So, what can you do?
There are a few general principles for getting a good night's sleep that applies to everyone. But, if you have arthritis, you have to be sure that it is well controlled, that's the first step. You should make sure that your doctor is working with you to resolve any problems related to your condition that is affecting your sleep. Your doctor may decide to switch your medications or instruct you to take them at different times of the day. I have taken my medications the same way for over four years and decided to use Google medical profile to keep track of my medical conditions and medications. Wow! Was I surprised to find out that the way I was taking them was wrong. I had four of the seven that inter acted with each other and that would cause some of the symptoms I was having. I switched the times I take them and now I've noticed a change in my pain levels, and my fatigue levels, for the better. Also, 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. While arthritis makes getting a good night sleep more difficult, a good night's sleep can minimize arthritis pain and make it more manageable.
You won't want to leave the work of controlling your arthritis to just medicine alone. You can use other strategies besides medicines for controlling nighttime pain. You can take a warm shower or bath before you go to bed to reduce pain and make sleep easier. If there is a problem with one joint then you can try using a warm, moist heating pad or ice pack for 15 - 20 minutes before bed. You might want to try doing gentle stretching, relaxation, or guided imagery exercises before going to bed will also help you to sleep better at night as well. You do want to remember though that you shouldn't exercise to close to bedtime, because it can actually make it more difficult to fall asleep. I've read several articles that say not to exercise 2 hours before bedtime.
Here are six other ways to make sure you get a good night sleep.
1. A great bed. A comfortable bed is a must and fortunately there are many new mattresses and mattress additions on the market that can make your bed more comfortable. You could use a bed board, which is placed under the mattress and can help make a soft and saggy mattress more supportive. This is important for those of you with back problems. You could add an inexpensive foam egg-crate pad or a more expensive pillow-top mattress pad can make a saggy mattress feel just like new. You can buy a new pillow-top mattress or a Sleep Number mattress and who knows, 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 all you have to do is adjust with a push of a button. Have you ever tested one of these mattresses? They are fabulous! For those of you who like mattresses that can change positions at the head or the knee, you might want to try an adjustable bed that is just like the traditional hospital bed that can be bought for your home. The costs for all of these items can vary widely, so make sure you try the less expensive options first.
2. Perfect pillows. It is very important to find a pillow that is comfortable for you, so investigate the material, thickness, and firmness of any pillows you buy. Sometimes snoring is a symptom of a sleep disorder known as sleep apnea. If you already have back and neck pain you might want to consider a cervical pillow. A cervical pillow supports your neck and also your head, and allows your head, neck and spine to remain in proper alignment, which can help to decrease your pain. When you have lower back pain, lying on your back and placing one or two pillows under your knees so that they are slightly bent will help support your back. You can also purchase a foam wedge that does the same thing. If you have knee problems, you should avoid sleeping with with a pillow under your knees so your knees are bent. This may increase knee stiffness and make it more difficult for you to straighten you knees. Putting a pillow under your entire leg helps as well. Putting a pillow between your knees as you lie on your side helps maintain back alignment, which can reduce hip and back pain. There again, there is a special pillow is for this purpose. Another helpful pillow is the dual position bed wedge, which can be used both for sleeping and in a different position, for reading or watching TV. You can find specialized pillows at medical supply stores and on the Internet.
3. Bed equipment. Some people with arthritis or fibromyalgia are bothered by heavy covers that press down on their feet at night. There is something called an adjustable blanket support that can keep your covers off sore feet and ankles and makes it easier to turn and change position without disrupting your sleep. The supports can attach easier on the sides or foot of a bed. You can also purchase sheets made of satin or another smooth material that can make it easier and less painful to turn over in bed. Partial side railing that anchor by sliding under the mattress to keep them in place are made to adjust in four positions and you can use the railing to help you turn over more easily during the night.
4. Other strategies. The best environment for sleep is one that is cool, dark, and quite. Is your sleeping environment this way? This is the only way I can get to sleep and stay that way. This is sometimes easier said than done but ear plugs or sleep machines can help with outside commotion and with noisy sleeping partners. Sleep machines create what is called "white noise" that drowns out other sounds. Weight and alcohol in the evening can contribute to snoring so if you lose weight and avoid the alcohol your snoring will go away. You see the alcohol will relax the muscles in the throat and cause your snoring. There are some people that like to use special tape on the nose to open up the nasal passages during sleep, although there is little hard evidence that this works. If your nasal passages are swollen because of allergies, be sure to ask your doctor whether it's okay for you to take allergy medicine to reduce the swelling and this will help reduce your snoring. Sometimes snoring is a symptom of a sleep disorder known as sleep apnea. Here's some more good strategies for getting a good night's sleep; go to bed at the same time every night and wake up at the same time every morning, even on weekends. Use your bedroom only for sleeping and sex, don't watch TV or read. If your partner snores or moves all over the place and you can't find any other way of dealing with the problem, you might want to move to another room.
