Joints affected by rheumatoid arthritis may not only feel painful but also tender and stiff. Depending on which joints are affected, you may find it challenging to fall and stay asleep.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and pain, among other symptoms like weakness, fever, and fatigue. Experts estimate that 80% of people with arthritis have sleeping difficulties potentially caused by these symptoms of joint discomfort.

Unlike other types of arthritis, RA tends to affect the same joints on both sides of your body, such as both of your hands. While RA can affect any joint, it’s most common in the joints of your knees, hands, and wrists.

If you have RA, you may already feel fatigue from this chronic inflammatory condition, making getting a good night’s sleep even more important for your health. In fact, not getting enough sleep regularly can make RA-related pain worse.

Consider how you can position yourself for a better night’s sleep, as well as other ways you may manage RA pain.

It may help to adjust your sleeping position according to the joints that RA affects. Here’s how you can accomplish this if you experience symptoms in one of these commonly affected areas of the body.

Relief for hand and wrist pain

RA commonly develops within the small joints of the hands and wrists. If this type of joint pain is keeping you up at night, consider asking a doctor about compression gloves or splints you may wear to sleep.

Sleeping on your side

If you’re a side sleeper, it can place more pressure on your shoulder, hip, and knee joints. Even if you don’t typically sleep on your side, it’s difficult not to move around in your sleep, and you might still end up on your side.

So, it may help to use strategies to help support these joints to ease pain whenever you’re on your side. For example, if you end up sleeping on a painful shoulder, you could try supporting it with a thick pillow so your shoulder joint doesn’t roll forward.

To ease hip pain from RA, try placing a pillow between your legs for additional support of your hip joints. This same strategy can help relieve knee pain from RA — try placing a couple of pillows in between your knees for support.

How to reduce RA foot pain

If foot pain from RA keeps you up at night, try placing a weighted blanket or towel on top of your feet. This works best while sleeping on your back.

For side sleepers, you may consider wearing compression stockings to support your foot joints.

Tips for sleeping on your back with RA

While not as common as other joint pain, it’s still possible for RA to affect your neck and spine.

If you sleep on your back, supporting these joints with the correct pillow is key to preventing worsening pain. You can also add pillows underneath your knees and the small of your back. A small U-shaped pillow can also help support your neck while sleeping on your back.

Can you sleep on your stomach with RA pain?

Sleeping on your stomach can place more stress on your back and neck. If RA has affected these joints, it’s best you try to avoid this sleeping position if you can.

Aside from adjusting your sleeping position, you may consider other tips to manage nighttime RA pain, such as:

  • applying cold compresses to the affected joints to reduce inflammation
  • using a heat pad on the affected areas before you go to bed
  • taking a warm shower or bath before bedtime
  • taking over-the-counter pain relievers — but only if a doctor recommends them
  • meditating before bed
  • creating a relaxing routine before bed, such as reading and avoiding electronics
  • sticking to a regular sleep schedule, which includes going to bed and getting up at the same times each day

Read more about managing RA pain at night.

It’s common to experience worsening RA symptoms at night, including joint pain. Here are some of the most commonly asked questions about nighttime RA pain.

Why is rheumatoid arthritis worse at night?

There are a few reasons why RA pain may be worse at night. When you’re trying to sleep and don’t have any other distractions, you may notice joint pain more than at other times of the day.

Your central nervous system may also play a role. For example, not getting enough sleep in the long term may affect how your body regulates pain. Another possible explanation may be increased inflammation at night.

What aggravates rheumatoid arthritis pain?

Worsening RA pain may be a sign of a flare-up. A number of different factors may cause a flare. These include stress, too much exercise, or weather changes.

Not getting enough sleep can also make RA pain worse the next day. One possible reason for this is an increase in inflammation from lack of sleep, and inflammation can worsen RA symptoms.

If you find that your RA symptoms are causing difficulties with falling or staying asleep at night or waking you up too early on a regular basis, it may be time to see a doctor for help. This is especially the case if you’ve tried adjusting your sleeping position or are currently receiving treatment for RA.

You should also consider getting medical help if you’re experiencing worsening pain and other RA symptoms. These could be signs of a flare-up that needs additional treatment.

Sleep deprivation is a complication seen in all types of arthritis, including RA. Pain and lack of sleep often occur together.

Not only can this be disruptive in the short term, but a chronic lack of sleep can make your condition worse. In turn, you may experience increased inflammation and worsening joint pain.

Adjusting your sleeping positions is one strategy that may help you get the sleep you need to help you manage RA symptoms and your overall health. Speak with a doctor about other RA treatment strategies that may help.