There is no class for dealing with sleep and Rheumatoid Arthritis (RA) but it is an art of learning how to position yourself so you can sleep. I have been thinking about writing this post for a couple weeks and then my older sister called today, we were discussing our the aches and pains of Rheumatoid Arthritis (also known as Rheumatoid Autoimmune Disease; see we refuse to be mislabeled). My older sister mentioned she talked to my younger sister who was having some aches and pains. It reminded me of last spring when I had talked to my younger sister and she mentioned it was hard to learn to lay on her back when she was dealing with pain in her hips and lower spine. All I could say was yes it is hard to learn to lie on your back.
So I kept thinking, what did I not say? What did I keep to myself? My first lesson of sleeping with Rheumatoid Autoimmune Disease (RAD) was learning how to keep moving at night. It is easy to learn to do but frustrating to have to do it. Basically when I start waking up because of pain I rotate my body to relieve the pain and fall back to sleep. At times I could do this every ten minutes, other times once every hour. Usually when I have nights like this I can take some Benadryl and it will help me sleep through the mild pain and stiffness. But if the pain and stiffness is more constant or higher pain levels I do not just sleep during the night, sleep becomes a 10-24 hour process since I am waking up so often.
I wish the above lesson was the only one I had to learn when sleeping with RAD, but it is not the only one. When my feet have been in higher pain levels I have learned to prop them up a little at night and then sometimes changing positions is not as easy to do if the feet are really weak and tender. This does not work well if I have any pain or stiffness in my knees or hips because then it adds stress to them.
In the beginning of 2007 I had my first severe flare in my hips, this was a whole new art of sleeping with RA. It took me awhile to find a way I could sleep with less pain, but I learned to sleep with my wrist and hands raising up my hip bones a little to relief pressure, it worked better than anything else I tried. So I laid on my stomach and pretty much held my hips up all night. I know I still catch myself doing that to this day even though I have no severe hip pain. I notice now because of the shoulder and neck pain. I feel pain increasing in my shoulders wake up and realize I have my wrists under my hips which increase the shoulder pain so I stop. It just became a habit after having to do it for several months during that hip flare I guess. So much so that I do in my sleep even though I only have mild hip stiffness now. Seems a bit strange? Well hold on to your seat because there is more.
Shoulder flares and neck pain another lesson in sleeping with Rheumatoid Autoimmune Disease. If the pain and stiffness are mild, Benadryl usually does the trick in helping me sleep a little better but I will still wake up off and on because of the pain. If the pain and tenderness is high this becomes a whole new maze. In September of 2010 the pain and stiffness hit hard in my shoulders. During this time the stiffness so strong that I could not turn my neck much at all. By May of 2011 the tenderness was so much that I had problems laying down, I could lay down for about an hour and then the pain was so high I had to get up. This makes sleep more like naps on and off 24 hours a day, pretty much it sucks. I found at times that if I sat up in my bed and laid my head, shoulders and back against the headboard it would reduce the pain levels and I could sleep.
In January of this year I had such a bad flare in my shoulders and neck that the pain levels increased just holding my head up. At that time I learned how to lay my head on the top of the couch; this relieved the weight of my head on my shoulders and neck. I also slept against the wall in the hallway for a bit one night; you can read about it here: Bad Week, Hard Lessons. During this time I had to rotate from the laying on the couch with my head held up by it, walking around with my hands in sweater pockets so my shoulders did not feel like they were being pulled apart and sleeping in bed. Sometimes I could not lay on my back because it caused pressure in my head above my eyes.
Currently the pain and stiffness in my shoulders are milder so when my love giver sleeps with me I usually use him as a brace I guess I could call it. I spoon him and put some of the weight of my shoulder and arm on him. But when the pain and stiffness are higher he sleeps in a different bed. When having pain and stiffness in my shoulders, hips, knees and feet during most nights it means I move around often. Also it means I cannot take the weight of my own body and if he happens to put his arm on me it will cause me more pain. Some nights the shoulders are a little worse, I usually lay on my back or if I lay on my stomach I cross my arms across my chest, place my hands under my shoulders and hold them up a little to relieve some of the pain.
How do you improve sleep when flaring? What hurts the most? What do you use? Do you prop up joints in some way? A few other items I have found helpful are bed buddy, extra pillows and Salonpas patches or Bengay do not overdue it (see Death by Bengay).
Finally my birthday is less than a week away and I have setup a Birthday Wish on Causes. My cause is Rheumatoid Patient Foundation, the first non profit for those suffering with Rheumatoid Arthritis. Please donate anything you can, thank you!