If you have arthritis, you’re probably no stranger to tossing and turning at night. Joint pain can make it tough to fall asleep, stay asleep or both. In fact, up to 80% of people with arthritis report some type of issue with their z’s.¹ 

So, what’s going on? “There are several reasons why people in pain can have a difficult time sleeping,” says Michael Guma, DO. He’s the medical director of rheumatology for Optum in Rutherford, New Jersey.  

For one, changing positions at night can cause pain. With some forms of arthritis, such as rheumatoid arthritis, joints can stiffen up when you’re not moving, says Dr. Guma. Then when you shift position during the night, those joints hurt.  

Unfortunately, bad nights can set up a vicious cycle. “Lack of sleep is like an amplifier for your pain. It can be like turning the pain volume knob to a higher number,” Dr. Guma says.  

And for older adults, missing out on sleep can increase the odds of falls or accidents, as well as memory issues and depression, according to the National Institute on Aging.²   

Bottom line, says Dr. Guma: “It’s so important to get that good night of sleep.” Here’s how to get started. 

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Soothe your muscles as you prep for bed 

Experts often recommend taking a warm shower to help you relax before bedtime.³ But it can have other benefits too. “For some people, a warm shower may help relax tight muscles,” says Dr. Guma. This can help take pressure off the joints, making sleep easier to come by.  

It’s also key to practice good sleep hygiene habits.² This is important for everyone, but especially if you find it tough to drift off. Keep your room cool, dark and quiet. And keep TVs and other devices out of the bedroom. Also try to avoid napping in the late afternoon or evening. 

Check your position — and bed accessories 

Depending on where you have stiff joints or pain, you may have to sleep in a certain position to feel your best, notes Dr. Guma. Let’s say you experience neck pain (a condition called cervical spondylosis).⁴ “The way you position yourself on your pillow, in addition to the type of pillow you’re using, can really make a difference in your pain and how well you sleep,” says Dr. Guma. 

A special pillow might support your neck as you snooze.⁵ Consider testing several if neck pain keeps you awake. Some people with arthritis also find that a fuller pillow that keeps their aligned with their spine can lead to better-quality rest. 

You’ll also want to find a comfortable mattress.⁶ There is no one best mattress for everybody with arthritis, notes Dr. Guma. Plus, your needs may change as you get older. “Some people find that a hard, stiff mattress is great for their arthritis, but they need a softer mattress as they age,” he says. 

Also handy: extra pillows. If you’re a side sleeper, for example, putting a pillow between your legs can ease hip, knee or back pain.⁷ 

Time your pain medications 

If you’re on regular pain medication, such as an anti-inflammatory, switching the time of day you take it might improve your sleep, notes Dr. Guma. Say you take a pain reliever in the morning, but you wake up at night from pain. Ask your doctor if you can take the medication after dinner or closer to bedtime.  

Doing so may allow the dose to peak at night. “This may help some people feel less stiff in the morning, and it may also help people get better sleep,” Dr. Guma says.  

Remember to check with your doctor or pharmacist before making changes to your medications or the timing of when you take them. 

Be active during daylight hours 

You might think that it’s what you do before bed that really matters. But daytime activities, especially if you’re outside, make a difference too.⁸ “When people have an active, busy day, they often sleep better at night,” says Dr. Guma.  

That goes double for getting exercise during the day, whether it’s walking around the park or dancing in the living room. “Exercise burns calories and uses muscles and joints, and that leads to deeper, less disrupted sleep,” Dr. Guma says. Just don’t work out within three hours of bedtime.² 

Need help putting together the right care team for you? That starts with finding a doctor you love. Find an Optum doctor. 

Manage your moods 

Having arthritis can affect your mental health, according to the Arthritis Foundation.⁹ Chronic pain can trigger depression, as well as anxiety. And depression can also make pain worse.⁹  

You don’t want to lie in bed thinking about how bad you feel, says Dr. Guma. That’s why it’s important to treat depression or anxiety along with arthritis, he notes. “It’s an important part of treatment that’s often ignored.” 

Therapy with a mental health provider who specializes in chronic disease may help. There are also certain medications, such as duloxetine (Cymbalta), that treat pain as well as depression and anxiety, suggests Dr. Guma.  

Just talk to your doctor openly about what you’re feeling. Together, you can come up with a solution for the pain and your moods. 

Stay away from sleeping pills  

“You want to avoid medications that are habit-forming,” says Dr. Guma. But you can try melatonin. It’s a supplement you can buy over the counter that helps promote sleep.¹⁰ Your brain naturally produces melatonin, a hormone, when it gets dark. It signals your body that it’s time to sleep. But as you age, your brain makes less of it.¹⁰ Talk to your doctor about the right dose to start with. 

At Optum, your health care team can connect you with the right specialist to help you manage arthritis pain. The goal is to help you feel your best, and make restless nights a thing of the past. 

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