As a rheumatology specialist, I have the opportunity to frequently treat rheumatoid arthritis sufferers at my private practice in London. Every now and again I am asked whether or not there is any relationship between rheumatoid arthritis and sleep. The simple answer is, yes.
It was once thought that this relationship was a one-way relationship. In other words, rheumatoid arthritis patients who mentioned sleeping difficulties attributed their inability to sleep to the pain they were experiencing. Their observations were absolutely correct, as they are today. But the relationship works in the other direction too.
Pain Disrupts Restful Sleep
It’s no secret that the pain of both rheumatoid arthritis and osteoarthritis can be significant enough to inhibit restful sleep. Your typical arthritis specialist knows enough to pay attention when patients complain of sleeping issues. One goal of treatment in such cases is to alleviate arthritis pain enough to allow patients to sleep better.
Research suggests that as many as 80% of all arthritis sufferers have trouble sleeping. They cannot sleep because they find it difficult to get comfortable. Despite every effort, their stiff, painful, and swollen joints prevent them from falling into that deep sleep that is so necessary for rest.
Unfortunately, this is where the relationship between arthritis and sleep becomes bi-directional. While the pain of arthritis may inhibit restful sleep, a lack of restful sleep can actually increase arthritis pain.
Sleep and Immune System Efficiency
Decades of studies have shown just how important sleep is to normal physiological functioning. Sleep is vital to immune system efficiency and overall performance. That’s why people who don’t sleep well are more likely to suffer from other health conditions. The body needs sleep to repair itself. It needs sleep to boost the immune system and fight off disease.
Rheumatoid arthritis is an autoimmune disease. It is the result of a patient’s immune system mistakenly attacking his or her own joint tissue. The immune system attacks the lining of the joints, causing chronic pain, bone erosion, and joint deformation.
If sleep is so essential to general physiological functioning and immune system efficiency, it stands to reason that it would also be essential to managing rheumatoid arthritis. That is exactly what the evidence suggests. Rheumatoid arthritis patients who don’t get enough restful sleep are more likely to observe gradually increasing pain as their disease progresses.
Sleep and Pain Perception
You might also be interested to know that, beyond the immunological implications, a lack of sleep can also change a person’s perception of pain. Research published in 2019 revealed that sleep deprivation can lead to amplified pain reactivity in the brain. In other words, the brain is more sensitive to pain when subjected to a lack of sleep.
This only leads to the vicious cycle that naturally occurs between rheumatoid arthritis and the presentation of pain. Chronic pain prevents the sufferer from sleeping, a lack of sleep encourages progression of the disease, and the brain makes both worse thanks to an increased perception of pain.
So what’s the solution? There are situations in which sleep supportive medications are appropriate. Other times, an arthritis specialist will recommend meditation, light exercise, joint elevation, dietary changes, and the use of hot and cold compresses. There is no one treatment that works for every patient.
If you are suffering from rheumatoid arthritis and sleep issues, I am a rheumatology specialist ready and waiting to help. Feel free to email me at email@example.com or contact my PA Daniela Ryan on 07943 404 279 to arrange an appointment.
Article by Dr. Naveen Bhadauria