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Strategies to Help Tackle Sleep and Manage Chronic Pain

Rebecca Gillett, MS OTR/L

Director of Content Strategy and Planning, Arthritis Foundation; Co-Host, Live Yes! With Arthritis Podcast 

More than 54 million people live with a form of doctor-diagnosed arthritis. The chronic pain can be debilitating, wreaking havoc on daily life. One issue that affects so many people with arthritis is difficulty with sleep.

Approximately 80 percent of people with arthritis report difficulty sleeping. I like to call this symptom “painsomnia.” Some days I fall asleep fast from sheer exhaustion and fatigue. Other times, nothing helps me fall asleep, thanks to nagging pain in my joints and back. Finding a comfortable position to fall asleep — or fall back to sleep — can be difficult.

Almost 20 years ago, I was diagnosed with rheumatoid arthritis, as well as osteoarthritis in my spine. I have had 15 surgeries, so “painsomnia” is no stranger to me. I know getting quality sleep on a regular basis is vital to managing my pain. 

As an occupational therapist who educates people living with chronic illness and pain, I emphasize making sleep a priority.

At your next doctor’s visit, review your current treatment plan to rule out potential sleep disturbance causes. Your doctor can evaluate if your disease is under control, if medications can be contributing to your sleep issues or if there could be an underlying medical condition. A sleep study may be recommended to help identify potential problems.

Review your treatment plan 

Spend time at your next appointment discussing your sleep issues and pain, and consider asking these questions:

  • Is your medication working well enough to control your disease activity?
  • Could your medication be contributing to sleep disturbances? Does the timing of when you take certain medications affect your ability to sleep?
  • Could there be an underlying condition or a possible sleep disorder causing issues?
  • Would a sleep study be beneficial?
  • Discuss any possible use of sleep aids or supplements. 

Once you and your doctor determine the cause of your sleep problems, you can implement strategies to address your needs.

Keep a sleep diary

Monitor your activities throughout the day that could impact your sleep and keep a daily sleep log for a few weeks, noting the following:

  • Amount of time you slept and what time you went to bed and woke up, including any naps
  • Log any physical activity, movement or range of motion exercises
  • Alcohol or caffeine intake for the day
  • List any medications taken
  • Note any stress or stressful events

Evaluate your sleep hygiene and environment

Review your typical behaviors leading up to bedtime and your sleep environment. Here are a few tips:

  • Prepare for sleep with purpose, developing a nighttime routine to unwind and relax.
  • Unplug from all devices with screens.
  • Create a stretching or meditation routine.
  • Reserve your bed for sleep and intimacy only.
  • Check lighting, temperature and noise levels in your room (quiet, dark and cool are ideal)
  • Seek help from a physical therapist or an occupational therapist to address your specific joint pain when it comes to sleep. 
  • Get recommendations on adapting or modifying your sleep posture to reduce stress on your joints, based on your specific needs and sleeping style.
  • Use a variety of pillows, wedges, etc., to reduce strain on your joints or spine.
  • Evaluate your mattress and pillow to find what’s right for you.

It is important to discuss your sleep difficulties and the significant role sleep plays in managing your pain and arthritis symptoms. Your loved ones play a supporting role in making sure you get the rest and sleep you need each day. This could lead to dividing chores or cooking duties throughout the week, or perhaps occasionally sleeping in the guest room so you can escape the melodical sounds of snoring.

Openly communicating your needs to loved ones is just as important as talking to your doctor about your sleep issues. Making sleep a priority will go a long way to managing arthritis pain.

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