by Wendy McBrair, MS, BSN, CHES
Many people take a good night’s sleep for granted. If you are one of those lucky individuals who have no problem getting to sleep, staying asleep, or waking up rested, you may not appreciate how precious a good night’s sleep can be. There are many reasons people can’t get to sleep, from crazy schedules and noisy neighbors to more serious problems that require medical treatment. This article focuses mainly on how the pain, stiffness, and stress of arthritis or fibromyalgia can contribute to sleep problems — and how you can use the many strategies, devices, and medicines available to achieve the sleep you want and need.
Sleep is one of life’s necessities. Although there’s a lot that researchers don’t yet understand about sleep, they do know that people who don’t sleep well are at higher risk for a number of health problems. These include heart disease, diabetes, and depression. Not sleeping well has other consequences, too. For example, it increases pain and sensitivity to pain. It impairs the functioning of the immune system, making it harder for people to fight off infections. It interferes with the way the brain lays down memories and impairs learning, concentration, and judgment. It even appears to contribute to obesity.
Lack of sleep, then, or poor sleep, can affect both mind and body. Experts believe that most adults need 7–9 hours of sleep a night. Studies have shown, however, that most Americans often sleep less than 7 hours. Even when people sleep more hours, though, they may not get sleep’s full benefits. This is because sleep has several stages, and we need to complete all of them successfully to get a good night’s sleep.
There are five stages of normal sleep. One stage is rapid eye movement (REM) sleep, and the other four stages are non-REM sleep. (See "The Stages of Sleep" for more detail on the different stages.) Your body goes through these stages, taking between 90 and 110 minutes to complete the full cycle. These cycles occur 4–6 times each night, and the time spent in Stage 5 (REM) sleep increases with each cycle. REM and non-REM sleep are both important. A person who does not sleep long enough or whose sleep is disrupted, for whatever reason, will not get the right mix of REM and non-REM sleep and will not feel refreshed in the morning.
There are general principles for getting a good night’s sleep that apply to everyone. But if you have arthritis, ensuring that it is well controlled is the first step. Make sure you are seeing your doctor and working to resolve any problems related to your condition that are affecting your sleep. Your doctor may switch the medicines you are on or instruct you to take them at different times of the day. If pain is keeping you awake, it certainly makes sense to try and time your pain medicine so that it works for you at night. (The paradox is that while arthritis makes sleeping well more difficult, sleeping well can make arthritis easier to manage.)
But don’t leave the work of controlling your arthritis or getting to sleep to medicine alone. There are other strategies besides medicines for controlling nighttime pain. For example, taking a warm shower or bath before you go to bed can help to reduce pain and make sleep easier. If one joint is particularly bothersome, try using a warm, moist heating pad or ice pack for 15–20 minutes before bed. Doing gentle stretching, relaxation, or guided imagery exercises before going to bed can also help you get to sleep. In addition, exercising during the day can not only improve your arthritis, it can help you sleep better at night as well (though you should avoid exercising close to bedtime as it can make it more difficult to fall asleep).
A great bed. A comfortable bed is a must. Fortunately, many new mattresses and mattress additions that can make your bed more comfortable are now on the market. For example, using a bed board — a board placed under the mattress — can help make a soft and saggy mattress more supportive. This is especially important for people with back problems. Adding an inexpensive foam egg-crate pad or a more expensive pillow-top mattress pad can make a saggy mattress feel just like new. Of course, you can have a “be good to yourself moment” and buy a new pillow-top mattress or a Sleep Number mattress. You may enjoy the Sleep Number mattress because you and your partner can each adjust your own side of the mattress to your preference. The mattress is so easy to use that if you start feeling uncomfortable during the night, you can change the mattress’s firmness with the push of a button. Other people like mattresses that can change position at the head or knee. These adjustable beds are just like traditional hospital beds, and you can now buy them for the home as well. Note that the costs for all of these items can vary widely, so make sure you try the less expensive options first.
Last Reviewed on March 9, 2011
Wendy McBrair spent 30 years as a health-care professional in the fields of rheumatology and orthopedics, where she specialized in patient and community service, patient education, and advocacy.
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