I was diagnosed with rheumatoid arthritis (RA) a few years ago. And while living with RA can be challenging on a variety of levels, one challenge that I wasn’t necessarily expecting is how it’s impacted my sleep.
RA (and the pain that comes with it) has made it harder for me to fall and stay asleep. It’s also made it harder for me to feel like I’ve gotten a good night’s rest—even if I’ve technically clocked a full eight hours.
So how, exactly, are rheumatoid arthritis and sleep connected? And how can people with RA (myself included!) get better sleep? Keep reading to find out.
What is rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune condition that affects the joints. Currently, there’s no known cause for RA (similar to other autoimmune disorders)—and while symptoms vary from person to person, the most common symptoms of RA include joint pain, stiffness, and fatigue.
Can rheumatoid arthritis cause sleep problems?
Sleep problems are common for people living with RA. Research has shown that anywhere between 50% and 75% of people with RA suffer from sleep disturbances—while another study found that nearly two-thirds of RA patients who participated in the study qualified for at least one sleep disorder.
“The exact cause of…[sleep] disturbance is multifactorial, and ranges from joint/muscle pain from the disease itself to medication side-effects and/or co-morbid conditions such as anxiety and depression,” says Saimun Singla, DO, triple board-certified physician and founder of Texas-based Rheum to Grow (and a person living with an RA diagnosis herself). “Regardless of the underlying cause, patients with RA end up with fragmented or poor sleep quality.”
RA impacts sleep in a variety of ways, including:
- Insomnia. People with RA often struggle to fall asleep, particularly when they’re experiencing pain—which can, over time, lead to more chronic insomnia. In fact, according to one study, more than half of patients with RA report struggling with insomnia.
- Not getting high-quality rest. One of the main symptoms of rheumatoid arthritis is pain—and that pain can make it difficult to fall and stay asleep. Even when people with RA are able to get to sleep, they often find their sleep quality lacking; research shows that people with rheumatoid arthritis report a high prevalence of non-optimal sleep (which is generally linked to pain level).
- Medication challenges. Most people with rheumatoid arthritis are on medication, some of which can cause issues with sleep. For example, prednisone is a steroid commonly used to treat inflammation associated with RA—and, in many patients, is also known to cause sleep issues, including insomnia.
Clearly, RA can cause poor sleep. And while poor sleep can negatively impact anyone’s health, it can be particularly detrimental to people living with rheumatoid arthritis.
“Most of us have felt the drag of not getting enough sleep,” says Singla. “But in RA patients, poor sleep can have detrimental effects on multiple levels.”
According to Singla, poor or fragmented sleep can cause an increase in stress hormones and inflammatory markers, which can make RA symptoms worse. It can also interfere with the way the central nervous system processes pain—lowering pain thresholds and increasing pain sensitivity.
“This leads to the vicious cycle of pain, inflammation, and disease flares,” she says.
How to sleep better with rheumatoid arthritis
The good news? There are ways to get better sleep with rheumatoid arthritis. Some key tips for how to sleep better with rheumatoid arthritis include:
Carve out more time for sleep
The first way to sleep better with rheumatoid arthritis is to schedule time for more sleep.
“When you have an autoimmune illness [like RA], you need more sleep than a normal person—especially during a flare,” says Singla.
While there’s no one-size-fits-all solution to how much sleep you’ll need to feel rested with rheumatoid arthritis, it’s important to give yourself more time than you think you’ll need to sleep—for example, by aiming to go to bed a few hours earlier or carving out time for midday naps when possible.
And if you’re struggling with this condition, don’t feel guilty about rheumatoid arthritis and sleeping all the time.
“It’s important to give your body the time to rest so it can heal both physically and mentally,” says Singla. “Listen to your body when it wants more rest.”
Treat pain before sleep
One of the main reasons RA impacts sleep is because it causes pain—and that pain can make it hard to fall and stay asleep.
So, if you want to improve your sleep with RA, one of the best things you can do is treat your pain before you get into bed.
Depending on your symptoms, “supportive treatment options to help improve joint pains include applying an NSAID topical gel or hot pack over the painful joints, a paraffin wax dip right before bed to help loosen the joints of the hand, or even sleeping in compression gloves,” says Singla.
A pre-bedtime bath or shower can also help. “Consider a hot shower or bath to not only loosen up painful joints but to create a sense of relaxation in general,” says Singla.
Choose the right sleep position…
The best way to sleep with rheumatoid arthritis is to find the best position. But what is the best sleep position for rheumatoid arthritis?
The answer? It depends. There’s no universal rheumatoid arthritis sleep position. Different people living with RA will have different types of pain—and, therefore, will need different sleep positions to sleep more comfortably. For example, someone who has knee pain is going to need a different sleep position than someone who has back pain.
The key is to find a position that takes the pressure off of your joints—and if you can’t find a position that feels comfortable, consider incorporating props (like pillows or a folded-up blanket) to relieve excess pressure.
“Adding a small pillow underneath the small of the back and/or the knees can also be helpful,” says Singla.
If you’re dealing with RA and haven’t found an ideal sleep position, keep experimenting. “Finding the right position can take some time, but it’s worth playing with to reduce pain and help you sleep,” says Singla.
…and the right mattress
If you want to sleep comfortably with RA, finding the right sleep position is important—but so is finding the right mattress.
“Finding a mattress that provides strong pressure relief is also key,” says Singla. “This means avoiding mattresses that…sag when you sleep.”
Find the best pressure-relieving mattress at Saatva
Saatva Rx Mattress
Specially designed to give maximum support and pressure relief that can help alleviate discomfort associated with serious and chronic back and joint conditions like sciatica, arthritis, herniated disc, and scoliosis.
Saatva Classic Innerspring Mattress
Our flagship luxury mattress is expertly engineered with coil-on-coil construction for durability, a layer of memory foam for enhanced back support, and a cushiony Euro pillow top for extra comfort.
Loom and Leaf Memory Foam Mattress
Premium memory foam, handcrafted in the U.S. with eco-friendly materials. Breathable organic cotton, cooling spinal gel, and layers of high-density support foam assure a cool, comfortable night's sleep.
Zenhaven Latex Mattress
Natural latex responds to every curve for pressure-free support and responsive comfort. Natural latex is supple, resilient, and durable, for the ultimate in elevated sleep. (It's naturally hypoallergenic too.)
FAQs
Why is it so hard to sleep with RA?
Rheumatoid arthritis causes pain, which can make it hard to fall and stay asleep. In addition, certain medications used to treat RA (like prednisone) can cause additional sleep issues.
Why does rheumatoid arthritis get worse at night?
RA patients experience increased pain at night for a variety of reasons. According to Singla, inactivity, additional pressure on certain joints (like the hips, knees, and back), and a decrease in cortisol, which has anti-inflammatory properties, are all reasons why rheumatoid arthritis symptoms might get worse at night.
Can rheumatoid arthritis make you unable to sleep?
Yes. For many people, the pain from rheumatoid arthritis can make it difficult—or impossible—to fall asleep, leading to insomnia.
How can I sleep comfortably with rheumatoid arthritis?
There are a number of ways to sleep comfortably with rheumatoid arthritis, including treating pain before sleep (for example, by taking an NSAID) and finding a sleep position and mattress that relieve pressure on the joints.
Check out our guide to the best mattresses for back pain to learn more about what to look for in a mattress if you experience pain while you sleep.
