Sleep Quality Affects Disability in Rheumatoid Arthritis

The relationship between Rheumatoid Arthritis, sleep, and disability

A small study in 2009 confirmed “Symptoms of Rheumatoid Arthritis (RA) negatively affect women’s sleep.” It’s no surprise that Rheumatoid Arthritis impacts the sleep of many patients.  Most patients could tell you why: pain, medication side effects, and emotional frustration or depression about chronic illness, chronic pain, and increasing disability.

However, a new study explores the influence of Rheumatoid Arthritis sleep problems on RA disability. Researchers made “a cross-sectional examination of the relationship between sleep quality and functional disability in 162 patients with RA.” This may sound a bit like the proverbial chicken and the egg question, but with a disease as mystifying as RA, it may be worth asking.

The new study considered the how sleep quality in a Rheumatoid Arthritis patient affects disability. This is the first time that the poor sleep associated with Rheumatoid Arthritis has been studied as a possible source for greater disability. Their conclusion: “Sleep quality has an indirect effect on functional disability through its relationship with pain severity and fatigue. Future research should investigate whether improvements in sleep can reduce disability in patients with RA.”

Importance of rest & sleep on fighting Rheumatoid Arthritis disability

Midnight launchIn the olden days, a RA patient was hospitalized and treated with cortisone to get an initial flare under control. Several days of enforced bed rest can do wonders for RA symptoms as I was reminded recently after a minor surgery. Of course, most of us can’t afford that very often.

Yet, I’ve said many times that rest – and sleep – is the most important part of treating RA after the advice and treatment of a good rheumatologist. That’s why I’ve written several other posts about sleep and RA and advocated strongly for quality bedding for Rheumatoid Arthritis patients. Getting the right bed for me made such a tremendous difference that I went back to “sleeping like a rock.” I’m so grateful for good sleep that I often call it the blessed relief. I know from the times when I could not sleep that it is even harder to manage RA without quality sleep.

More posts on Sleep and Rheumatoid Arthritis:

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/

16 thoughts on “Sleep Quality Affects Disability in Rheumatoid Arthritis

  • February 17, 2011 at 7:24 am
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    hi kelly,

    i believe and agree with you that quality sleep is needed for us RAers. sleep heals… 😀

    God bless always…

    Reply
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  • February 17, 2011 at 9:52 am
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    Sometimes I wonder if you aren’t tapping into my brain. Last night, I was hurting so bad, I couldn’t find the right position, every little movement to adjust was like pulling teeth, and all I could wish for was the “luxury” of being able to take a Tylenol PM or, if I had one, a tramadol to help ease the pain and give me the extra help to sleep. (I respond all too well to the PM and Tramadol, so I’d be a zombie today if I took it after 8PM.)

    I am going to have to hit a mattress store this weekend with the hubby to find a good mattress, because our is REALLY old.

    I think a lot of problems could be helped if we could get a good quality of sleep. Rest is essential for so much. The natural state for our eyelids is closed and the natural state for our mouths is open. Not to mention all the rest of the stress we put our bodies thru, if we don’t have a dibilitating disease. Sleep is the only time we can give our bodies/muscles a break.

    Thanks for this article, and for reading my mind *giggles*.

    Reply
    • February 17, 2011 at 11:12 am
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      Thanks for the smiles, Katie. 😀 There are some suggestions & links about mattresses on the tackling sleep problems post. They might help.

      Reply
  • February 17, 2011 at 5:40 pm
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    I know that sleep is important but I feel that all I do is sleep. I am 34 and work a full-time job. When i get off work, I go home and nap for an hour or so and then get up for a bit and go back to bed. On the weekends I have to take a 3-4 hour nap. I am blessed that my fiance is understanding but no matter what I say to myself about how it is important to sleep, deep down I feel lazy.

    Reply
  • February 17, 2011 at 6:55 pm
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    Agree 100%. At my worst RA pain levels I could not get any sleep. It became a vicious cycle as the days went by and the lack of sleep made my pain worse. My rheumatologist gave me medication to help sleep and the pain decreased – not disappeared – but improved.

    In my early RA days I struggled to find a new mattress. It took me a month , 4 mattress and many pillow tops to finally find the right one. Lack of sleep was making my RA worse.

    Reply
  • February 18, 2011 at 8:48 am
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    Good topic. Sleeping in a mattress with coils really, really caused my hips a lot of pain. We now have a Sleep Number bed and it is so much better. I’ve never been someone who cold take naps (prior to RA). Some days the fatigue is so bad that I have no choice. Some days I can’t get any good sleep at all, not even with a good mattress. My belief is that I should try and get more rest – my mother who had RA for many years would always at least rest on the bed for an hour or two even if she couldn’t sleep. I think I should do that too, but that makes me feel guilty of being lazy, even though I know better.

    Reply
    • February 19, 2011 at 10:37 am
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      I agree that coils and RA do NOT mix! Try not to be so hard on yourself if you have to rest – we all fight that guilt. But it’s like a phantom – we aren’t at fault.

