Mr. Sandman

O sleep, O gentle sleep, nature’s soft nurse…
-William Shakespeare

PajamasRheumatoid Arthritis Guy slept in this morning. I hoped that by adding a few extra hours of sleep I might be able to charge my batteries a little bit more. That’s not how things ended up working out. Still, I was happy to be able to get the extra rest.

While I have always tried to make sure I get enough sleep in terms of quantity, I really haven’t looked too closely at the quality of my sleep – until recently. Looking back, I have no doubt that my rheumatoid arthritis has been having a negative affect on my restorative sleep for quite some time.

I have no problems whatsoever actually falling asleep – as soon as my head hits the pillow, I am usually out within fifteen minutes, if not sooner. My sleep patterns are pretty routine, except for the slight variation that one might expect on the weekend. And I usually wake up, without an alarm clock, at around the same time each morning. (Although my dogs do act somewhat as an alarm clock – it’s amazing the internal clock these pups have, especially when it comes to feeding time!)

It seems that the problems come when I an actually “asleep”. Take last night as a reference point. I woke up at least once an hour. These aren’t full wake ups, as I turn over and fall back asleep in the matter of minutes, but they are wake ups nonetheless – and they are probably preventing me from entering into my deep sleep cycles.

The tell tale sign comes when I actually wake up, though. More often than not, I wake up more tired than when I went to sleep.

I started thinking a bit more about sleep, and asked myself: How much sleep does a superhero need? This is what I found.

“I know that in the Dan Jurgen’s novel Death and Return of Superman it was mentioned that he needs only one hour a night, not to rest his body but to dream (for sanity’s sake).”

And…

“[Superman] doesn’t need to sleep, but he can induce it upon himself.”

Darn, I ended up in those comic book forum once again! Gotta stop doing that… (You should give it a try sometime – really – you wouldn’t believe some of the conversations that you’ll come across!)

So, I found a source that seems to be a little more appropriate to the situation. Living with Rheumatoid Arthritis, a Johns Hopkins Press Health Book (and the best resource I have found yet on living with rheumatoid arthritis).

Individuals with RA require more rest than they did before they developed the condition. Adequate rest takes many forms, including physical, emotional, and “local” rest (described below).

Getting adequate sleep is imperative, because sleep provides healing to the body and the mind. We recommend ten hours of sleep daily, particularly during periods when the arthritis is flared up. You may prefer to sleep eight hours at night, and take two one-hour naps during the day. If getting adequate sleep provides difficult, ask your doctor to recommend or prescribe pain or sleeping medications to help you.

Actual sleep is not the only way to rest physically and emotionally. Taking a fifteen- or twenty-minute break in the morning and afternoon can also make an incredible difference in productivity. Learning and performing stress reduction and relaxation techniques during tense times may be particularly beneficial. During these breaks try to relax your mind and body. If you can manage to lie down with your feet elevated, you’ll increase the benefits of the break. Deep breathing exercises can also markedly reduce fatigue, particularly if combined with meditation. Taking prescribed breaks routinely each day may allow you to avoid the severe exhaustion that occurs when you become overly fatigued.

From time to time it’s good to reflect on the day’s activities. Think about what you did during the day and when you felt most tired. This review will allow you to schedule your rest breaks strategically, which will help you avoid becoming overtired. If necessary, discuss these recommendations with your employer; he or she will probably agree that this is time well spent. It is to everyone’s benefit for you to retain your energy so you can be as efficient and productive as possible.

Local rest means resting specific parts of the body. Getting local rest helps you protect your joints from undue stress; this can be achieved by wearing splints. which can be fabricated to protect the wrists and hands, and by using techniques designed to reduce joint stress.

Starting today, I plan to implement the suggestions described above. I am already doing many of the activities, but on a more piecemeal basis. Maybe if I perform them with more regularity and mindfulness, the result might be that my energy levels start topping out just a little more closer to full.

What are some techniques that have helped you deal with the fatigue of living with rheumatoid arthritis? And more specifically, what has helped you overcome the difficulties that are raised by not being able to achieve restorative sleep during the night?

Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!

7 Comments
7 comments
  1. kertslittlebird says:

    I too have that sleep/wake pattern that you wrote about. I cannot sleep during the day at all, no matter how tired I am. When I was first diagnosed the doctor precribed plaquenil and sleeping pills. He said the plaquenil was for the fatigue but he said it would cause vivid dreams. I thought a “good side effect”. Vivid dreams are short for night terrors! Scared my family to death every night. So I started taking the sleeping pills. Much better now. I didn’t realize how much sleep I wasn’t getting until now. Started backing off the plaquenil so maybe I won’t need help sleeping. We will see.

  2. greenstar says:

    Hi RA guy. Thanks for your blog! I’ve read all of your posts.
    I’m 31 and I have lived with RA since the last 9 years.
    The only thing that helps me to deal with the fatigue of RA is to exercise regularly. I cannot always practice the same exercise, I choose my daily activity depending on which joint I can use that day. I also try vitamin complex from time to time… I think it helps a little. But regular exercise keeps my metabolism up and also helps me to feel better (not only the body, but also it helps me to feel psicologically better).

  3. Andrew says:

    Love your post. My entire approach to rest is ever evolving and expanding since RA creaped into my life. I must have a nap most days. Resting joints is important. Getting a full night sleep is something that may happen a few times a week. Anyone else take ambien or something similar at night?

  4. Sadie K. says:

    As part of my diagnosis, my rheumatologist sent me to a sleep clinic to have sleep studies. $700 later, I can safely say it was interesting and informative, but not really helpful (or worth the money). However, my doctor did give me a few important insights, such as:

    -No one can tell you how much sleep you NEED except you.
    -Don’t beat yourself up over your sleep patterns, whatever they may be.
    -Accept that sometimes you’ll be tired, no matter what you do.

    I am a terrible sleeper, and that was the case long before I had R.A. I almost never sleep through the night without a period of being awake, and I can’t nap unless I’m critically ill. Many people have tried to make me feel as though I’m exacerbating my R.A. because I don’t sleep more, but I physically can’t. I’ve finally decided that’s ok, because it has to be.

    As an aside- who has TIME for ten hours of sleep?? I’d have to go to bed at 8pm to sleep for ten hours– and sometimes I’m not home until 6! Forget that noise.

  5. Kali says:

    Have you spoken to anyone about adding a small dose of trazadone? It won’t make you fall asleep (for me, at least), but once you are asleep it’ll keep you in a deeper sleep cycle which makes the wake-ups less frequent.

    It’s a total life-saver for me. I was on it ages ago when I messed up my shoulder for the…third time? At that point, the pain was messing up my (already bad) sleep. I’m on it again, as I officially have a diagnosis for my poor sleep. The trazadone is a marvelous drug, for me.

    ~Kali

  6. RA Guy says:

    Thanks for all the feedback and suggestions, I’m going to see what helps me and I will let you all know! Sweet dreams…

  7. Christine says:

    Using a sleep aid has definitely helped me. I still have wake-ups, but fewer of them. Also, it is so hard to sleep when the pain is bad. When I am in pain at night, I will take the prescribed pain medication (which I loath taking!) Daytime naps really help. When I was still working in a high-stress job, a 45 minute rest at lunchtime was my lifeline.

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