Many of us with autoimmune and arthritis issues suffer from impaired sleep. Facing difficulty either falling asleep, staying asleep, or getting back to sleep is both common and frustrating. For women, add in hormone related issues (i.e., menopause) and the typical recipe for sleep is disaster. Our APAB members have found there are many helpful tips for improving the overall quality of your sleep.

1. General sleep hygiene tips

• Try to stay on track with sleep schedule and routine by controlling daytime sleeping and sticking with the same routine each night
• Make your bedroom “spa -like” – a place you want to go to sleep
• Try a clean crisp sheet set and a nice duvet. If you get too hot, check out the silk duvets.
• Try to control your daytime sleeping as much as possible. If you need a nap, try fastening on your FitBit and going for a short (or long) walk outside. If you are still tired when you get home then take a short nap. Some experts claim 15 to 20 minutes naps can rejuvenate yet not be disruptive
• Aim to get some fresh air during the day regardless of the weather
• Avoid overly strenuous exercise in the evening to prevent over-stimulation
• Aim to reduce your stress levels, particularly avoiding emails right before bedtime

2. Tips for falling asleep

• Prepare for sleep by turning off TV’s, computers, handheld electronic devices and even extra room lights 30 minutes or so before going to bed. This helps in calming your mind in preparation for sleep.
• Make sure you are comfortable. You may need warm socks.
• Aim to reduce your pain if possible as any amount of pain can impede getting to sleep. Try taking meds or topicals for the pain well before you go to sleep, but beware that some painkillers also contain caffeine, which will disrupt restful sleep.
• Ask your doctor if Voltaren cream is okay for you as a recommended topical for pain reduction.
• You may try a “spa-like” bath experience with Epsom salts, candles, and relaxing music. While a hot bath may work for you, if you have active inflammation it may be best not to take a hot bath or shower immediately before bed.
• Train yourself to not look at the clock after you go to bed. If you are having trouble falling asleep, it is not helpful to see that the hour grows later and you are still not sleeping.

* Progressive relaxation can be useful to help you fall asleep. One member used to start at her toes and do an inventory of her aches and pains, while making nonsense rhymes about pain and joints, and giving positive reinforcement to the “good joints”. As you concentrate on rhymes you try to relax each joint. She was usually asleep before she got to the hipbones.

* A Stress Management skill worth trying is the stop sign. If you are trying to get to sleep and keep thinking of things, envision a stop sign in your mind.

* There are many free “guided meditations” (Google “guided meditations” or use the search function in YouTube to do the same) to assist in falling asleep. Alternately, some people find ambient music restful enough to lead to sleep.

* To calm the nervous system lie on top of a foam roller placed vertically under the spine to release back and head tension. One member finds that placed under C3 at the back of the head, it seems to release headache tension and calm nerves and combined with deep breathing it is especially effective.

3. Tips for staying asleep

• Use lots of pillows for support wherever that may be at any point through the night
• Try experimenting with placement of pillows to support head, neck, spine, knees and hips.
• Check and ensure that your bedroom room temperature is comfortable. Open windows if necessary or use a ceiling fan if it doesn’t make too much sleep-blocking noise.
• A humidifier may be helpful in preventing dry mouth or stuffy nose.
• If a partner’s or spouse’s sleep patterns are disruptive, you can possibly minimize the impact by wearing earplugs. Also ensure that potential sleep apnea problems are investigated thoroughly.

* Make sure you don’t go to bed hungry. One member suggests combining a carbohydrate with a protein for evening snacks to stabilize blood sugar. (Greek yogurt, or cheese and apple, or almond butter with crackers) to avoid ravenous early wakeups.

4. Tips for getting back to sleep

• If you are up, physically change locations and then return to bed.
• Try drinking a cup of warm milk.
• Do not look at the clock if you happen to get up in the night to use the bathroom or get a drink. If your brain doesn’t know the time, you won’t know how much sleep you have lost. If you are really bold, you might eliminate clocks from the bedroom altogether.
• Practice relaxation techniques and stress management skills. An excellent one is to breathe in and out concentrating on your breath. With each exhalation pretend the bed is a warm comfortable surface and relax your body. Each exhalation should see you sinking further into the bed.
• Continue your breathing skills and relaxation skills at the same time.
• Use a reverse memory technique to aid in falling back asleep. For example, think of anything in backwards order, such as what food you ate that day, the order of your last vacations, what activities you did that day, and so on. One member finds that this “backward/reverse” thinking changes your brain thinking/wiring to shift sides and promote sleep. Perhaps this is just an advanced version of counting sheep, but it does seem to work.

Finally, there are many online resources for sleep:

Check out: Tips for falling asleep: http://www.cnn.com/2015/04/22/health/fall-asleep-faster/

And, from the UCLA Mindful Awareness Research Center, a series of free guided meditations online at: http://marc.ucla.edu/body.cfm?id=22

And remember, sleep won’t cure your arthritis, but a sustained lack of it will surely make your day-to-day life nearly intolerable.