People with psoriatic arthritis tend to have more trouble with sleep, and that can make their symptoms worse. You should have a nightly ritual that checks all the usual boxes for good sleep. Then take steps to manage the top sleep robbers linked to psoriatic arthritis: pain, itch, and stress.
Shut Down and Unplug
Go to sleep and get up at the same times every day to put your body clock in the best rhythm. Start by turning off all electronics with a screen an hour before you turn in. This gets you into the mind-set for slumber. You can listen to soothing music instead.
Regular exercise eases pain and stiffness in achy joints. But stick to a slow, gentle pace at night. Stretching after a warm (never hot) shower or bath can help with sleep and next-morning stiffness. Yoga is ideal because it's both a stress reliever and a stretching routine. Another two-in-one choice is tai chi. An expert can create a program for you to follow at home.
Create a Bedroom Oasis
Make this room just for sleep -- no gadgets of any kind. Set your thermostat so that the temperature is cooling. If the air is dry, add moisture with a humidifier. Close the shades to keep your bedroom dark and the sun from waking you up too soon.
Talk to your doctor about medication you can take before bed, like aspirin or acetaminophen, when your joints are bothering you. For a nondrug alternative, try heat and cold therapy and see what works best. A heat pack or an ice pack (or bag of frozen food) can soothe sore, swollen joints as well as itchy skin patches.
With this form of Chinese medicine, you press on key points on your body with your fingers or even a tennis ball and hold for a few minutes to relieve pain. For overall pain fighting, try the spot between the big and second toes on the top of your foot. Get an acupressure chart to see how to target pain in a specific joint.
Soothe the Itch
If you have psoriasis, too, don't give itch the chance to ramp up while you sleep. Moisturize with a thick cream after your evening bath or shower. Ask your doctor if you can double up with a hydrocortisone or vitamin D cream. Wear loose-fitting cotton or silk clothes that won't irritate as they touch and rub against you. Test out different sheets and blankets to find the least scratchy.
It could be scratching, more than the itch itself, that wakes you up in the middle of the night. So keep nails short. And to really limit how much you can go after your skin in your sleep, wear cotton gloves to bed. If psoriasis has pitted your nails and applying a cream is part of your treatment, the gloves will also help keep it in place.
Anxiety about your illness and about not being able to sleep can build on itself. Use deep breathing along with a mind-body practice like mindfulness or meditation to relax. Focus your thoughts on a happy image. This can help you better manage your emotions and, in turn, sleep better.
Fill the air with a fragrance you like to help put you in a calm, peaceful state of mind. Try a scented candle (snuff it out before you go to sleep) or scented oil diffuser. In one study of people with constant pain, using aromatherapy even eased the pain itself.
Your favorite drink might relax you and make you feel drowsy. But alcohol gets in the way of deep sleep, the kind you need to feel well-rested. It can also interfere with some psoriatic arthritis medications and possibly worsen side effects. If you find a hot brew soothing, be sure to go decaf. Chamomile tea in particular seems to encourage sleep.
If your medicine isn't doing enough to control the symptoms that keep you up at night, talk to your doctor. A different dose or drug may bring you enough relief to finally rest. Some people in studies that tested the effectiveness of medicines called biologics, which slow down the disease, also had better sleep.
Depression has been linked to psoriatic arthritis, and it could be a reason you're not getting a good night's sleep. A therapist can show you ways to boost both your mood and sleep quality. The mind-over-matter approach called cognitive behavioral therapy helps you see the challenges of your condition in a more positive way. You can practice it on your own before bed.
Related Sleep Thieves
Psoriatic arthritis makes you more likely than the average person to have other conditions that are linked to sleep problems. These include sleep apnea, restless legs syndrome, TMJ disorder, and fibromyalgia. Get tested, which often means a sleep study. Treatment, if needed, may bring the rest you crave.
National Psoriasis Foundation: "Tips for better sleep with psoriatic disease," "Mind and Body Therapies," "Nonsteroidal Anti-inflammatory Drugs (NSAIDS)," "Alternative Therapies," "Shopping with a purpose," "Hands, Feet and Nails," "6 tips for getting a better night's sleep," "Depression, anxiety common with psoriatic arthritis."
International Journal of Rheumatic Diseases: "Sleep quality in patients with psoriatic arthritis."
Sleep Medicine Reviews: "Psoriasis and sleep disorders: A systematic review."
The Arthritis Foundation: "Psoriatic Arthritis Self Care," "Psoriatic Arthritis Self-Care Tips," "13 Tips to Soothe Your Skin," "Meditation: Benefits for People with Arthritis," "Meditation for Arthritis: How To."
UpToDate: "Patient education: Psoriatic arthritis (Beyond the Basics)," "Patient education: Arthritis and exercise (Beyond the Basics)."
American College of Rheumatology: "Exercise and Arthritis."
University of Washington Medicine, Orthopaedics and Sports Medicine: "Psoriatic Arthritis."
Cleveland Clinic: "Psoriatic Arthritis."
Journal of Advanced Research: "Effectiveness of acupressure versus isometric exercise on pain, stiffness, and physical function in knee osteoarthritis female patients."
Yoga & Physical Therapy: "The 'Magic' Touch -- The Simple Guide to Acupressure from Your Own Home."
Mount Sinai Hospital: "Knee Acupoint Exercises."
Aurora Health Care: "3 Acupressure Points That Can Relieve Body Pain."
Health and Quality of Life Outcomes: "The impact of itch symptoms in psoriasis: results from physician interviews and patient focus groups."
Psoriasis and Psoriatic Arthritis Alliance: "Nail Psoriasis."
Reumatologia: "Nail involvement in psoriatic arthritis."
Seminars in Arthritis and Rheumatism: "The psychosocial burden of psoriatic arthritis."
BioMed Research International: "Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?"
National Sleep Foundation: "Alcohol's Effect on Sleep."
Molecular Medicine Reports: "Chamomile: A herbal medicine of the past with a bright future."
PLoS One: "Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review."
British Journal of Dermatology: "Sleep quality and other patient-reported outcomes improve after patients with psoriasis with suboptimal response to other systemic therapies are switched to adalimumab: results from PROGRESS, an open-label Phase IIIB trial."
Journal of the European Academy of Dermatology and Venereology: "Improvement in aspects of sleep with etanercept and optional adjunctive topical therapy in patients with moderate-to-severe psoriasis: results from the PRISTINE trial."
International Journal of Molecular Sciences: "Psychopathological Variables and Sleep Quality in Psoriatic Patients."
Mayo Clinic: "Sleep and psoriatic arthritis," "Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills."
Journal of Clinical Sleep Medicine: "Psoriasis and Sleep Apnea: A Danish Nationwide Cohort Study."
International Journal of Medical Sciences: "Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study."
Arthritis: "High Frequency of Fibromyalgia in Patients with Psoriatic Arthritis: A Pilot Study."
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.