5. Are you the type of person who has no trouble going to sleep but you wake up in the middle of the night and can't get back to sleep? If you are walking up to go to the bathroom, you might want to think about not drinking whatever you're drinking, a few hours before you go to bed. If you wake up and are upset or worrying, you can try to top the upsetting thoughts by using a technique called progressive relaxation, in which you relax each muscle in your body, one at a time. To do this, first tighten all the muscles in your face for several seconds and then release them. Work from the top to the bottom, tightening and relaxing the muscles in each area of your body until you reach your feet. Concentrate on the relaxation process rather than on the fact that you are upset because you are awake. For me, I have a busy mind and will wake up thinking about what I needed to do tomorrow. My doctor gave me the term "busy mind". I now do a brain dump. I write down everything going on in my mind, everything I have to do, phone calls to make, or if there is just something that's bothering me. This technique works great for me. I no longer have a busy mind.
6. Foods and medicines. Did you know that the medicines you take and the foods you eat can cause sleep problems or at least make them worse. Prednisone and other corticosteroid drugs, which people with inflammatory arthritis often take, can cause sleeplessness. Other medicines that can do this are decongestant and some blood pressure drugs, can cause sleep problems, also. If you think that a drug is causing your sleep problems, check with your doctor or pharmacist. Here are some more drugs that cause problems with your sleep; caffeine, nicotine, and amphetamines, these are all stimulants. You may want to try reducing your intake of caffeine from coffee, tea, energy drinks, or soda to one cup or glass a day, preferably before 5 pm. Others have to stop drinking these drinks altogether, and don't forget that there are some headache reliever, such as Excedrin, that may contain caffeine. You should also avoid alcohol before bed if sleep is a problem, because alcohol does more than make you snore, it can suppress deep sleep and REM sleep. Do you remember hearing about drinking heated milk at bedtime? Well it really can help some people relax and get to sleep faster. Sleeping Pills. Hopefully the change in your sleep habits, sleep environment, and behavioral strategies will do the trick, there are also medicines that can help you sleep. Most experts believe, however, that these drugs should only be used short-term or as a last resort, because they are not risk-free. Some people try over-the-counter sleeping pills. These pills usually contain an antihistamine. These drugs are not recommended for long-term use and can interfere with alertness during the day. They often reduce the quality of your sleep, and you may quickly develop a tolerance for then. Check with your doctor before taking these. Sleep medicines your doctor might prescribe include olpidem tartrate (Ambien CR), zalepion (Sonata), and eszopiclone (Lunesta), all of which works in a different way; also there is ramelteon (Rozerem). Tranquilizers such as fluraepam (Dalmane), temaepam (Restoril) and estazolam cause drowsiness. They tend to be effective for only a few weeks and then they can lead to drug dependence. Some antidepressants, such as trazdone, are used for sleep problems. The tricyclic antidepressants, which include amitriptyline, can, when taken in small dose, help a person obtain deep, restorative sleep. They are often prescribed for people with fibromyalgia. Benadryl, an antihistamine, can help people relax and is available over the counter, sometimes in combination with Tylenol (Tylenol PM). Most of these medicines are used to help with short-term sleep problems, but some people do take them regularly.
7. If you and your doctor have tried all the strategies described here and nothing seems to help it's possible that not all of your sleep problems are caused by arthritis or the other common causes of sleep difficulties. You might have an underlying sleep disorder. Examples of sleep disorders are sleep apnea (in which you stop breathing temporarily while you sleep), narcolepsy (in which you skip the non-REM stages of sleep and go straight to REM sleep), and restless legs syndrome (unpleasant sensations in the legs while you are at rest). You might want to go to a doctor who specializes in sleep disorders or even to a sleep center, where doctors can observe your sleep to better diagnose your problem.
I've tried some of these sleep aids with no success. I've tried Ambien and it did the opposite to me, it kept me awake. Not only that, but the reports of sleep walking and driving while taking Ambien came out. That made it a no brainier for me to stop. Then there was Trazadone. That one worked for a while but about every year I had to have the dose increased. Then one day I had ran out and wasn't able to get my prescription and when I was finally able to go and get it, I had a panic attack on the way home from the pharmacist and got a speeding ticket. I got off of it real quick. I've even taken an all-natural sleep aid called Midnight, and it would put me to sleep giving me about two hours of sleep but then I would wake up. I take amitriptyline now and I've had excellent results with it. I take it about two hours before I go to bed and as soon as the lights go out I am asleep.
