Trouble Falling Asleep Heightens Pain Sensitivity
One of the common ways that people with chronic pain use to eliminate pain is through distractions. Therefore, during the day, most people dont experience pain.
However, at night, when there are no distractions, the body is at rest, and the perception of pain actually increases. As a result, the longer you stay awake, the more you become sensitive to pain.
Also, research suggests that certain chemicals -known as cytokines -are produced due to sleep deprivation. Such chemicals are to the effect that they increase the production of inflammatory chemicals, which cause additional pain.
How Can You Manage Pain That Causes Insomnia
The first step to counter insomnia is to reduce the pain. This means treating the underlying condition that causes pain. Therefore, your physician can manage this pain in the following ways:
- Administering medications
- Physical therapy
- Talk therapy.
Also, to improve your sleep patterns, you need to exercise regularly. Exercising improves pain and sleep problems. As such, you can achieve this through undertaking swimming, yoga, or you can even go for a walk.
Tips For Treating Insomnia In Rheumatology Patients
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Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis , with more than 50% of chronic pain patients reporting sleep disturbances.
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Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD, a licensed clinical psychologist in Reno, Nev., who specializes in cognitive-behavior therapy for chronic pain. Pain makes sleep more difficult, and sleep deprivation can exacerbate pain.
What Are The Symptoms Of Insomnia
First, a quick primer on what this sleep disorder actually does to your body and mind. Potential symptoms of insomnia may include:
- Struggling to fall asleep
- Lower energy, motivation, or performance at work or school
- Being more prone to mistakes and accidents
- Feeling frustrated or worried about poor sleep
What You Can Do
There are a number of things you can do to improve your sleep, short of using sleep medications and experiencing the side effects that come with them. Try some of the following behavior changes instead:
- Avoid heavy meals right before bed.
- Stay away from caffeinated or alcoholic beverages in the few hours before you retire.
- Keep your television set out of your bedroom.
- Maintain a sleeping environment that is comfortably cool, quiet, and dark.
- Go to bed only when you feel tired and sleepy.
With a few adjustments in your evening habits, you may find yourself enjoying more restful nights, and relief from the discomfort of osteoarthritic joints.
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Schedule More Time For Sleep
One of the first thing that Mark M.s doctor told him when he was diagnosed with psoriatic arthritis was to forget the rule that you need seven to eight hours of sleep every night. Ive learned that when you have an autoimmune illness you need way more sleep than a normal person, says the 31-year-old from Katy, Texas. During flare-ups I really need 12 to 14 hours of sleep per night so I actually put my early bedtime into my calendar. I treat it like an appointment, non-negotiable.
Pain Interrupts Your Sleep
If you can’t sleep because pain is keeping you up at night, then you may be experiencing one of the most common reasons that inflammation can cause insomnia.
“Muscle pain can disrupt your sleep, especially if moving about in bed causes sharp pains that awaken the sleeper,” Myers says. “Itâs one of the reasons you see over-the-counter pain medications that combine drowsiness-causing ingredients with other non-steroidal anti-inflammatory drug ingredients. But those medications create havoc for your liver and stomach, so they are only a short-term solution at best.” Finding a trustworthy doctor who you can talk to these symptoms about is important.
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Why Does Arthritis Cause Painsomnia
The reason people with arthritis are more likely to have sleep issues is likely due to several issues. Your levels of cortisol, a hormone that helps control inflammation, are lower at night. Lying down can cause inflammatory chemicals to pool in the fluid that cushions your joints, which makes them stiffen up. And your perception of pain may be heightened during the nighttime because youre not distracted by anything else.
But just because painsomnia is normal and common doesnt mean you have to accept it. Like Lackey, you have to find what works for you to help you get your rest. We talked to people with arthritis about the tricks theyve learned for getting a good nights sleep.
Sleep With A Thin Pillow
Sleep problems were actually how I discovered I have osteoarthritis in my neck, says Nancy B., 52, of Gig Harbor, Washington. For years, all she knew was that lifting her head, even a little, caused terrible pain and a night of no sleep. To keep her neck straight, she slept with the thinnest pillow possible. Last year she started having neck spasms, which lead her to get diagnosed with arthritis. Ive had to change a lot of things since my diagnosis, but the flat pillow has stayed. People think Im weird when they see my sad little pillow its actually a pillow designed for backpacking but its the only way I can sleep without my neck hurting, she explains.
