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Sleep Loss Exacerbates Inflammatory Markers in Rheumatoid Arthritis

By September 16, 2020No Comments

Researchers at the Tabriz University of Medical Science found pain and sleep affect inflammatory markers in rheumatoid arthritis (RA) patients. Learn more about the link between sleep and inflammatory markers and how it affects you.

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How Sleep Affects Inflammatory Markers and Pain

RA Pain and Inflammatory Markers

a man holding the elbow with the bones image | RA Pain and Inflammatory Markers | Sleep Loss Exacerbates Inflammatory Markers in Rheumatoid Arthritis Patients

Rheumatoid Arthritis (RA) is a chronic inflammatory disease with a slow onset. It’s a fairly common condition, affecting roughly 1% globally.

RA is an autoimmune disease. That is to say; your immune system attacks healthy cells by mistake. The biggest complaint is usually joint pain and swelling, but other symptoms include:

  • Pain, tenderness, stiffness, and swelling in more than one joint
  • The same symptoms on both sides of the body (such as in both hands or both knees)
  • Weight loss
  • Fever
  • Weakness, tiredness, or fatigue


Active RA increases inflammatory factors. Two of which are C-reactive protein (CRP) and erythrocytes sedimentation rate (ESR). These factors may indicate RA changes and how the disease is reacting to treatment.

Determining the factors that increase these markers can help limit the severity of RA.


Inflammatory Markers and Sleep Connection

We usually associate sleep problems with feeling grumpy or being unable to focus at work. But, it can wreak havoc on your health, as well. It affects many chronic conditions, such as diabetes, obesity, and heart disease. There’s also a link between inadequate sleep and inflammation.

Adults need more than seven hours of sleep each night. But, how well you sleep is as important as how much you sleep. Signs of sleep problems include:

  • It takes more than 30 minutes to fall asleep at night.
  • You often wake up more than once a night.
  • It takes more than 20 minutes after waking up in the middle of the night.
  • You feel tired even after sleeping for hours.

Sleep is vital to keep inflammatory markers in check. According to several studies, sleep problems lower your pain threshold. At the same time, it raises inflammatory markers that increase pain sensitivity.

In other words, if you don’t get enough high-quality sleep, you can’t tolerate pain well, and you are more sensitive to it.

An increase in pain sensitivity, paired with more pain, leaves many RA patients unable to function normally.

A study by the University of Pittsburgh School of Medicine concluded rheumatoid arthritis patients with low-quality sleep are at a higher risk of functional disability. Researchers go on to note the relationship may be due to pain severity and fatigue.

RELATED: Is a Hormone Imbalance Affecting Your Sleep


Sleep, Pain, Depression Cycle

Most patients with RA, between 60% and 80%, have sleep problems. Studies show a correlation between sleep problems and joint stiffness, pain, weakness, anxiety, depression, and disease duration.

On the other hand, inflammatory markers increase pain. Pain, in turn, affects sleep patterns and quality.

Researchers found a significant link between pain and sleep issues such as apnea, trouble falling asleep, and leg twitching or numbness. They also saw a strong link between daytime napping and pain that leads to sleep disruptions.

In short, RA pain may worsen depression and affect sleep quality. At the same time, sleep quality may also increase pain sensitivity and the risk of depression.

As a result, it creates a vicious cycle. Pain disrupts sleep. Then a lack of sleep increases inflammatory markers leading to more pain. All the while, it may worsen depression.

Lastly, the study noted changes in biological factors increase markers as well. For instance, consuming glucose increases pro-inflammatory proteins.


Prioritize Sleep

a man is sleeping at night | Prioritize Sleep | Sleep Loss Exacerbates Inflammatory Markers in Rheumatoid Arthritis Patients

RA pain and sleep problems seem like the chicken or the egg conundrum. But because both are predicting factors of increasing CRP, managing one may improve the other.

In most cases, patients prioritize pain management. However, getting as little as 15 to 30 minutes more sleep a night could make a difference in how you feel. Improving sleep may also be the easiest of the two.

For instance, people who are motivated to get more sleep reported around 36 minutes of extra sleep each night. Among those who experience pain, motivated people slept longer and better.

You can also limit caffeine, practice meditation, and restrict alcohol to help you sleep better.

Besides behavioral changes, your doctor can address sleep problems with drug interventions.

Pro Tip: Peptides are a potent anti-inflammatory agent. Some peptides may help improve sleep quality, reduce pain, and improve your overall quality of life.

To sum up, rheumatoid arthritis patients frequently experience sleep problems and pain. Some studies show sleep problems increase inflammatory markers, which in turn increases pain. Thus, addressing sleep issues may reduce pain. While we need to study whether improving sleep quality can reduce pain and depression in patients with RA, it surely won’t hurt to sleep more.


YM offers a range of cutting edge treatments that may improve sleep and manage pain. Contact us today to see how we can help you! We have offices in Ocala, Florida, as well as Fruitland Park and Daytona.


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