      Reply
  • March 7, 2012 at 9:38 am
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    Hello,
    I’ve been a lurker for a while but thought I’d introduce myself. I am a 48 year old woman and I was offically diagnosed with RA last fall. I’ve had symptoms for at least a couple years, though. I have a knowledeable, kind, RA doctor and I am on MTX, Plaquinil, Folic Acid and have my second Humira injection on Friday. I really struggle with fatigue. In addition to the RA, I also have Hashimoto’s disease and Restless Legs Syndrome and take medication for both. I grind my teeth at nigh and so I have to wear a night guard. Lately I find myself awake in the middle of the night and unable to get back to sleep. Thankfully, it’s not my legs wiggling that keeps me awake. I think it’s a combo of worry over this disease, muscle tension and of course, the aches in my joints. I have an active lifestyle – married with two middle school aged kids, my own business, and two horses that I train and compete with in the sport of dressage. There are so many days that I get up just wanting to go back to bed. I think the fatigue is just the worst thing about this disease, and it really is debilitating. Thanks for reading ~ Tami

    Reply
  • March 7, 2012 at 10:15 am
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    I have to agree about the coils, we have these and I’d not linked those before reading this but I had been finding it increasingly hard to sleep well, waking several times at night and not being able to get comfy to read (something I do almost every night in bed). We recently bought a memory foam topper and memory foam pillows and oh boy they really do help. Last night I slept 9.5 hours,I felt awful when I went to bed, only briefly waking when hubby got up for work. I’m so glad we bought them. I don’t normally sleep that long as usually I go to bed just after 10 & read anywhere till 1 or so. I like to read until I can’t keep my eyes open and that way I think less about the pain when I lie down. I’m up around 7, 7-30 to ensure my youngest is up for school. I think sleep is very important for us. I’m not a daytime napper though, although when the fatigue really hits hard it has been known, I hate it though!

    Reply
  • March 8, 2012 at 4:11 am
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    I have to say, lack of sleep affects my RA/psoriasis more than RA/psoriasis affects my sleep. Though I suppose it’s just a viscous cycle… good post, Kelly.

    Reply
  • March 9, 2012 at 8:00 pm
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    I think of my RA and restful sleep as a cycle….The worse my RA symptoms, the more difficult it is to have a good night’s sleep, but the poorer my quality of sleep, the worse my RA symptoms. Luckily I have a great psychiatrist who recognized this from the very beginning of my RA diagnosis. I respond very well to a psychiatric medication, Seroquel, which also helps depression. At least for me, the dose can be adjusted as needed for sleep. Sometimes when I get so tired, sore and achy beyond belief, sleep (with the aid of Seroquel and an NSAID or light pain reliever) is the best medicine. There is no comparison to my symptoms pre- a good night’s sleep, and post…Thankfully my psychiatrist recognizes this, as my Rheum as never mentioned it.

    Reply
  • July 11, 2012 at 10:52 am
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    At the time I found out I had RA I really had very few symptoms, if any. The family doctor had ordered the test because I had knee problems and he wanted to rule out Ra as a cause. That was in October and I had my first appointment with the Rheum doc in Dec. Subsequently started on methotrexate 6 tabs a week. I definitely had joint pain and fatigue after that!!! I thought it was a coincidence. Never heard of that side effect till today. Currently am not on Metho anymore and have just mild joint pain and fatigue. Taking another DMARD and weaning off prednisone and feeling pretty good. Think the whole time I was on Metho I didn’t feel well, about a year, and then ended up in the hospital with a lung infection for four days. Went off the metho, and stopped Simponi, and was ok for a couple of months, but then had a pretty good flare. Back on the metho, only four tabs this time, and prenisone. Felt really bad for days each time, so asked the Dr for a different medication and am doing fine. Thank God!!!

    Reply
  • January 20, 2014 at 2:03 pm
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    I have a warm water bed.
    It does help.
    But know matter what you do,when the pain starts you are not going to sleep

    Reply
  • September 6, 2015 at 4:01 pm
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    I have suffered with RA for years. I have been going to a pain doctor for a long time but he recently referred me to a rheumatologist. I had been on Norco, Celebrex, and Flexeril, but I was still in significant pain. The rheumatologist put me on methotrexate, 4 pills a week for 2 weeks and then 5 pills a week, as well as folic acid. The nausea was overwhelming but even more disconcerting, I was not able to sleep more than 2 hours a night no matter what. Also, my joint pain and ability to ambulate even short distances was 3 times more painful than it had been. Though I have mentioned to my pain doctor, rheumatologist, and PCP my inability to get more than 2 hours of sleep a night, they all have had no solutions and will absolutely not give me anything to help me sleep. I have resorted to OTC medications, which do not help at all, and I have been told to take nothing for pain, besides the Norco, except Tylenol, which does not help me. I am 67 and I am still working full-time and need to work at least 3 more years but the outlook is dismal when I look ahead. My rheumatologist told me that sleep was vital to my alleviation of symptoms, but still offers no help in that regard.

    Reply
  • August 28, 2016 at 10:15 am
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    I had sleep depravation years before true consistent RA pain showed up.(since I was in my early 30’s) So I do not agree mY sleep issue are based in pain. I am in total agreement that my quality of sleep factors into my level of pain. Since I went thru menopause at 46 (I completed it in 3 month) I have not slept more than a few hours at any one time. Medications to relax me either don’t work or give me hideous side effects. I wish there were doctors that took more than one factor onto consideration. They ask about sleep but then really never address it again. They do act like it is only a result of the pain and they seem to not see it as a causation of the body breaking down and increased pain. I feel I will never heal from anything I have a horrible time getting over a common cold or sinus infection because I simply cannot and don’t sleep

    Reply

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