A man lays crumpled on his bed as his back inflamed in pain causing insomnia.

How AxSpA Affects Your Sleep

Axial spondyloarthritis (AxSpA) is a chronic inflammatory disease that most often affects the spine. Its first symptoms are usually back pain and stiffness. People with AxSpA often report that these symptoms cause poor sleep. Poor sleep is known to affect quality of life and other measures of health, but few studies have looked at the relationship between sleep and AxSpA symptoms.

Can axial spondyloarthritis cause insomnia?

Previous studies have shown that people with AxSpA who also have comorbidities such as inflammatory bowel disease, anxiety, and depression report poorer sleep. Women also reported more difficulty sleeping than men. Poorer sleep was related to increased disease activity as well. This study was performed to better understand “good sleep” and “poor sleep.”

Researchers worked with over 600 patients with AxSpA or non-radiographic axial spondyloarthritis using the Jenkins Sleep Evaluation Questionnaire. Results from this survey compared sleep quality with age, mood, and disease symptoms to see how sleep affected quality of life. Researchers also looked at the link between sleep and performance at work. They defined good sleepers as those who reported 3 or less nights of disturbed sleep in the last month. Poor sleepers reported 15 or more nights of disturbed sleep.

It can lead to worse pain

Poor sleepers reported more disease symptoms such as back pain and fatigue. They also reported poorer daily function and quality of life. Poor sleepers who were worked said they missed work more often and did not feel as productive as good sleepers. Finally, poor sleepers were more likely to feel anxiety and depression. Further testing revealed that women were more likely to be poor sleepers. There was no significant data that linked sleep and age.

The data cannot say if poor sleep caused these symptoms or if these symptoms caused poor sleep. Very few studies have looked at sleep quality in AxSpA patients. Those that exist have shown similar findings but have used different methods to measure sleep. More studies are needed to create a consistent way to analyze sleep quality and the causes of poor sleep in those with AxSpA.

What does this mean for people with AxSpA?

Though this study was unable to determine if AxSpA symptoms contribute to or are affected by poor sleep, everyone can benefit from better sleep. Sleep quality may be of extra interest to people who have similar experiences as the study participants. It may be helpful to keep track of what worsens symptoms or sleep. For many, stress can be a trigger. Others report that weather can be a trigger. Understanding and improving sleep quality can improve quality of life and give your body time to heal.

How can people with AxSpA improve sleep quality?

There are many methods to try to improve sleep. What is most important is finding what works for your body and being patient with your body. It may take some trial and error to find what is best for you. The following tips may be helpful:

  • Reduce caffeine in the late afternoon. This can keep you awake later than you planned.
  • Practice “winding down.” Focus on soothing activities before bed like reading or meditation. Limiting screen time may also help because the bright light from a phone or TV can convince your brain that it is still daytime.
  • Gentle stretches can help relax your muscles and improve sleep.
  • Improve your sleep environment. Restrictive bedding or an unsupportive mattress can make it hard to move during the night or can worsen symptoms. According to your preferred sleeping position, supportive pillows may also help.
  • Make a plan for when pain wakes you from sleep. Recheck your bedding and pillows for maximum support. Stretch out tight areas or walk around to settle your mind. Use pain relief remedies like heating pads or topical creams prescribed by your doctor.
  • Try calming activities like soothing music, more reading or meditation.
  • Talk to your doctor. If you are still having difficulty sleeping or staying asleep, they may be able to help.
  • Be kind to yourself and your body. Chronic pain is not your fault.

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