Painsomnia

Key Takeaways 

  • Researchers found that sleep disturbances significantly predicted subsequent pain (and possibly increased pain sensitivity) in patients with rheumatoid arthritis. 
  • More research is needed to establish causality and determine if better sleep can lead to less pain.
  • If pain is interfering with your sleep, talk to your rheumatologist. 

If you’re living with rheumatoid arthritis (RA), you may be one of many who struggle with sleep disturbances — which is often attributed to joint pain. In a chicken-or-egg scenario, sleep disturbances might also influence pain by increasing sensitivity to pain.

In a new study published in Arthritis Care & Research, researchers analyzed data from 221 patients with active rheumatoid arthritis who were followed for three months after initiating a disease-modifying anti-rheumatic drug.

The researchers measured baseline pressure pain thresholds at the wrists, knees, back, and thumbnails. They assessed temporal summation (the increase in perceived pain intensity after repeated, equal-intensity stimuli) at the wrist and forearm — and conditioned pain modulation (the reduction of perceived pain intensity after conditioning).

They also looked at baseline sleep disturbance and subsequent pain intensity, then evaluated the correlations between sleep disturbance, quantitative sensory testing, and subsequent pain intensity.

Sleep disturbance was correlated with all quantitative sensory testing measures except for wrist temporal summation and conditioned pain modulation. Overall, the results showed that sleep disturbance significantly predicted subsequent pain.

“Pain sensitization may be one mechanism through which sleep disturbance contributes to pain,” note the researchers. “The small magnitude of association indicates that unmeasured pathways may contribute to this relationship.”

More research is needed to establish causality and determine if improving sleep can improve pain in patients with rheumatoid arthritis.

Several patients with arthritis say they have trouble falling and/or staying asleep, whether they have osteoarthritis or inflammatory types of arthritis.

“The pain from my arthritis was unimaginable, which made it impossible to sleep. Then the feelings of exhaustion due to lack of sleep made everything feel worse, turning into a vicious cycle,” Kimberly Lackey, whose experiences with reactive arthritis and cancer led her to become a therapist and integrative health coach, told us previously.

If you’re having trouble sleeping at night, talk to your doctor about potential treatment. Meanwhile, here are tips for sleeping with arthritis from our CreakyJoints.org community.

Found This Study Interesting? Get Involved

If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints’ patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.

Song J, et al. Pain sensitization as a potential mediator of the relationship between sleep disturbance and subsequent pain in rheumatoid arthritis. Arthritis Care & Research. March 31, 2022. doi: https://doi.org/10.1002/acr.24888.

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