Lupus and Insomnia: Is There a Connection?
According to the Lupus Foundation of America, survey studies among people with lupus found that about 50 to 60 percent had issues with poor sleep or insomnia.
Sleep affects everything: my thinking, productivity and mood. I am more likely to really struggle through the next day if the night before yielded little sleep.
I know it results in my feeling more depressed about my overall situation (having fibromyalgia, Hashimoto's and lupus). The pain increases throughout my body because healing sleep never really comes to me lately. At times, I wonder if the lack of sleep perpetuates the lupus flare I have been in.
I mean, would this ongoing flare have quieted down a bit if I were able to actually get some rest? My gut tells me yes, it would have, and there is actually research that supports this thought.
Does Lack of Sleep Fuel Lupus?
Researchers are learning through multiple surveys and tests that sleep plays an important role in regulating immune function. If a patient suffers from sleep deprivation (basically not getting enough sleep) or sleep disorders (like insomnia or sleep apnea), they have consistently been shown to experience increased inflammation.
Therefore, sleep problems are likely to exacerbate lupus disease activity and associated symptoms, such as fatigue, pain, depression and cognitive dysfunction. Poor sleep can also increase sensitivity to pain, the very last thing someone with chronic pain needs.
The relationship between a general lack of restful sleep and anxiety is a close one as well. Anxiety may cause you to be unable to get to a point of falling asleep and/or staying asleep. But lack of restful sleep can fuel worries and can make your anxiety worsen.
By itself, what doctors call “sleep hygiene" education is rarely effective in treating chronic sleep issues with lupus. This is where your doctor tells you to stop drinking coffee or putting anything with caffeine in your body, avoid alcohol, and create a routine to help you relax at least one hour before bedtime.
Pain makes it hard to sleep well, and not sleeping well will probably increase your pain. It is better to speak with your doctor to find something that manages the pain better, rather than addressing the sleep issue with a sleeping aid prescription.
Also, it is recommended with flares that cause increased pain, to not head to bed for the day, especially if you are simply lying there awake. Studies have found that doing this conditions your body to associate the bedroom with being awake, not for a good night’s sleep.
So it is suggested that when pain is severe and you must get some rest, do so in a room other than your bedroom.
Trying to catch up on sleep by sleeping later than normal throws off your body’s sleep rhythm. Experts say you should try and keep a regular time to get up each day and a regular bedtime. By not doing this, you may throw off your body’s sleep-wake clock and contribute to sleeping problems.
Research suggests one of the best ways to improve chronic insomnia symptoms is to get up at the same time every day, even on weekends, and avoid napping too much, which can make it harder to sleep at night.
But, for some patients with lupus, a nap is the only way to get through the day and to get a reasonable amount of sleep in a 24-hour period. For example, some warriors survive better by obtaining six hours at night and an hour nap during the day, and this proves to be an ideal pattern for them.
If you feel you must nap, it may be best to limit the daytime naps to less than one hour and take them early enough so it is not close to your bedtime.
Exercising is something recommended for sleep, but with lupus it can be tricky. If you are in pain or sick, you are not able to get regular exercise.
But if your body allows, research shows that consistently doing a gentle form of exercise (walking or yoga for instance) in the morning can be very beneficial for maintaining a regular sleep-wake rhythm. Avoid exercising at night as this tends to have the opposite affect and interrupt sleep.
The Reality of Lupus Sleep Issues
I struggle and push through many days completely exhausted. I try and go to bed a bit earlier and avoid stress (like reading work emails) at least two hours before bedtime.
I listen to relaxing music while getting ready for bed, and I bought a white noise machine that drowns out at least some of my dear husband’s snoring.
I am not good at napping (and I work full-time), so that is rarely an option for my lack of sleep. I have been prescribed medications for sleep by my rheumatologist, but all that I have tried leave me feeling very sleepy and unable to think well the next morning.
I typically do not take anything, except on weekends, and then I take a quarter of a pill. Along with having lupus (or maybe because of having it), I am very sensitive to medication.
I have recently started walking on a treadmill at the gym a couple of mornings per week, and I might actually fall asleep easier and faster on those nights. But, I still wake up about every hour or two, so exercise is not a cure by any means.
I find reading a bit before bed helps put my body in the right state to welcome sleep, and praying helps me unload all my thoughts and put them in someone else’s hands. It is hard. I have not found one solid answer that works and it feels like the solutions that help one time, fail me the next.
But I rest assured that I am not alone. As I lay there waiting for sleep to come tonight, I know there are many other lupus warriors fighting the same battle.
Maybe tonight will be restful for all of us. What helps you sleep, even during a lupus flare?