What can I do when I can't sleep because my hands ache so?

Many people with RA and other conditions that cause chronic pain have issues with falling asleep and staying asleep due to pain.  I usually take painkillers before going to bed and that helps.  You can also try getting some wrist warmers - sort of fingerless gloves/mittens - as keeping warm helps.  If you know a knitter, ask them to knit some for you, but you should be able to find them in a store, as they seem to be fashionable these days.  Talk to your rheumatologist about it - s/he may have other suggestions.

I sometimes have my husband rub my hands and wrists with icy hot then elevate them on a pillow with a frozen gel pack.

Try Borax.  Soak your hands in a few tablespoons in warm water.  I used to do that and it worked for me. Then I graduated to 1/2 cup in a sit bath and use it instead of soap.  It really makes you sleep well when you have RA. Nothing works for me like Borax bath and magnesium, pantethine and b complex for sleep. If you live in a high humidity climate it usually makes RA worse, like FL yuk!  That is why I am moving to an area where the humidity is low. You could try a dehumidifier.  Pantethine and b-complex  helps pain and helps you sleep although you take it during the day.  Timed release is good I think.also food cures like real salted butter,organic coconut oil, flax oil, iodized salt, asparagus and asparagus juice, magnesium, manganese asporotate caps, vit e D-alpha only.  I also take an occaisional Alieve always with food and 8 oz of water with a sprinkle of salt.  You can check earthclinic.com look for Ted he is brilliant.  A book called Lets get Well on amazon.com is great too.  Don't take my word please read, read, and read some more.  I don't worry about BP 'cause the magnesium keeps it normal.  New charts now say bp should be 140 over 80.  Who makes up these numbers anyway? Big Pharma.lol  the numbers keep changing. Last year they were 120 over 70 Who are these people who haven't heard of magnesium or Hugh Downs.  lol  Good Luck and keep researching.