If you have psoriatic arthritis (PsA) and you’re having trouble falling or staying asleep, you’re not alone. As frustrating as it can be to toss and turn at night, this doesn’t have to be completely out of your control.

Here are 12 tips that can help you get a better night’s sleep when living with PsA.

Sleep apnea is a disorder that affects how you breathe at night, and it disproportionately affects those with psoriasis and PsA. Somewhere between 36–82% of people with psoriasis may also have obstructive sleep apnea, compared to just 2–4% of the general population.

Sleep apnea may not produce any obvious symptoms, so you could have the condition without realizing it. If you experience insomnia, you may want to discuss the possibility of sleep apnea with your doctor.

To keep your dry or itchy skin in check, try wearing loose-fitting cotton or silk clothing to bed. This can prevent you from further irritating your skin if you toss and turn at night.

To make yourself even more comfortable, you may want to consider purchasing softer sheets. As a starting point, consider looking for sheets with a high thread count made from high quality cotton.

Before bed, use temperature therapy to give your joints some relief. Different methods work better for different people, so experiment with hot and cold temperatures to see which one works better for you. You might prefer a warm shower, sitting against a hot water bottle, or using an ice pack.

Incorporate the method that you find most effective into your nightly pre-bedtime routine. With any luck, you’ll be able to keep the pain away long enough to get to sleep quickly.

One of the simplest steps you can take to keep your skin calm is to regularly moisturize. Apply lotion to your skin just before you go to sleep to prevent itchiness from keeping you awake.

When choosing a moisturizer, look for products that specifically target dry skin. You can also consider natural alternatives like shea butter or coconut oil.

In addition to moisturizing your skin with lotion, you’ll want to make sure that you’re staying hydrated by drinking enough water. Water not only helps keep you hydrated, but it also helps to lubricate and cushion your joints. This makes water a powerful ally in your battle against your PsA symptoms.

Don’t forget to spread out your water consumption throughout the day instead of tanking up just before bed. You don’t want to fall asleep only to find yourself waking up to use the bathroom!

Stress can make your PsA worse, and it can keep you up at night. Reduce your stress levels by trying out calming meditation exercises to decompress your thoughts before you go to bed.

Meditation doesn’t need to be complicated. Start out by simply closing your eyes and focusing on your breath as you inhale and exhale. Keep your body still and relaxed, and try to enjoy the quiet.

While the idea of a long, hot bath may sound like the perfect way to relax before bed, hot water can actually aggravate your skin. Limit your showers to 10 minutes or less so that your skin doesn’t become too irritated.

To prevent dryness, choose warm water over hot water. When you’re finished with your shower, gently blot your skin dry instead of rubbing it with a towel. A warm shower can still be part of your bedtime routine as long as you take precautions.

To avoid becoming overtired, try to go to bed earlier. If you’re consistently not getting enough sleep, fatigue can weaken your immune system. This can lead to a vicious cycle in which your symptoms become worse, making it even harder to sleep.

The cycle can be hard to break, but one way to begin is to choose an early bedtime and stick to it. Even if it takes some time to fall asleep, you’ll be able to relax and wind down at your own pace. If you go to bed at the same time every night, you can stabilize your body’s circadian rhythms, and you may find it easier to drift off to sleep.

The sooner you can get off your phone before going to sleep, the better. Using electronics before bedtime can be detrimental to your quality of sleep.

Despite the fact that these drawbacks are well known, a 2018 study found that 70% of participants used an electronic device before bed. Of these, 15% used it for an hour or longer.

Instead, set an electronic curfew for yourself by powering down your devices at least 30 minutes before you go to sleep.

Eating a balanced diet is going to help you maintain a moderate body mass index (BMI) for your age, sex, and height.

Maintaining a moderate weight can help reduce PsA symptom severity, which can in turn help you sleep better.

Anti-inflammatory diets that are suitable for living with PsA, according to research, include the Mediterranean diet and the ketogenic diet.

That said, generally eating a variety of foods, including fruit, vegetables, whole grains, and lean meats, while avoiding processed foods is a good idea. Your specific dietary needs, however, may be different, so speak with your doctor before attempting any change in your nutrition.

Exercising regularly is good for your general health and can help you sleep better, especially if you’re living with PsA.

If a long workout is too much, just 10 minutes a day can help improve the quality of your sleep. The more you can do, the greater the effect.

The general recommendation is 150 minutes of aerobic and strengthening weekly, as well as stretching. Of course, only do what feels comfortable and what your doctor says is appropriate for you.

Exercise also helps keep joints strong, which can help relieve some of your symptoms and reduce nighttime discomfort, which also can help you sleep better.

If you’ve tried all of the above tips but still can’t seem to get quality sleep due to your symptoms, it may be time to re-examine your medication regimen.

Keep a log noting your sleep habits, your symptoms, and any other related observations. Then, talk with your doctor about your trouble sleeping and ask whether there are any new or alternative treatments that could offer some relief.

Does psoriatic arthritis affect your sleep?

Although PsA doesn’t directly cause insomnia, common side effects like itchy, dry skin and joint pain can keep you awake at night. In fact, one study determined that 84% of participants with PsA have poor sleep quality.

Do people with psoriatic arthritis need more sleep?

Having PsA doesn’t mean you need to sleep more than people without the condition. Generally, adults need to sleep about 7–9 hours a night. That said, having poor sleep can be a trigger for PsA flares.

Why does psoriatic arthritis get worse at night?

While there isn’t research to explain this, doctors believe that inflammatory conditions like PsA or rheumatoid arthritis (RA) cause pressure on musculoskeletal parts of the body, such as the lower spin and pelvis, which can result in pain, particularly after lying down for a prolonged time.

These conditions may also affect fluid circulation, which can also result in more swelling-related pain in the morning in some cases.

Living with psoriatic arthritis doesn’t mean you have to sacrifice your sleep. With the right routine and healthy habits, a good night’s sleep can be well within reach. By taking steps to encourage more restful evenings, you can boost your energy throughout the day.