Overview of Psoriatic Arthritis

Psoriatic arthritis is a type of inflammatory arthritis that affects millions of people who already have psoriasis. Psoriasis is an autoimmune skin disease that is characterized by the appearance of a red, scaly rash that is covered with silvery scales. The rash typically appears on your knees, elbows, feet, ankles, hands, and other areas.(1)

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Psoriatic arthritis is also an autoimmune disease, meaning that it happens when the body's immune system goes haywire and starts attacking the healthy tissues by mistake. The disease most commonly affects your skin and the joints, making them become inflamed, stiff, and painful. Over a period of time, if you do not treat the condition, the inflammation that is accompanied with psoriatic arthritis can cause severe and permanent damage to your joints and tissues.

Psoriatic arthritis can affect either the joints on only one side of your body, or it can affect the bones on both the sides of your body. The signs and symptoms of this disease are quite similar to those of rheumatoid arthritis, and both these diseases can cause joints to become severely painful, swollen, and sometimes warm to the touch.

Psoriatic arthritis is also more likely to cause the following symptoms:(2)

Swollen Fingers And Toes: Psoriatic arthritis causes pain and swelling in your fingers and toes, to the extent that your fingers and toes can start to look like sausages. You may also end up developing deformities in your feet and hand before you start to experience any major joint symptoms.

Foot Pain: Another common symptom of psoriatic arthritis is a pain at the points in your feet where the tendons and ligaments attach to the bones, particularly at the back of the heel or in the sole of the foot.

Lower Back Pain: Many people develop spondylitis due to psoriatic arthritis. Spondylitis may also cause inflammation of the joints to present between the vertebrae of the spine and even in the joints located between your pelvis and your spine.

The most commonly affected joints by psoriatic arthritis are:(3)

  • Neck
  • Back
  • Shoulders
  • Fingers
  • Knees
  • Elbows
  • Wrists
  • Ankles
  • Toes

8 Useful Tips to Sleep Better with Psoriatic Arthritis

If you suffer from psoriatic arthritis, then it is quite common that you are also facing trouble falling asleep or staying asleep. Even though psoriatic arthritis is not directly responsible for causing insomnia, the commonly occurring side effects of the condition such as dry and itchy skin, and joint pain, are likely to keep you awake during the night.

In fact, a study carried out by the University of British Columbia in Canada found that about 84 percent of all people who have psoriatic arthritis report having a poor quality of sleep.(4)

It can indeed be very frustrating to keep tossing and turning throughout the night being unable to sleep. However, this does not have to be a situation that is entirely out of your control.

Here are some tips that will help you sleep better at night, even while living with psoriatic arthritis.

Confirm Whether You Have Sleep Apnea

Sleep apnea is a sleeping disorder that affects the way in which you breathe at night. If you have sleep apnea, you might stop breathing suddenly in the night. It has been observed that sleep apnea tends to disproportionately affect people who have psoriasis and psoriatic arthritis.

A study carried out by the University of Western Ontario in Canada found that nearly 36 to 82 percent(5) of people who have psoriasis end up also having obstructive sleep apnea, as compared to just two to four percent of people who are healthy.

Sleep apnea is not likely to produce any apparent symptoms because it typically happens when you are asleep. However, you could be having this condition without realizing it.

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If you are having trouble sleeping at night and you have psoriatic arthritis, you should discuss the possibility of sleep apnea with your doctor so that there is no doubt remaining on whether your insomnia is being caused by a type of sleeping disorder.

You should all the more discuss the possibility of sleep apnea with your doctor if you recognize any of the following symptoms common to sleep apnea:(6)

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Pay Attention To Your Clothing

People who have psoriatic arthritis also have psoriasis, the symptoms of which are often also a factor responsible for keeping you awake at night. When you have psoriasis, it is essential to pay attention to your clothing, especially what you wear to bed.

In order to keep the dryness and itchiness of your skin under control, you should opt for wearing loose-fitting or silk clothing when you are going to sleep. This helps prevent causing further irritation to your skin and will also not irritate your skin when you toss and turn at night.

Patients with psoriatic arthritis have been observed to have very dry, itchy, irritated, and cracked plaques or patches of skin. The fact is that certain types of clothing only aggravate this type of skin irritation and trigger flare-ups of psoriasis, causing a vicious cycle that is just not going to let you get any sleep.