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Tips For Osteoarthritis Patients Struggling With Insomnia
We know that osteoarthritis and insomnia are connected. If you are struggling to get a good nights sleep, weve got some tips to help you reclaim peaceful nights without sleep aids or medications.
It is challenging enough to deal with the pain of osteoarthritic joints as you go about your activities during the day when night falls, you want the comfort of a refreshing nights sleep. People with hip and knee osteoarthritis experience insomnia more often than their peers with healthy joints, but there are steps you can take to sleep better and wake ready for a new day.
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Your Mind Races Before Bed
While there are almost-endless causes of racing thoughts, it is possible for this symptom of insomnia to be caused by inflammation. This is particularly true if you feel especially alert when you’re supposed to be falling asleep.
“Inflammation raises the stress hormone cortisol, which has to drop to very low levels so we can fall asleep,”Jacob Teitelbaum, M.D., tells Bustle. “If your mind is wide awake and racing at bedtime, this is a sign your bedtime cortisol is too high.” Finding ways to cope with stress, and talking to your doctor about other health issues, may help these symptoms abate.
Psoriatic Arthritis: Flares And Fatigue
Psoriatic arthritis might cause fatigue in several ways. In part, the disease process itself may be to blame.
When you have psoriatic arthritis, your immune system releases proteins called cytokines. Those proteins trigger inflammation throughout your body a hallmark of the disease. Researchers believe the cytokines also cause fatigue, perhaps through several different pathways in your body.
Psoriatic arthritis symptoms come and go. Sometimes, they are relatively mild. Other times, the pain and swelling become significant. Those bad periods are known as flares. And when a flare occurs, fatigue often comes along for the ride.
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How Does Arthritis Pain Affect Sleep
The term arthritis is used by the CDC to describe a number of conditions that cause trouble, most often pain and stiffness, for your joints or tissues around the joints. All these types of arthritis affect sleep.
That is because the thing these conditions all have in common is that they keep someone in pain. The discomfort makes it difficult to fall asleep and stay asleep. The inability to get enough sleep then makes managing the pain more difficult, and that in turn makes sleep harder.
Insomnia And Chronic Pain: A Glimpse Into The Research
When exploring the relationship between chronic pain and insomnia, researchers have found its not as simple as pain causing insomnia . Below are findings from three studies to help illustrate the connection between chronic spine pain and insomnia.
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Develop An Arthritis Pain Management Strategy
A person can work with a doctor to develop a plan for managing arthritis pain.
Where possible, it is important to avoid going to bed in pain. A doctor can recommend an appropriate pain relief medication to prevent pain before bedtime. They might suggest:
- nighttime release arthritis drugs
- drugs that work for 24 hours
- an evening dose of pain medication
Identifying and managing arthritis triggers can also be helpful. A person can try keeping a pain and sleep log to determine and address any patterns that seem to worsen sleep or pain.
Insomnia And Arthritis Often Go Hand In Hand
Feb. 16, 2000 — Sleep disruption causes older adults with arthritis to seek more treatment than any other arthritis-related problem, according to a report in the February issue of the journal Archives of FamilyMedicine. But researchers say that poor sleep quality is often neglected.
Because little is known about what causes older adults to seek arthritis treatment, researchers surveyed over 900 men and women age 65 or older. The large sample, drawn from the National Survey of Self-Care and Aging, included subjects from urban and rural communities across the country. Each subject, contacted by phone after an initial interview three years before, reported that arthritis symptoms had limited their activity in the previous 12 months.
The data showed that arthritis caused sleep disruption in almost one-third of those surveyed. Also, sleep disruption caused the respondents to seek more medical, complementary, and self-care treatment than any other arthritis-related problem. In fact, those with sleep problems were almost four times as likely to see a physician. The lead author says sleep disruption is quite common.
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Better Sleep Tip: Meditate Before Bed
Stress management is key to good sleep, and meditation can help. Among older adults with moderate sleep disturbances, mindfulness meditation improved sleep quality more than twice as much as following sleep hygiene tips, according to a study from UCLA. Try five minutes of deep breathing before bed, recommends Weijia Yuan, M.D., a rheumatologist at the Hospital for Special Surgery in New York. Or try using an app .
Rheumatoid Arthritis And Sleep
Are your RA symptoms affecting your sleep, or is your trouble sleeping making your symptoms worse? The answer may be both.
