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Arthritis can cause pain and inflammation in any joint in your body, but it’s especially common in the knee joints.
Swelling, stiffness, and pain can prevent you from doing daily activities, including walking for long distances and going up and down the stairs.
It may also affect how you sleep at night.
Here are some things you can do to make your night comfortable and relaxing so you’ll be better prepared for a fresh start the next day.
To help find a comfortable sleep position, try using a pillow to support the painful parts.
You can put the pillow:
- between your knees, if you sleep on your side
- under your knees, if you sleep on your back
You may want to try specially designed “propping pillows.”
If arthritis makes it difficult to get into or out of bed, this may put off going to bed. It can also make it harder to get up for the bathroom.
The following may help:
- Satin sheets or pajamas. Satin sheets or pajamas are slippery and reduce friction that leads to tugging. They also make it easier to make subtle adjustments in your sleeping position.
- Raise the bed level. Putting a brick or wooden block under the legs of your bed can help raise it so that you don’t have so far to bend your knees when you get in or out of bed.
Establish a bedtime routine that prepares you to wind down.
Spending 20 minutes in a warm bath before bed is relaxing, and it may also soothe aching joints and make sleep arrive more quickly. You could light candles or play your favorite low-key music while you soak.
Other relaxation options include:
Make bedtime a ritual you look forward to.
Heat and cold can help you manage pain and inflammation.
The following tips may help:
- Apply a heating pad or an ice pack for 15–20 minutes before bed.
- Use a hot water bottle during the night.
- Massage a topical medication containing capsaicin before sleeping.
Remember to wrap the ice pack in a towel to prevent damage to your skin.
If you’re not tired at the end of the day, it can be harder to get to sleep. If possible, make sure your routine includes:
- Regular exercise. Water-based exercises are good options as they take the weight off your knees. Tai chi and yoga can help with strength and flexibility. Exercise can also help reduce stress.
- Social activities. If you’re no longer working, attending a day center, joining a club, or spending time with friends, family, or neighbors can help you get out and about.
If you’re concerned that your stress and anxiety levels are too high or never seem to go away, speak to your doctor. They may be able to help with counseling or medication.
A suitable environment and regular sleeping habits can help improve sleep quality.
- making sure the temperature is not too hot and not too cold
- changing to a more suitable mattress, if necessary
- using blackout blinds to keep out the light
- leaving phones and other devices outside the room
- shutting the door if other people are still up and about
- using earplugs to cut out any noise
- if possible, using the bedroom only for sleeping, not for working or watching television
- having a regular time to wake up and go to bed
- avoiding eating a large meal near bedtime
- avoiding drinking too much fluid close to bedtime or you may wake up needing the bathroom
If you feel anxious about falling when you get up in the night to go to the bathroom, add nightlights in key locations to help you see your way.
Over-the-counter medications can help relieve arthritis pain in some cases. These include:
- oral medications, such as acetaminophen
- topical preparations, such as capsaicin
Sometimes, OTC drugs aren’t strong enough to ease the pain. If so, your doctor will prescribe a suitable alternative.
If arthritis pain keeps you awake, you may need to adjust the timing of your medications. Your doctor can help you decide if changing your dosing schedule might provide more nighttime pain relief.
Some medications can make you drowsy. If you find you’re napping in the daytime after starting a new drug, speak to your doctor about it. They may suggest changing to another option or reducing the dose.
Medications, weight loss, exercise, and other techniques can all help reduce the risk and manage symptoms of osteoarthritis of the knee.
However, if the pain becomes severe and starts to affect your mobility and quality of life, a doctor may recommend knee replacement surgery.
Since arthritis pain stems from inflammation, overusing the joint can make the discomfort worse.
“When people are walking around and not paying attention to their knees all day and then you lie down, you start feeling that inflammation from the day,” Podesta says.
Dr. Podesta makes these recommendations:
- If you’re walking a long distance, take breaks to let your knees rest.
- Instead of running on a treadmill, exercise on a bicycle or an elliptical to reduce strain on the joints.
- If you experience pain with a specific activity, stop that activity and think about how you’re moving. It’s likely you’ll need to make a change.
- Try water exercise. A lot of pool-based activities are helpful because they take some of the gravitational force off of your knees.
- Avoid stairs whenever possible.
- Try to lose weight. Reducing your body weight helps to reduce the amount of strain your body puts on its joints.
Many people with knee arthritis find it hard to sleep. Following your treatment plan and tips for good sleep hygiene may help relieve this problem.
Guidelines published in 2020 suggest that addressing insomnia may be a step toward improving the overall success of treatment for osteoarthritis.
If severe knee pain is keeping you awake and none of these tips seem to work, ask your doctor for advice. They may recommend stronger medication or surgery.
Is it time to think about knee surgery? Find out more here.