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    RA Patients With Poor Sleep Quality May Be At Greater Risk For Pain.
    Scott Zashin, MD posted:
    RA Patients With Poor Sleep Quality May Be At Greater Risk For Pain. WebMD (2/16, Hendrick) reported, "People with rheumatoid arthritis (RA) who don't sleep well face significant risks of greater functional disability due to pain and fatigue symptoms associated with poor sleep quality," according to a study published in the Feb. 15 issue of the Journal of Clinical Sleep Medicine.

    The researchers asked 162 patients, who had RA on average for 14 years, to provide "information concerning fatigue, depression, severity of pain, and functional disability." The results showed that "61% of participants were poor sleepers" of whom 33% reported having "pain that disturbed their sleep at least three times per week."
    BarbaraCee responded:
    Thanks for sharing this. My husband and I were just talking about this type of thing this morning! I told him my pain level was really high this morning and I had a bad sleep night. He told me when he was awake I was snoring louder than he's ever heard me. He wondered if the pain levels and sleep are directly related.
    Pamzd responded:
    I was diagnosed with RA a year ago. I have problems with sleep and fatigue, but I had them before I was diagnosed blaming it on post menopausal issues. I went in with my index finger swollen, but most of my pain was just below my finger in the trapezoid area, which made my Dr. check for RA in the first place, but unlike most cases it was only in one hand. I have pain in other joints, such as my left elbow, but with a visit to a therapist it was diagnosed as tennis elbow. As of lately I have had a lot of pain in my left knee area and left side around the ligament area and back of leg, which I have attributed to a long walk I made with flat shoes, but every time I have pain in or around my joints and it hangs around a while it occurs to me it could be the RA getting worse. I do have fatigue each day, but I am also on a med for sleep, so not sure about anything. I go to my RA Dr. Monday for new blood work, but could you maybe shed some light on what I have written? Thank you, Pam
    Scott Zashin, MD replied to BarbaraCee's response:
    People who do not get the restorative or non Rem sleep may develop pain or an increase in existing pain. When I get a history of loud snoring from my paitients, I typically look into the possibility of sleep apnea. Many sleep centers now offer a test for sleep apnea that cn be done at home instead of going to a sleep center. Treatment of snoring may include sleeping on your side. In addition, sleep apnea and subsequent snoring may be improved with an oral appliance or a CPAP machine.
    Scott Zashin, MD replied to Pamzd's response:
    It is not uncommon for patients with RA to also have fibromyalgia (FM) FM is characterized by pain on both sides of the body, above and below the waist. The pain, typically occurs at trigger points, (soft tissue that overlies a bone such as an elbow or knee. Fatigue is common in both RA and FM. Poor sleep can predispose a patient to FM. Ask your doctor to see if this is what might be going on and how to best treat it if that is the case.
    Scott Zashin, MD replied to Pamzd's response:
    Hi Pam
    A good number of my patients with RA also have a condition called Fibromyalgia (FM) which is often associated with a sleep disturbance and subsequent fatigue. Even with some meds, patients wake up non refereshed. FM patients all have pain and it typically affects the muscles or ligaments, especially in areas over bony prominences such as an area afflicted by tennis elbow. It is not uncommon that I will see patients complaining of increased problems from their RA and it is actually due to FM.In addition to asking questions about the possibility of sleep apnea, I also obtain thryoid studies in my patients with these symptoms. Ask your doctor if your symptoms could be from something other than RA.
    mariefnp replied to Scott Zashin, MD's response:
    I have RA and was also diagnosed with sleep apnea recently. I know that my quality of sleep has been poor for quite a while. I just got my CPAP machine delivered today, and when I did the CPAP trial, I slept actually quite well at the hospital. I hope this helps some to get checked for sleep apnea too, because it will really affect your total quality of life.
    mcginnisj replied to Scott Zashin, MD's response:
    I was diagnosed with RA in 1999. At the same time, ny snoring became impossible to live with. I've struggled with chronic pain, fibromyalgia, poor memory and fatigue for years. Had a sleep study done in a lab back in 2003, but the results were voided because I only got 4 minutes of REM sleep!

    Finally this year I was able to get a home sleep test done. The results showed that I had moderate to severe sleep apnea. Now I use a CPap machine every night and all my symptoms have decreased dramatically.

    On this week, there was a discussion about fibromyalgia amongst clinicians. One family doctor said that 75% of his fibromyalgia patients were diagnosed with sleep apnea!
    BarbaraCee replied to mcginnisj's response:
    How does the home test work? My husband had his done at a sleep clinic. Wondering how they do all they do there from your home. Thanks!

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