People with psoriatic arthritis (PsA) have higher rates of sleep disturbances. Findings vary, but some studies have reported that more than
Several sleep conditions are more common in PsA. People with PsA are more likely to deal with sleep apnea, insomnia, and restless legs syndrome. The joint stiffness, swelling, and pain of PsA can also make it hard to sleep.
Many people with PsA also live with psoriasis. The discomfort and itchy skin of psoriasis can also disturb sleep.
But there are things you can do to support better sleep when you live with PsA.
People with PsA have higher rates of certain sleep conditions. These sleep conditions can be treated with sleep aids.
Restless legs syndrome (RLS)
Restless legs syndrome (RLS) is a movement condition that is typically worst in the evening and when you’re trying to sleep. It causes an uncomfortable sensation in your legs, giving you an intense urge to move them. It can wake you up intermittently, which breaks up your sleep.
People with PsA have higher rates of RLS. One 2019 study compared three groups of 50 people each: one control group, one group with psoriasis, and one group with PsA. In the control group, 14% had RLS. In the group with psoriasis, 20% had RLS. In the group with PsA, 64% also had RLS.
Sleep apnea
Sleep apnea is a condition that causes you to stop breathing multiple times at night. It prevents you from getting a full, restful sleep.
If you snore or gasp for air while sleeping, a doctor may order a sleep study to find out whether you have sleep apnea. People with sleep apnea also feel excessive fatigue, making it difficult to stay awake during the day.
Insomnia
Insomnia is a sleep disorder in which you have trouble falling asleep or staying asleep, and it can interfere with quality of life.
Insomnia may be short-term in response to a specific life stressor, or it can also be chronic. Chronic insomnia is defined as having trouble sleeping 3 or more nights per week for at least 3 months.
You may be diagnosed with insomnia if there’s no other reason for sleep disruption.
There are many reasons why psoriasis and PsA may contribute to insomnia. But in general, itchy, uncomfortable skin and painful joints can make it hard to fall asleep and stay asleep.
Depression
Depression is a mental health condition that can cause overwhelming feelings of sadness and hopelessness.
People with depression find that it affects all parts of their life. Difficulty sleeping and fatigue are typical symptoms of depression. Depression can also
In a 2019 literature review of 24 studies, it was found that 20% of participants with PsA had mild depression and 14% had moderate depression.
Living with a chronic disease can take a toll on a person’s mental health.
There are tools and aids you can use to improve your sleep. Some tools will be helpful for several sleep concerns, while others are designed for a specific sleep problem.
Supportive mattress
The right mattress has the potential to significantly improve your sleep. Everyone’s mattress preferences will be slightly different.
When you have PsA, you may want to consider:
- A firm mattress: A mattress that’s firm enough to support your body and keep it in alignment.
- A memory foam or pillow top: This can help take pressure off of your joints.
- Buying a mattress with a trial period: That way, you can be sure that it’s a good match before you commit to it long-term.
Cooling sheets and blankets
Cooling sheets and blankets are made of fabrics that help to keep you cooler overnight. These fabrics are breathable and help to wick moisture away to keep you feeling cooler. Fabrics that help you stay cooler include:
- bamboo
- eucalyptus
- Tencel
- cotton
Sheets made of these materials are helpful if you tend to overheat at night. If you also have psoriasis, getting sweaty overnight can make your skin feel worse. In general, feeling hot and uncomfortable will make it hard to sleep well.
Knee pillows
Sleeping with a pillow between your knees can better support your joints and align your body. This can help relieve hip and back pain.
Some people use a standard pillow placed between their knees, but this may be tough to keep in the right place and may not provide enough support. Instead, you might consider buying a specialized knee pillow made of dense material and designed to stay exactly in position.
The knee pillow for side sleepers is shaped to fit in between your knees. The knee pillow for back sleepers looks like a half circle, and you sleep with it under your knees.
Gloves
There’s some debate about whether compression gloves are actually helpful. They’re often recommended to help people with inflammatory arthritis in their hands.
Research actually suggests that there’s no real benefit to compression gloves.
It could be that the most important benefit is providing some extra warmth to your hands. Wearing gloves made of soft material may provide a bit of relief at night.
Heating pads and cooling packs
Heating pads and cooling packs can both be part of managing the joint pain of PsA. Heating pads are helpful for stiffness while cooling packs help to reduce inflammation in an area.
Many people find that heating pads help to soothe achy joints before bed. Alternatively, a warm (not hot) bath can help just before you get into bed.
A cooling pack is great if you’re dealing with swelling and inflammation. It can also reduce pain.
You may decide to use the heating or cooling packs before you get into bed or bring them into bed with you.
Supplements or medications for restless legs syndrome
If you’re diagnosed with RLS, you’ll likely have blood work done to check your iron levels. Sometimes, iron deficiency can cause symptoms of RLS. If your iron levels are low, an iron supplement can raise your levels to a normal range.
There are also medications used to treat RLS. They
- antiseizure medications, including gabapentin, enacarbil, and pregabalin
- medications that increase levels of dopamine in the brain, including ropinirole, pramipexole, rotigotine, or levodopa plus carbidopa
- benzodiazepines, often used for insomnia or anxiety, including lorazepam and clonazepam
Medications and natural remedies to ease insomnia
There are different approaches to treating insomnia.
Usually, the first step is changing your routine to support better sleep. This is known as sleep hygiene.
Good sleep hygiene includes:
- going to bed and waking up around the same time every day
- avoid screens in the hour before bed
- keep your bedroom cool and dark
- try relaxation techniques such as visualization or deep breathing before bed
- doing physical activity earlier in the day
You may consider taking the supplement melatonin. Your body naturally makes melatonin as it gets closer to bedtime, signaling to your body that it’s time to sleep. Melatonin supplements will increase these melatonin levels so that you can fall asleep faster.
You may also consider taking medications for insomnia. Before you start any medication or supplement, it’s wise to talk with your doctor or pharmacist to make sure it’s a good idea for you.
The groups of medication that may be used for insomnia
- benzodiazepine receptors agonists
- melatonin receptor agonists
- orexin receptor antagonists
- benzodiazepines
It’s important to note that natural sleep aids should be given priority, as there’s a risk of dependence with most insomnia medications.
CPAP machine for sleep apnea
If you’re diagnosed with sleep apnea, you might need to use a continuous positive airway pressure (CPAP) machine. This is one of the most common treatments for sleep apnea.
A CPAP machine works to keep airways open as you sleep. The machine provides continuous air to you through a mask placed over your nose and mouth.
There are different mask options, and it can take some time to figure out the best mask and air flow rate.
You’ll need to use your CPAP machine every time you sleep. People with sleep apnea who start using a CPAP typically feel much more rested and energized.
Living with PsA means you may also have trouble with your sleep. You’re more likely to be diagnosed with a sleep condition including sleep apnea, restless legs syndrome, and insomnia.
On top of that, symptoms of psoriasis and PsA can also interfere with your sleep.
But there are sleep aids that can help. Depending on your sleep challenges, you may consider making changes to your mattress, pillows, or sheets. There are also medications and supplements that can help.