Fatigue and Sleep

I have tried Sonata,Restoril,Seroquel,Remeron,Ambien,
Ambien CR,Lunesta,and Belsomra. None of which work. Trazadone works great but I can’t take it with the medication I take for Atrial Fibrillation. I have tried reading before bed, no TV, meditation, and breathing exercises. Nothing works. Any suggestions? I’m desparate for some restful sleep.

Hi Marie,

sleeplessness is no laughing matter. I hope you don't find my question silly, but is there anything that you feel keeps you from falling asleep or wakes you? I ask because your course of action might change depending on whether your sleeplessness is from a racing brain or from pain or muscle spasms. Wanna share?

I think we all have sleep troubles from time to time. Yes, it would help if we knew what was keeping you awake. For me it's RLS and joint pain. I use lots of pillows and light blankets to find a position that works well for me. No TV in the bedroom and I take medication when needed.

I too use multiple pillows to prop and brace my painful areas. My mind just won’t stop long enough for me for sleep to come but the joint pain is what wakes me multiple times during the night if I ever get to sleep. And returning to sleep is impossible. My fatigue is so bad that I drift off at work and feel weak and jittery inside. It gets bad enough that my legs feel too heavy to lift in order to walk.

If your in a state with legal or medical marjuana, give it a try. It works! Make laughter part of your day. Amazing how laughing stops pain!

Is there a time when you tend to sleep better? And if so can your arrange your life around it? I sleep better after about 4 or 5 am. That is a very inconvenient thing! I'm now able to sleep that bit longer ..... get up around 8am usually but back when I had to rise at 6am life was hell.

I've analysed my sleep pattern a lot and learnt to make concessions to myself as far as possible rather than aiming to be like everyone else. If your mind is racing you probably need a long-ish wind down in the evening, with dim lights and no tv or computer activity. I find I sleep better if I anticipate having a long period available for sleep, thinking "I've got 7 hours to get my head down and that's it" causes stress to insomniacs I reckon. You can re-train your body clock over a period of weeks or months. But from what you say, effective pain relief is key. What does your rheumy say about this?

Hi again Marie,

As you know there are things you can do to retrain your brain and stop some of the racing thoughts. I went through a tough patch of insomnia and had to do some hard work to get over the anxiety that it induced. I signed up for a mindfulness-based stress reduction course which really helped. They train you to conduct meditative body scans which can relax you and identify areas that are causing the most discomfort. You might look at/listen to this Youtube video for an idea of a body scan practice.

Once I had done this kind of thing for several weeks (6-8 at least) I then re-consulted my doctor about where the pain was. I know we are all very different, but we all seem to have the same techniques with pillows and props for our aches and pains. It is hard, thought, to always isolate where the pain is, or how the pain affects us. Only after learning how to relax into the pain through the body scan approach was I able to identify that I had pain and tingling in my feet and legs which caused me to move, move, move after just a few moments of being asleep. Once that was clear to me and I could more effectively describe the type of pain to my doctor, he diagnosed neuropathy and gave me a targeted medicine for it. This has, essentially, fixed my pain-based insomnia. I still have anxiety-laden nights or earl-morning wake-ups, but they are much fewer than before.

I'm not advocating for this approach for everyone--just letting you know how it worked for me. Had i not really gotten "into" my pain, I wouldn't have been able to accurately describe my discomfort and would most likely have just kept up the Ambien and Tramadol which turned me into the Walking Dead at work!

I really hope that you can find some answers to help get some sleep. Good luck!

I'm not sure what you are taking for your Atrial fib but generally the tricyclics play well with the cardiac meds while the tetracyclics such as trazadone will not. In fact they are often used to together. Have you tried or can you try one of those. The most common for PsA patients is amitriptyline. In fact its even used in conjunction with trazadone. for sleep. The only cardiac med I am aware of that it doesn't play well with is Cardizem. which their are alternatives to. Get your rheumy and cardioloigist together. They need to work this out..... No sleep makes BOTH worse. BTW sleep medications more often than not make the sleep issue worse for PsA patients. They hynotics do weird things to the immune system (or visa versa................

I have severe anxiety that manifests at night time before I go to bed. My mind will not shut down. I take Paxil now and it helps a lot. I also make sure I take pain meds closer to bedtime.

I went through the hypno drugs too, trying to get some sleep, my Rheumy is having me back on Melotonin, i am taking 5mg in the evening nd 5mg when going to sleep. Last night I got 3 hours of sleep! Just got up from a noon nap…