Sleep Hygiene & Arthritis

People who live with arthritis, probably know firsthand how difficult it can be sometimes to get a good night’s sleep.

It’s a catch 22 situation. Those who live with chronic pain often have a hard time getting enough good quality sleep, and those who don’t get enough good quality sleep often experience higher bouts of pain and disability. Sleep and pain interestingly enough, share very similar pathways.

What do we know about Arthritis pain?

Pain is a very unpleasant sensation that experience when something is wrong and is a very common symptom of Arthritis. We can have acute or chronic pain. The origin of pain can be mechanical, nociceptive, inflammatory, and neuropathic meaning, it could come about from joint damage, inflammation, or sensitization of the nerves that overreact when receiving a pain signal. The way the brain interprets pain can depend on a number of things like your physical health, sometimes your mood, reason for the pain, even your sleep can influence the intensity and perception of pain.

How does Arthritis affect sleep?

Arthritis pain can affect sleep in many different ways. Some types of arthritis (inflammatory types) can flare up at night, or sometimes arthritis in a specific joint can be irritated by certain sleeping positions or the weight of a blanket. In addition, chronic pain can cause frequent nighttime wakings and prevent us from entering a deep, restorative sleep.

There are also other additional factors that can affect sleep like medications, physical inactivity, drinking too much coffee, drinking alcohol, and mental health.

The sleep cycle

When we sleep, we cycle through light sleep, slow-wave, non-rapid eye movement (non-REM) sleep, and rapid eye movement (REM) sleep. In order to feel well-rested we need a balance of all 4 different stages of sleep, especially slow-wave sleep and REM sleep. When this cycle is disrupted and someone cannot enter slow-wave and REM sleep, it can lead to less restful sleep, next-day tiredness, some studies have even demonstrated this a cause of hyperalgesia (hypersensitivity to pain signals). It is promising that, many studies have also found that for the long term, achieving good quality sleep may improve chronic pain.

Sleep hygiene & Arthritis

Sleep hygiene, the art and science of good sleeping habits, is increasingly becoming an area of focus for improving the management of pain, backed by decades of research. Studies have found that by achieving the recommended amount of good quality sleep every night, we can improve the bodies resilience to stress and pain, reduce intensity of pain and possibly lower inflammation.

Because it can be difficult to get to sleep when you are living with chronic pain, it’s important to make your sleep hygiene a priority. For those living with a persistent sleep-deficiency due to chronic pain, it can sometimes cause an unhealthy relationship with sleep, so here are a few things you can do;

Simple, yet effective sleep hygiene tips

  1. Limit electronic screentime, coffee and alcohol close to bed. Avoid these stimulants for at least 3-4 hours before bed time.
  2. Good sleep habits start from the moment you wake up. Make sure you expose yourself to natural sunlight upon waking and avoid any exposure to light emitting devices like your phone before this.
  3. If you find the pain worsening at night time just before bed, find something to distract you this could be a crossword puzzle or light reading.
  4. If pain is something that awakens you through the night, or you’ve realized you have gone a couple nights in a row without sleep – plan ahead. Take your medication or apply your pain relief cream just before you go to bed. You could also keep it near your bedside table so you can easily apply it upon waking during the night.
  5. Avoid daytime napping. Sure it can be good if your running low on energy during the day, but they will come at a cost to your sleep during the night.
  6. Set a schedule and try stick to a routine every night. Falling asleep and waking up at the same time every day and night can help train your sleep/wake cycle.
  7. Explore meditation practices. It could be guided meditation or listening to a podcast that helps distract you from your pain and calm your nervous system down to help you fall asleep easier.
  8. Set a cool, yet comfortable temperature in the bedroom. We sleep best at 18-22 degrees celsius.
  9. Try calming scents – lavender.
  10. Avoid eating dinner and exercising to close to bed. Exercise can bring your heart rate and temperature up making it difficult to fall asleep.

Make sure you jump onto our Arthritis & Sleep webinar on Thursday 24 August at 7.00pm or view the recording to learn more about your body clock and how you can work with it to get the most out of your sleep.

Mary Zagotsis
Health Educator
Arthritis NSW

August 2023