How Rheumatoid Arthritis Affects Your Sleep

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Older Caucasian woman lying awake in bed next to sleeping husband

Fifty to 75% of people with rheumatoid arthritis (RA) have sleep problems. Some have trouble falling or staying asleep. Others wake up feeling less than refreshed or battle drowsiness during the day.

You may have noticed that it’s harder to manage RA when you don’t get a good night’s sleep. Pain and fatigue often seem magnified. You’re also more likely to feel depressed, and that may affect how you take care of yourself. Luckily, there are things you can do to sleep better at night—and feel better the next day.

Pain, Depression, and Sleepless Nights

It helps to understand a little bit about the complex relationship between sleep and RA. Although poor sleep can worsen arthritis symptoms, the reverse is also true. Stiff, painful joints, a hallmark of RA, can certainly keep you awake. Depression, which is twice as common in people with RA as in the general population, can lead to sleep problems as well.

One study published in the journal Pain in 2012 looked at factors associated with sleep problems in 106 people with RA. Not surprisingly, pain was an important factor. Yet depression seemed to play an even bigger role.

The implication: To catch more ZZZs, you need to work with your doctor to get RA pain under control. But that alone may not be enough. If you’re depressed, it’s also important to talk with your doctor or a mental health professional about treatments that lift your mood. Options include therapy and antidepressants.

Exercising Your Right to Good Sleep

RA can make your joints stiff, achy, and difficult to move. Plus, it can leave you feeling tired all the time. So it’s no surprise that many people with RA stop being physically active. Unfortunately, when you don’t get enough exercise, it can be harder to doze off later.

Talk with your doctor about the best type and amount of physical activity for you. Besides helping you sleep, regular exercise may reduce joint pain, increase flexibility, strengthen muscles, boost energy, and improve your mood. But because exercise is invigorating, avoid doing it within three hours of bedtime.

More Tips for Better Sleep

Unhealthy habits only make sleep problems worse. Try these tips to sleep tight, all night:

  • Stick to a sleep schedule. Go to bed and get up again at about the same time every day, even on weekends.

  • Limit caffeine and alcohol. Caffeine is valued for its pick-me-up effect. But it can take up to eight hours to wear off, so say no to coffee after early afternoon. Alcohol has a relaxing effect, which may help you nod off at first. But it interferes with deep, restful sleep and can leave you wide awake in the middle of the night, so skip the nightcap close to bedtime.

  • Wind down before bed. Start a relaxing ritual, such as reading yourself a bedtime story or listening to soothing music. Or soak in a warm bath, which is not only relaxing, but also eases joint pain.

  • Set the stage for sleep. Keep your bedroom dark and quiet. If you can’t eliminate light and noise, consider using blackout curtains, a sleep mask, a white noise machine, or ear plugs. Put the thermostat at a comfortably cool temperature. Choose a comfy mattress that offers good support.

If a good snooze still escapes you, talk with your doctor or a sleep specialist. You’ll feel more alert and energetic after sleeping well—and you may feel less bothered by joint pain, too.

Key Takeaways

  • Fifty to 75% of people with RA have sleep problems.

  • Stiff, painful joints can keep you awake at night, as can depression, which is twice as common in people with RA as in the general population.

  • If you don’t get enough exercise, it can be hard to fall asleep. Ask your doctor about the best type and amount of physical activity for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Aug 9
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. Sleep Loss Exacerbates Fatigue, Depression and Pain in Rheumatoid Arthritis. Irwin, MR, et al. Sleep. 2012;(35):537-43.

  2. The Contribution of Pain and Depression to Self-Reported Sleep Disturbance in Patients with Rheumatoid Arthritis. Nicassio, PM, et al. Pain. 2012;153:107-12.

  3. Depression in People with RA. Arthritis Foundation, undated. ( PM 8/13/2015

  4. Warm Water Works Wonders on Pain. Arthritis Foundation, undated. (

  5. Exercising with Rheumatoid Arthritis. Arthritis Foundation, undated. (

  6. Rheumatoid Arthritis. American Academy of Family Physicians, July 2010. (

  7. Your Guide to Healthy Sleep. National Heart, Lung and Blood Institute, August 2011. (

  8. How Is Depression Diagnosed and Treated? National Institute of Mental Health, July 27, 2011. (

  9. Healthy Sleep Tips. National Sleep Foundation, undated. (

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