Sleep Problems With Lupus
I need more sleep. Not just one good night of it either, but a regular schedule of it.
Every day, I drag myself through all of my obligations, fighting to be an alert and a fully functioning version of myself. Then at night, when my head finally is allowed to hit the pillow, sleep becomes elusive.
When I do sleep, it is for one-hour increments. I literally wake up every single hour throughout the entire night. Is this deep or restorative sleep? Absolutely not.
The question is how can someone as exhausted as I am still not be able to fall asleep and stay asleep each night? The answer lies in the root cause of my fatigue — lupus.
In fact, it is hard for me to determine which came first — my lupus fatigue or the abundant sleep issues I suffer from that perpetuate the fatigue.
In a study published in 2013 by the Journal of Rheumatology, researchers discovered that patients with lupus had far more problems with sleep than the rest of the population. And it really is a “which came first" scenario, since lupus causes a feeling of incredible, debilitating fatigue as well as these sleep disturbances.
Contributing Factors to Sleeplessness
Stress and Anxiety
Let’s face it, your life is not what it was before lupus. You have added worries about your health and what lies ahead for your life. You might be worried about a new symptom or pain and are in a quiet mental debate with yourself about whether you need to see the doctor again or just wait it out.
Maybe it is nothing. Maybe it is a major organ under attack. Maybe the doctor’s outrageous bill is worth the peace of mind of knowing what it is.
Perhaps seeing the doctor about it could save your life. Or maybe it is not a big deal and you will be kicking yourself for making yet another doctor’s appointment. Sound familiar?
Guilt and Depression
With lupus you are often not able to do everything you feel you should be doing for your work, your family or your friends. You undoubtedly feel at some point that you are failing everyone and it seems, for most part, you are helpless to change it. If you have been on a treatment of steroid medication, you probably have gained weight, something else you feel bad about but are helpless to change, short of not eating.
Lupus depression and guilt can greatly affect your ability to sleep. When you combine the fact that lupus can cause depression along with logical solid reasons to be depressed, it is amazing it is not worse than it is.
Medications
Steroid medications cause us lupus warriors to feel anxious, revved up and in general, unable to fall asleep and stay asleep. They can cause severe headaches as well, which disturb your ability to fall asleep because of the pain.
Accompanying Conditions
Many people who have lupus also have fibromyalgia, restless leg syndrome, autoimmune thyroid disease and sleep apnea, according to experts at the Mayo Clinic. As these conditions combine, they are quite the foe to a good night’s sleep. Patients often awaken tired even though they seem to get plenty of sleep, or they experience restless sleep or insomnia.
Experts believe that patients with more than one of the sleep-affecting conditions rarely reach the deep restorative stage of sleep that is needed.
The Effects of Poor Sleep
So how desperately do those of us with lupus need a good night’s sleep? The answer is disturbing.
Sleep deprivation can be harmful to the immune system. Research from the National Institute of Neurological Disorders and Stroke shows that neurons within the body that control sleep interact closely with the immune system.
The tiredness caused by the flu is evidence of this. Basically any sort of infectious disease tends to make the body feel sleepy.
This is believed to be caused by “cytokines," chemicals that your immune system produces while it is fighting infection. These natural body chemicals are strong inducers of sleep, which is your body’s way of conserving energy and other resources that the immune system needs to mount an attack against an invader.
With lupus, our immune system is always in attack mode, so that natural chemical is being produced for us on a regular basis, particularly during a flare.
I for one know that I need more sleep than I am getting. I am in a constant battle for clarity of thought, my memory is horrible, and at times I feel close to drifting off to dreamland while sitting up. I fear that my driving is impaired because it feels like I am in slow motion at times.
Quite simply, something has got to give. I have been heading to bed shortly after I tuck the kids in for the night, but if I then cannot fall and stay asleep, it does little good. My doctor has prescribed something for sleep, which I reluctantly am going to try simply because I realize I am not winning this battle on my own.
Tips for Improving Sleep
- Have a nighttime schedule: I try and head to bed at about the same time each night and get up at about the same time each morning. Though I love to try and catch up on sleep, sleeping in on weekends seems to make it harder for me to wake up early on Monday morning.
- Relax before bed: Avoiding any screen time before bed can help sleep. Reading is a great relaxing routine for sleep. I am trying to train myself to associate certain restful activities with sleep and make them my ritual.
- Try to exercise daily: I have been off my schedule of gentle exercise, three days per week, for several months now. I know that’s not helping me. Working out with lupus through as little as 30 minutes of walking a few times each week often helps people sleep better at night.
- Limit caffeine and alcohol: Caffeine acts as a stimulant and keeps us awake. It is found in coffee, chocolate, soft drinks, non-herbal teas, diet drugs and some pain relievers.
- Don’t stay in bed tossing and turning: If you can’t get to sleep, don’t stay in bed. It can help your chances of sleep to get up for a bit and read or listen to relaxing music. Try going back to be again in 15 minutes.
- Control your room temperature: Maintain a comfortable temperature in the bedroom. Extreme temperatures may disrupt sleep or prevent you from falling asleep.
- See a doctor if sleep continues to allude you: If you have difficulty falling asleep night after night, or if you always feel tired the next day, then you may have a sleep disorder and should see your doctor.