Also, it is a good idea to keep your skin well moisturized because if he skin is dry, cracked, and oozing at places, whatever clothes you wear will tend to stick to these open areas, which will contribute to bleeding.

If you want to make yourself even more comfortable, then you can consider buying some softer bedsheets. To begin with, try looking for bedsheets that have a high thread count and is made from high-quality cotton.

Here are some helpful tips on what you can do clothing-wise to help manage the pain and discomfort at night:

Keep Your Clothes Fragrance Free: Laundry detergents can sometimes also affect your psoriasis. This is why it is wise you use unscented detergents and fabric softeners. Scented products are also known to aggravate skin conditions such as psoriasis, which is usually a pre-cursor to psoriatic arthritis. Opt for using liquid detergents over solid ones as they tend to dissolve better and the detergent particles are less likely to stick to your clothing.

Wear Loose Clothing: Wearing tight clothing is going to worsen your symptoms, making it difficult to sleep at night. If your dress is too tight, it might rub on an existing skin lesion, causing more pain or irritating the sore area. So it is better to choose loose-fitting clothes and undergarments whenever possible, especially when you are heading off to bed.

Wear Silk or Satin: These fabrics do not irritate your skin as much as others do and are also kinder to your skin than synthetic clothing. Your chances of getting a good sleep are much higher when you feel comfortable in the clothes you are wearing.

Use Heat or Cold Therapy

Before you head off to bed, you can think about using temperature therapy to give some relief to your joints. You can experiment with both hot and cold temperatures to see which one works best as different methods work better for different people. You may find that you prefer having a warm shower before bed or you can try sitting with a hot water bottle. If heat therapy does not work for you, then you can also choose to use an ice pack.

Incorporate any method that you find to be the most effective and make it into a daily nighttime pre-bedtime routine. You will find that you are able to keep the pain away for long enough to get some sleep.

Moisturize, Moisturize, Moisturize

It really cannot be stressed enough. One of the easiest steps you can take to keep your skin free from irritation is to moisturize it regularly. You should apply lotion or cream to your skin before going to bed so that it prevents itchiness while you are sleeping. Itchy skin is one of the most common symptoms of psoriatic arthritis that prevents you from sleeping through the night.

Psoriasis plaques are going to cause your skin to become dry, itchy, and flaky, and moisturizers help form a protective seal over your skin to boost hydration, decrease itching, and improve the overall appearance of your skin.

Skin that is consistently moisturized is stronger and better at avoiding cracking and also prevents other damage.

However, while moisturizing is essential, it is equally important to choose the correct moisturizer. You should search for a moisturizer that contains oat extract and aloe so that it can help calm the inflammation and also protect your skin.(7)

Also, apply moisturizer after cleansing to lock in the moisture in the skin. Since lotions are generally thinner in consistency than creams and ointments, they also help cover a larger area of skin without having to rub too hard and causing irritation to the skin's surface. If you find that you are often getting irritated due to the itchiness at night, consider storing your moisturizer in the refrigerator as the coolness can help soothe the itch.

Hydrate

It is necessary to drink plenty of water apart from moisturizing your skin with lotion. Stay hydrated by drinking plenty of water because water does not only help you stay hydrated, but it also helps cushion and lubricates your joints. This is why water is your best friend in this battle against the symptoms of psoriatic arthritis.

Drinking adequate water also helps flush out toxins from your medications, and you will notice that there is a marked decrease in the side effects of your psoriatic arthritis medications. You will also find that your psoriasis symptoms will be less severe when you drink lots of water. As it keeps your skin well hydrated, the skin does not become dry and itchy.

According to the US Centers for Disease Control and Prevention (CDC), drinking water also helps in the following ways:(8)

  • Protecting your spinal cord and other critical tissues of the body
  • Lubricating and cushioning your joints
  • Helping in digesting food and absorbing nutrients
  • Flushing out wastes through perspiration, urination, and bowel movements

However, keep in mind that instead of loading up on water just before bedtime, you need to spread your water intake throughout the day. After all, you don't want to finally fall asleep only to be waking up for using the bathroom.

