How Can Arthritis Impact Your Sleep?

Luckily, there are certain lifestyle changes you can make that should help your arthritis symptoms and your sleep. Before we get into that, though, it’s important to understand how arthritis can impact sleep, and how sleep can impact arthritis. If you’re having difficulty sleeping because of arthritis, we also encourage you to talk to your doctor, who may be able to guide you to solutions that work best for your particular body and health history.

There are two main types^[2] of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis^[3] is caused by the cartilage that surrounds the bones wearing out over time, whereas rheumatoid arthritis^[4] (R.A.) is an autoimmune disorder in which the immune system mistakenly attacks your own body’s tissues.

Both types result in joint pain, stiffness, swelling, and inflammation – all of which tend to get worse at nighttime. According to Harvard Health, there is a simple reason for this: the anti-inflammatory hormone, cortisol, is at its lowest during the night^[5].

A 2022 study^[6] also suggests that chronic pain, like arthritis, might follow a circadian rhythm, like the one that regulates our sleep-wake cycle.

This discomfort can result in a lack of sleep, and at the same time, sleep deprivation can make pain worse^[1].

Arthritis pain and sleep have a bidirectional relationship. Pain and discomfort can lead to poor sleep quality, and poor sleep quality can lead to more pain and discomfort^[1]. This is because sleep plays a pivotal role in managing pain^[7].

Deep sleep, in particular, is important in healing and repairing the body, as well as controlling stress, hormones, energy, and the immune system. When we consistently don’t get enough sleep, these systems go out of whack.

A 2019 study^[8] published in The Journal of Neuroscience scanned the brains of 25 healthy adults in two different environments, one in which they’d slept for eight hours and the second in which they were kept awake for 24 hours. During both scans, participants received uncomfortable levels of heat to their legs.

What they found was that when the group was sleep-deprived, they had a 120 percent increase in the brain’s somatosensory cortex, the region that interprets what pain feels like. The brain scans also showed a 60 to 90 percent drop in activity in the areas of the brain that typically dampen the perception of pain.

Though this test group was smaller, it does suggest that a lack of sleep not only heightens the brain’s interpretation of pain but also hinders the brain’s ability to block that pain.

Establishing a consistent sleep and wake time, even on weekends and vacations, will help train your body to feel more sleepy at night. This also helps ensure you set aside enough hours of sleep each night to help prevent sleep deprivation, which, as mentioned, can worsen pain symptoms.

Keeping your bedroom dark, quiet, and cool at night is helpful because these are the optimal conditions for fostering better sleep. Preventing distractions, such as outside lights, too much warmth, or noise is key for helping you sleep easier.

Certain medications, like pain relievers, anti-inflammatory drugs, and medications that treat arthritis (like corticosteroid prednisone), can help alleviate some of your arthritis pain to help you get a better night’s sleep. It’s important to note that long-term use of these drugs can be damaging to the body^[9], so these should be a temporary solution.

That being said, we advise consulting with your primary doctor before taking any new medications.

Keeping a sleep diary is a great way to find out what is impacting your sleep in a positive or negative way. In your daily entries, make notes on the following:

• What time did you go to bed and wake up?
• Did you take any naps during the day?
• How tired did you feel throughout the day?
• Did you consume alcohol or caffeine? At what time? How much?
• Did you take any medications?
• Did you experience any stressful events during that day?
• Did you exercise? At what time? How much?
• What did you have to eat?

You can also share any patterns you find with your doctor.

Most of us know not to drink caffeine right before bed, but did you know that caffeine can negatively impact sleep up to six hours^[10] before bedtime? That means, if you go to bed around 10:00 p.m., it would be best to have your last cup of coffee before 4:00 p.m.

Additionally, alcohol has a disruptive effect on sleep^[11]. While it might feel like a drink or two helps you get sleepy at night, alcohol actually disrupts the release of melatonin and can increase the risk of nighttime awakenings.

Exercising regularly has been shown^[12] to improve both sleep quality and duration.

Exercise can also help improve the symptoms of arthritis^[13], but you should be careful to stick to low-impact exercises, like biking, walking, yoga, swimming, or moderate weight training. If you’re at all unsure what exercises are safe for your arthritis, be sure to talk to your doctor.

Read More: Exercise and Sleep

Stress can have a negative impact on both arthritis and sleep. With arthritis, stress can set off the immune system’s inflammatory response^[14], and stress can make getting to sleep and staying asleep more difficult.

The best thing is to have several go-to tools in your toolbelt to keep stress at bay, and other tools that you can use when stress inevitably creeps in. For example, meditation, taking walks, talking with friends, cuddling with your partner or dog, and journaling are all great tools to help manage and prevent stress. You might also invest in therapy to handle bigger stressors, unprocessed trauma, or anxiety.

Devices like your phone, television, and computer emit a blue light that’s harmful for sleep. This type of light suppresses melatonin production, which means it will take you longer to get sleepy. We advise putting down your phone and devices 30 minutes to one hour before bed and dimming the lights in your home to start winding down. When you sleep, your room should be pitch dark; however, if you need a night light, we recommend one that emits red light.

Many people with arthritis swear by a Mediterranean-based diet^[16] to help manage inflammation and mitigate painful symptoms. The staples of this diet are foods high in omegas, like fish, nuts, and seeds; plenty of fruits and vegetables, healthy fats like olive oil and avocado, gluten-free whole grains, and certain types of beans.

Avoiding processed foods, sugar, white flour, dairy, and fried foods should also help mitigate inflammation and help promote sleep.

Learn more: The Connection Between Nutrition and Sleep

Generally speaking, if you have joint pain, you’ll want a mattress and pillow that are pressure relieving for the joints yet still supportive enough to keep your spine straight, no matter what position you’re lying in. This combination should help improve arthritis pain and lead to a deeper night’s sleep. If you haven’t replaced your mattress in over eight years, it’s probably time to do so.

Helpful Finds: Our top picks for the best mattresses for arthritis and best mattresses of 2023

Talking to your doctor is an important step for those with arthritis. Your doctor may be able to provide advice that is specific to your body and health history, while also honing in on what is causing your arthritis or sleep issues.