Sleep Disorders Common with RA
Do you have problems falling asleep? Do you wake frequently during the night? Do you feel fatigued or sleepy during the day? If you do, you aren’t alone. Many adults and children with RA and other rheumatic diseases have sleep problems. So many, that statistics show that 72% of adults over the age of 55 who have some form of arthritis also have problems sleeping. Over half of these adults report having insomnia. And other problems include short sleep (less than 6 hours); daytime sleepiness; a diagnosed sleep disorder, such as sleep apnea (temporary cessation of breathing during sleep); restless leg syndrome; and poor quality sleep.
For RA patients, worsening disease activity and increased pain are associated with increased sleep disturbances such as waking during the night, increased movement during sleep, and a decrease in restful sleep. Many people with RA also report having sleep apnea, restless leg syndrome (RLS) and periodic leg movements of sleep (PLMS). RA patients are also at risk for depression, which can cause insomnia. Children with JRA are also likely to suffer from these common sleep disturbances. In fact, studies have found that children with JRA have 90% more frequent awakenings during the night and have significantly shorter intervals of uninterrupted sleep, causing the children to have poor sleep quality, more daytime sleepiness, fatigue, mood changes and anxiety.
If you suffer from a primary sleep disorder, such as sleep apnea or RLS, or you frequently feel tired during the day or have difficulty sleeping comfortably, then you may want to consider consulting your rheumatologist or a sleep specialist. Sleep disturbances can be caused by medication side effects, joint pain and stiffness, depression or deterioration of the jaw joint (temporo-mandibular joint). The doctor should systematically review the possible causes, starting with any medications and supplements you might take and possible primary sleep disorders such as RLS or sleep apnea. The doctor will look for environmental or dietary issues, depression or anxiety that might be causing insomnia. Once the doctor determines the cause, then she may try to address pain issues through medication, injections for specific pain or nerve blocks. She may also refer you to an occupational or physical therapist for treatment to improve flexibility and range of motion and to reduce pain, or for splints or supports to help you either during the day or while sleeping. There are also many drugs that help induce sleep or that can be used to treat RLS and PLMS or muscle pain.
Have you suffered from a sleep disorder like sleep apnea or sleep disturbances caused by your RA? What strategies have you used to help you sleep better (e.g. relaxation techniques, medicines, splints)? Please share your stories.
Christine Miller wrote about rheumatoid arthritis as a Patient Expert for HealthCentral. She was diagnosed at 16 months old with polyarticular juvenile rheumatoid arthritis and has gone through the ebbs and flows of disease activity — many medications, much time spent in physical and occupational therapy, surgeries, and periods of relative remission.