If rheumatoid arthritis has you tossing and turning at night, youre not alone. While the exact percentage of RA patients who experience sleep problems is hard to nail down, more than 80% of people with RA report fatigue as part of their symptoms. Why Sleep Matters
Sleep problems can increase levels of stress hormones and aggravate flares, says Rochelle Rosian, MD, a Cleveland Clinic rheumatologist. And even if youre not flaring, you may not manage your pain as well if youre not sleeping. When you sleep, you make all those brain chemicals that you need to feel better. If youre not rested, you dont have all of these good hormones. So it may be more difficult to handle your pain.Besides increased flares, RA patients with sleep disruptions tend to have more trouble with depression, pain severity and performing normal daily functions than RA patients who dont have sleep problems. Also, in the deepest stages of sleep, the body releases growth hormones to repair tiny muscle tears that occur during the course of the day. People with RA who sleep fitfully may not get enough growth hormone to make needed repairs.Anxiety, Stress and Sleep
A good nights sleep can improve your pain and your ability to manage it. Talk to your doctor, eat well, get plenty of exercise, and follow good sleep hygiene practices.
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Or Sleep With Ice Packs
Everyone says heat for arthritis but for me ice is the best, especially if I cant sleep, says Jennifer D., 28, of Washington, D.C. Heat makes the rashes from my psoriatic arthritis feel worse so I have ice packs I keep in the freezer and put them down my pajamas at bedtime. It takes some getting used to but its worth it for me to sleep better. Her trick is to buy ice packs that dont leak or sweat so she doesnt wake up in a wet bed.
Why Arthritis Symptoms Get Worse At Night
Researchers have several theories to explain why many people with arthritis experience worse pain at night.
One theory is that the bodys circadian rhythm may play a role. In people with rheumatoid arthritis , the body releases less of the anti-inflammatory chemical cortisol at night, increasing inflammation-related pain.
Other processes may also intensify RA pain, including the nighttime release of pro-inflammatory cytokines, an increased number of cells traveling to inflamed tissue, and changes in the bodys immune response.
Additionally, the body releases higher levels of melatonin and prolactin at night, both of which can cause an increase in inflammatory cytokines.
A persons arthritis inflammation and pain may worsen if:
- they are already in pain when they go to bed
- their mattress or pillow puts pressure on their joints and irritates their arthritis
- they have other risk factors for insomnia, such as high stress levels or drinking caffeine before bed
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Psoriatic Arthritis And Brain Fog
Some people find that psoriatic arthritis leads to another kind of fatigue: brain fog. People have reported problems with concentration, memory and other thinking skills.
In part, this fuzzy-headed feeling may be the result of not getting enough sleep at night because of chronic pain. Its also possible that the inflammation caused by psoriatic arthritis may affect brain function in some way.
The Benefits Of Good Rest
Not surprisingly, people with RA who sleep well are better able to recover from the activities of the previous day, says Christopher R. Morris, MD, a rheumatologist in private practice in Kingsport, Tennessee. But if a person sleeps poorly, the muscles cant fully relax. If theyre fatigued, they hurt. If they hurt, they get fatigued, and they hurt more.
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Better Sleep Tip: Assemble Your Support Team
A useful thing to do first? Find help. That means asking your family doctor for effective strategies, suggests Dr. Hylland, and possibly seeking a sleep specialist. Meanwhile, keep working with your rheumatologist to find the right balance of medications and therapies to control your RA symptoms. By seeking assistance across fields, youre more likely to find solutions that work for you.
Are There Different Types Of Insomnia
Experiencing short-term disturbed sleep is more common than chronic insomnia, per the U.S. National Library of Medicine. In this case, you may experience symptoms for days, weeks, or sometimes a couple of months due to a particularly stressful period at work or a traumatic life event, like losing a family member or going through a painful breakup.
Chronic insomnia, on the other hand, means you have trouble falling and staying asleep at least three times a week for three months or longer. It can also be triggered by things like never-ending stress, difficult emotions you havent worked through, or constant travel thats throwing your schedule out of whack. However, this type of insomnia can present as a side effect to a deeper issue as well, like an underlying health condition, medication plan, or substance use.
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Getting The Help You Need
Sleep problems and their effect on your ability to deal with arthritis are sometimes ignored because people think the problems cant be solved. Southern Pain Clinic feels differently. Our highly qualified staff members know all about the latest pain management techniques, and we specialize in non-surgical pain relief. When the pain of arthritis interferes with your sleep, contact us. We will work with your doctor and you to find the best treatment for you.