Rest Up, Sleeping Beauty: Tips for a Better Night’s Sleep with PsA

Psoriatic arthritis (PsA) is essentially a combination of the skin condition psoriasis and the inflammatory condition arthritis. This can mean painful, itchy skin; achy joints; bodily pain; fatigue; and general discomfort.

Though the condition has no cure and no known cause, there are many treatments to reduce symptoms. Sleep is a big part of managing PsA.

Stress is one of the biggest triggers for PsA flare-ups, so a stressful time can bring on an onslaught of rashes, inflammation, and pain. Reducing stress can help ease the symptoms in the short and the long term.

One of the best ways to manage your stress levels is to get high quality sleep, but sleeping isn’t always easy when you have PsA.

Your skin can become painfully itchy (some people describe it as more like a burning sensation than a traditional itch), and joint or bodily pain can be severe. All those things make it hard to catch some Zzz’s.

A 2017 study found that 84 percent of people with PsA had poor sleep quality. Poor sleep has a direct connection to increased fatigue, anxiety, and joint inflammation — all things you’re trying to avoid when you have PsA.

You *can* sleep well with PsA. You just have to make a few changes and be aware of some unusual ways PsA might be affecting your slumber.

Since your skin is extra sensitive, it’s best to wear soft, loose, comfortable clothing, especially while in bed.

Try wearing PJs made from soothing fabrics like cotton or silk. It’ll help if your sheets are made from those materials too. Keep the PJs loose, so they make minimal contact with the sensitive areas of your skin.

And don’t forget about detergent. Some detergents can be extremely irritating to the skin, so choose one that has no fragrance and is made with sensitive skin in mind.

Try cold therapy on any irritated areas. Cold can have a light numbing effect and often feels good on dry, itchy skin.

Take a cold shower or place a cold compress on the affected area for 20 to 30 minutes. This should help reduce irritation and itch.

Hot showers can make dry skin even drier. But that doesn’t mean you have to bathe in ice-cold water.

Keep showers warm (not hot and steamy) and limit them to about 10 minutes. This will help your skin retain more of its natural moisture and limit itching.

Day or night, moisturizing is key. Keeping your skin moisturized can greatly reduce itching, irritation, and flaking.

After you take a shower, be sure to immediately lotion up. Try to choose a lotion that has no fragrance and is designed for dry skin.

Also, if you have psoriasis on your hands, be sure to use lotion right after you wash your hands. Moisturizing reduces itching, which can help you relax into sleep.

If you have psoriasis scales on your skin, they can crack and cause more itching and irritation. By gently removing the scales, you reduce the chance of irritation.

Over-the-counter lotions with salicylic acid, lactic acid, urea, or phenol can help soften the tissue and remove the scales.

With the scales reduced, your skin will absorb anti-itch treatments more easily. Apply calamine, camphor, or your preferred anti-itch cream, and you should feel some relief.

Stress is a huge factor in PsA, so it’s important to make extra time to relax. Before bed, give yourself a few minutes to meditate, journal, or do another soothing activity.

A 2015 study found that meditation significantly helped adults with sleep disturbances get better rest. If meditation isn’t your jam, you can do anything that helps you ease your mind and wind down.

These extra moments of relaxation will help your PsA overall and will help you drift off to dreamland.

Yes, scrolling on your phone in bed is bad for your sleep. This isn’t specific to PsA, but being on devices right before bedtime can greatly impact your sleep.

Research suggests that the blue light from electronics suppresses the release of melatonin, aka the sleep hormone. Less melatonin means it’s harder to get to sleep.

So, the longer you stay on Instagram, the longer it might take you to fall asleep. It’s hard, but try to put your phone away at least 30 minutes before bedtime.

With PsA, you may need to try a little harder to get good rest, so it’s best to practice the best sleep hygiene possible.

Exercising during the day (at least a few hours before you go to bed) helps your body wind down at night. About 30 minutes of light exercise, 5 days a week, will help you reduce stress, keep your joints mobile, and get better sleep.

Also, all you night owls out there, try not to drink caffeine in the evening, and keep alcohol consumption low (or at zero, if possible).

Make sure your bedroom is designed for sleep too. Keep it dark, quiet, and cool to help you drift off and stay asleep without distractions.

If you can, use your bed only for sleeping (or sleep-adjacent things *wink, wink*). Don’t watch TV or read in bed. Let those be living room activities and reserve your bed for sleeping. These changes may seem small, but they make a big difference.

If you’ve tried these modifications and nothing has worked, talk with your doctor. Your medication could have a side effect that’s interfering with your sleep.

Your doctor can then decide if trying a new medication is a good option to help you get better sleep.

If you often wake up with a headache or feel like you didn’t get any real rest after a full night’s sleep, you might have sleep apnea. People with PsA are more likely to have this condition than those who don’t have PsA.

A 2016 review found that 36 to 82 percent of people with psoriasis have sleep apnea, while only 2 to 4 percent of the general population does.

To find out if you have sleep apnea, you can do a sleep study at a doctor’s office or at home. You’ll be monitored overnight, and the pros will be able to tell if your airway is being obstructed while you sleep.

If you receive a diagnosis of sleep apnea, you’ll likely have to use a machine or an oral appliance to help keep your airways clear at night. These treatments for sleep apnea will help you actually get some rest and improve your overall sleep quality.

Another sleep disorder that’s more common in people with PsA is restless legs syndrome (RLS). This condition is exactly what it sounds like — your legs feel like they want to keep moving.

RLS tends to get worse at night and causes a pulling, crawling, itching, or throbbing feeling in your legs. These sensations make it hard to sleep, so you don’t get much rest, hence the poor sleep quality.

If you think you may have RLS, contact your doctor. You may be able to treat it with mild lifestyle approaches like dietary changes, exercise, or a magnesium supplement. Your doctor may also prescribe a medication to get your legs to rest.

Psoriatic arthritis may make sleeping difficult, but with a few changes you can counteract the itching and irritation to get the rest you need.

Wearing soft, loose clothes; practicing good sleep hygiene; and staying moisturized will help you sleep better. And if those changes aren’t enough, check with your doctor to see if sleep apnea, restless legs syndrome, or a medication is causing the problem.