Tackling Rheumatoid Arthritis Sleep Problems
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 bed 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 Resources:
- 15-part series by a doctor on How Stuff Works.com with lots of general good sleep advice.
- Lists from Healthkey of more meds which may interfere with sleep.
- Dr. Sears’ lists of foods to help sleep.
- WikiHow: Dozens of tips on how to fall asleep.
- 32 mattress buying guides on ConsumerSearch.com
Related posts:
- A serious look at problems with sleep and RA: Rheumatoid Arthritis Sleep Issues (Great reader tips!)
- A humorous look at sleep and RA: Encountering Signs of Rheumatoid Arthritis: A Modern Princess and the Pea
- Comparing Risks and Benefits of Rheumatoid Arthritis Medicines
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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.
Thanks. There are already lots of great tips on yesterday’s post, too. Folks have lots of good ideas.
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!
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.
An electric blanket works well for me. The heat feels so good and can help you relax.
Caffeine – remember that chocolate contains both caffeine and theobromine, and therefore also interferes with sleep.
Also chili might interfere with sleep.
CU Lothar
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.
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!
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.
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.
Yep. I run a “loud” bathroom fan when I need “noise.”
I agree a good back rub hits the spot
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.
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.
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!
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i sleep with three pillows also body pillows are great
i love your site almost as much as sleep
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.
Off topic a bit, but you RA Warriors are a little sunshine in my day. Here’s some sunshine back at you, Kelly:
http://itsybitsyspidercrochet.blogspot.com/2010/02/sunshine-award.html
I know my cousin did it first, but I second the motion!!
http://fromthispoint-forward.blogspot.com/2010/02/sunshine-award.html
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?
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?
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
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