucks.

    Reply
  • December 29, 2012 at 3:55 pm
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    Hi… just surfed in and found your site. My ex (with whom I am still good friends) was just diagnosed earlier this month and he is having a difficult time. My medical background is in public health and sports medicine, so my knowledge is limited for RA. His chief complaint is the inability to sleep. I suggested that the predisone he’s taking is part of the culprits. I’ve made suggestions such as a warm bath, L-tryp-containing snacks and soft lights/sounds to lull him to sleep. Any other suggestions? I know there is some [mental] adjustments that have to be made, as well, but right now he just needs sleep. Anyone here experiment with cannibus? Thanks!

    Reply
  • December 30, 2012 at 1:32 pm
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    After 4-5 years of Enbrel injections I now have no pain. However, I am still dealing with fatigue. I also have had two knee replacements done and one shoulder. All of these were described as “bone on bone” joints without nature’s padding of cartilege. I have been off Enbrel for 8 months and continually wondering just how long I will be able to say that the pain is gone. Has anyone else had this experience? Any guesses on just what I can expect?

    Reply
  • May 17, 2013 at 2:51 pm
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    A pillow top is the only kind of mattress I can tolerate.

    Reply
  • Pingback: Falling asleep and Juvenile Arthritis | RArainbow

  • January 20, 2014 at 11:31 am
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    I’ve found that working out during the day and getting your heart rate up even for only 6 minutes a day, and drinking enough water (64 oz in my case at least) help me sleep at night. I do have sero-negative arthritis so I count myself lucky in that aspect, but I still have all the symptoms, but have been able to control the fatigue, stiffness, weakness, fevers, achiness, pain and sleep deprivation with exercise, medication, and hydration. What I haven’t been able to control at all is the Vertigo I get whenever there is any moisture in the air. Any suggestions anyone?

    Reply
  • February 3, 2015 at 2:40 pm
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    As of now, Feb 2015, we have been on a waterbed for 35+ years. I like it because it is comfortable and warm. But my back and neck have started being painful and stiff. My daughter urged us to get a Tempur-Pedic (memory foam) bed. We compromised – just the mattress to fit in the “box” our water matress is in. Once we have slept on it for a month (won’t put it in for another 2-4 weeks), I’ll get back with this comment and give my opinion – for my mattress needs.

    Reply
  • October 18, 2016 at 3:56 am
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    I have been on Lyrica for years. My rheumatologist also insists that sleep is essential so she prescribes sleep meds to use as needed. Tramadol for pain if its bad or flanax. Recently have been using magnesium lotion that seems to help.

    Reply

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