Video: Knock on Wood| Webinar: ACR/CHEST ILD Guidelines in Practice
fa-facebookfa-linkedinfa-youtube-playfa-rss

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Lupus Nephritis
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Sleep Tips for RA Patients & Rheumatologists

Carina Stanton  |  January 23, 2018

Evidence-Based Interventions
For patients who follow good sleep hygiene and still experience sleep disturbance, evidence suggests several strategies for relief, according to Dr. Irwin.

The gold standard for addressing sleep disturbance is cognitive behavioral therapy intervention (CBT-I), as recommended by the American Academy of Sleep Medicine. This approach has the strongest evidence supporting success, he says. However, a rheumatologist would need to refer their patient to a psychologist for this therapy.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Emerging evidence shows that community-based treatments that use mindfulness may also be effective. Example: Dr. Irwin and his colleagues found a movement meditation, tai chi, can be equally effective as CBT-I. However, tai chi is a series of low-impact meditative movements and may not be the best approach for RA patients experiencing joint inflammation, Dr. Irwin notes.

A separate published study co-authored by Dr. Irwin shows that mindfulness meditation is promising for reducing sleep disturbance. He suggests more research for alternative sleep support is needed, particularly for RA patients who are more susceptible to inflammatory response from their disease.3

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

One approach Dr. Irwin does not recommend is pharmacological sleep aids, especially in older adults. “Sleep aids are contraindicated in older adults and in older patients with rheumatologic conditions because these pharmaceuticals can impair function during the day and increase the risk for falls if patients get up in the night.” He is also concerned that these pharmaceuticals may wane in efficacy and mask underlying issues with sleep behaviors.


Carina Stanton is a freelance science journalist based in Denver.

References

  1. Irwin MR, Olmstead R, Carrillo C, et al. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. Sleep. 2012 Apr 1;35(4):537–543. doi: 10.5665/sleep.1742.
  2. Irwin MR, Olmstead R, Carroll JE. Sleep disturbance, sleep duration and inflammation: A systematic review and meta-analysis of cohort studies and experimental sleep deprivation. Biol Psychiatry. 2016 Jul 1;80(1):40–52. doi: 10.1016/j.biopsych.2015.05.014. Epub 2015 Jun 1.
  3. Black DS, O’Reilly GA, Olmstead R, et al. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015 Apr;175(4):494-501. doi: 10.1001/jamainternmed.2014.8081.

Additional Resources

Learn more about the evidence linking RA and sleep disturbance with pain and depression.

Read this study investigating tai chi vs. CBT to address late life insomnia and inflammatory risk.

Page: 1 2 | Single Page
Share: 

Filed under:Conditions Tagged with:DepressionfatiguePainSleepSleep Strategies

Related Articles

    Restoration of Sleep Physiology vs. Sedation for Sleep Disorders, Fibromyalgia

    June 15, 2015

    Sleep disturbance is an important medical problem, requiring intervention, not simply to reduce latency to its onset, but to ensure achievement of the depth of sleep that has been documented to restore homeostasis and prevent the falls that are responsible for so much morbidity and mortality.1 ad goes here:advert-1ADVERTISEMENTSCROLL TO CONTINUESleep disturbance is present in…

    Tips for Treating Insomnia in Rheumatology Patients

    June 15, 2015

    Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis (RA), with more than 50% of chronic pain patients reporting sleep disturbances. Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD,…

    7 Tools to Identify Depression

    August 1, 2014

    Why screening for depressive symptoms in patients with arthritis is needed

    Depression in Rheumatoid Arthritis

    November 1, 2012

    Examining the psychological and health-related comorbidities of rheumatoid arthritis patients with depression

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
fa-facebookfa-linkedinfa-youtube-playfa-rss
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences