The pain of arthritis makes it difficult for many people to get a good night’s sleep. Worse yet, turning and turning at night can actually increase the perception of pain.
“There is a reciprocal relationship between pain and lack of sleep. The poorer people sleep, the more they tend to suffer, ”says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “While people with arthritis can improve the quality of their sleep, they can generally reduce their daily pain. “
Here are eight tips for better sleep from arthritis experts.
1. Don’t go to bed with joint pain
Managing arthritis pain is important at all times, but it is especially critical before bedtime. “If you go to bed in pain, you’re almost certain to have trouble sleeping,” says Fontaine. Try to organize your treatment schedule so that it provides maximum relief when you want to go to bed. Avoid doing activities at night that cause flare-ups of arthritis pain. “Some people with arthritis find they sleep better after taking a hot shower before bed or using an electric blanket to relieve joint pain,” says Andrew Lui, PT, DPT, clinical assistant professor, University of California, San Francisco.
2. Avoid stimulants before bed
It’s not news that having coffee or other caffeinated drinks at the end of the day can interfere with sleep. But many people don’t know about other hidden sources of caffeine, including colas and some over-the-counter pain relievers. Always check labels to make sure you are not consuming caffeine. Black tea also contains stimulants that can make some people feel wide awake when they want to sleep. Evening herbal teas are a better choice if you have trouble sleeping. Alcohol can help some people fall asleep, but too much can disrupt sleep in the middle of the night, leaving you awake and restless.
3. Manage daily stresses
The inevitable stresses of everyday life can also disrupt sleep. You can’t eliminate them all, of course, but you can put them back in their place. “One strategy is to avoid stressful activities or thoughts before bedtime,” says Fontaine. “Don’t look at the news if it irritates you. Don’t pay the bills. Don’t make a list of all the things you have to do tomorrow. Instead, organize your schedule to do something relaxing in the hour or two before bedtime. Listen to music. Read a book. Work on a hobby, as long as you find it calming. If you’re still worried, practice some relaxation techniques such as meditation or gradual relaxation.
4. Exercise to help your arthritis and your sleep
Be as active as possible during the day. This will strengthen your muscles and joints and can help you tire enough to fall asleep. Activity has also been shown to relieve stress, which promotes restful sleep. Being active isn’t always easy when you have arthritis. Yet, activities such as swimming, water aerobics, and moderate walking are achievable for many people with arthritis. “Common wisdom is to exercise earlier in the day because the exercise itself can be stimulating,” says Fontaine. “But some of our patients like to do a light activity in the evening, a walk in the neighborhood for example, to get tired. The best advice is to find what works for you.
5. Create a sound sleep chamber
Reserve your room to sleep. That way you will associate getting under the covers with falling asleep. “Avoid watching TV, reading, working at your computer, or doing other stimulating activities in bed,” says Wilfred Pigeon, PhD, assistant professor of psychiatry at the Sleep and Neurophysiology Research Lab. University of Rochester and author of Sleep Manual: Train your mind and body to get the perfect night’s sleep. “Make the bedroom as conducive to sleep as possible.” Install heavy curtains or blinds to eliminate distracting lights. Use earplugs if sound is a problem.
What is the best type of mattress? Experts say a mid-firm mattress is often the best for lower back pain. “If you have knee pain, try placing a pillow under or between your knees to relieve your joints,” says Kimberly Topp, PhD, professor and chair of the Department of Physical Therapy and Rehabilitation Services at the University of California, San Francisco. “A small pillow under your neck can help align your spine and prevent neck pain while you sleep. Experiment to find what makes you comfortable.
6. Don’t linger in bed
It might sound like a paradox, but staying in bed too long can create poor sleep. To treat insomnia, experts often limit the time people spend in bed. “That way, you help ensure that when you go to bed, you’re more likely to get enough sleep to fall asleep,” Pigeon explains. “If you find yourself in bed for more than 15 minutes without being able to sleep, get out of bed and do something that isn’t too stimulating until you get enough sleep to try to fall asleep again. The reason: you will not associate the bed with a feeling of restlessness. Over time, this strategy will help you associate the bed with sleep, not rolling and rolling.
7. Use sleeping pills sparingly
Sleeping pills can be helpful for people with acute insomnia. But if you have chronic insomnia, which many people with arthritis often do, the first-line treatment should be better sleep hygiene, Pigeon explains. “The drugs treat the symptoms. Behavioral medicine can actually cure insomnia, ”he says. In fact, some studies show that behavioral medicine can be more effective for many people. “Sleeping pills are often helpful in helping people get through a bad period of insomnia,” Pigeon explains. “But when people stop taking them, insomnia often returns – unless they learn to adopt better sleep habits.”
8. Put it all together in good sleep hygiene
The basic advice on how to promote good sleep habits is sometimes referred to as “sleep hygiene”. Together, they can have a dramatic effect on improving the quality of sleep. In a study published in the Journal of Clinical Sleep Medicine in 2009, elderly volunteers with osteoarthritis who participated in a sleep hygiene program reported significantly better sleep and less pain. The benefits were apparent even a year after the program ended.
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