Avoid Long, Hot Showers or Baths

For most people, a long, hot bath is just the thing one needs to unwind at night before bed. However, hot water can irritate and aggravate your skin condition. This is why you should restrict your showers to just 10 to 15 minutes or even less so that your skin does not become red and irritated.(9)

In order to prevent your skin from drying out, opt for using lukewarm water over hot water. Also when you finish showering, simply blot your skin dry gently rather than rubbing your skin with a towel. If you really like taking a warm shower before bed, then you still continue having it, but by taking the proper precautions.

Practice Meditation to Eliminate Stress

Stress is a known factor that worsens your symptoms of psoriatic arthritis. It is essential that you reduce your stress level if you want to manage your symptoms, and meditation exercises is a great way to gather and compose your thoughts before heading off to sleep.

Most people immediately associate the term meditation with complicated routines and strict rules. However, meditation exercises do not need to be complicated. All you need to do is simply close your eyes and focus on your breathing while you inhale and exhale. Keeping your body still and relaxed and just soaking up the silence will help lower your stress levels significantly.

Practice a Routine Bedtime

It is best to have a fixed time at which you go to bed each night. It is also advisable that you try and go to bed a little bit earlier than you usually do so that you avoid becoming overtired. If you find yourself consistently not being able to get sufficient sleep and waking up tired, then this is not only going to worsen your psoriatic arthritis symptoms, but also weaken your immune system. This will once again lead to a vicious cycle in which your symptoms get worse, continuing to make it difficult for you to sleep.

This vicious cycle might not prove to be that easy to break free off. However, one easy way to get out of it is to start practicing an earlier bedtime and sticking to it. Even if you find that you are unable to sleep at that time, just by lying in bed and allowing your body to relax will help you wind down from a tiring day at your own pace.

Going to bed at the same time each night will also stabilize the body's circadian rhythm, and you will find that this makes it easier to fall asleep with time.

Conclusion

Living with psoriatic arthritis is not easy, and you will often find yourself unable to sleep and waking up tired in the mornings. However, just because you have psoriatic arthritis, it does not mean that you need to sacrifice your sleep. Develop a healthy routine and practice healthy bedtime habits so that you can have a good night's sleep.

Make a conscious decision to make your evenings more restful and avoid getting into stressful situations towards the end of the day so that you don't spend your night worrying about the same.

A healthy bedtime routine and following the tips given here will go a long way in ensuring a good night's sleep so that you wake up refreshed and ready to face another day.

References:  

  1. Arthritis.org. (2019). What is Psoriatic Arthritis?. [online] Available at: https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/what-is-psoriatic-arthritis.php [Accessed 31 Aug. 2019].
  2. Arthritis.org. (2019). Symptoms. [online] Available at: https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/symptoms.php [Accessed 31 Aug. 2019].
  3. Versus Arthritis. (2019). Psoriatic arthritis. [online] Available at: https://www.versusarthritis.org/about-arthritis/conditions/psoriatic-arthritis/ [Accessed 31 Aug. 2019].
  4. Wong, I.T., Chandran, V., Li, S. and Gladman, D.D., 2017. Sleep disturbance in psoriatic disease: prevalence and associated factors. The Journal of rheumatology, 44(9), pp.1369-1374.
  5. Gupta, M.A., Simpson, F.C. and Gupta, A.K., 2016. Psoriasis and sleep disorders: a systematic review. Sleep Medicine Reviews, 29, pp.63-75.
  6. Krajewska-Włodarczyk, M., Owczarczyk-Saczonek, A. and Placek, W., 2018. Sleep disorders in patients with psoriatic arthritis and psoriasis. Reumatologia, 56(5), p.301.
  7. Sharecare. (2019). A Guide to Moisturizers for People With Psoriasis. [online] Available at: https://www.sharecare.com/health/psoriasis-skin/article/guide-moisturizers-people-psoriasis [Accessed 31 Aug. 2019].
  8. Cdc.gov. (2019). Water & Nutrition | Drinking Water | Healthy Water | CDC. [online] Available at: https://www.cdc.gov/healthywater/drinking/nutrition/ [Accessed 31 Aug. 2019].
  9. Psoriasis.org. (2019). Life with psoriasis: Managing itch | National Psoriasis Foundation. [online] Available at: https://www.psoriasis.org/life-with-psoriasis/managing-itch [Accessed 31 Aug. 2019].

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 11, 2019

This article does not provide medical advice. See disclaimer

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