It’s no secret that sleep is necessary for our overall physical and mental health. For the average adult, doctors recommend sleeping at least 7 hours each night to feel well-rested and promote optimal health. Yet, nearly 80% of adults with psoriatic arthritis experience some degree of fatigue.1
When your sleep is disrupted or cut short, your body doesn’t get the chance to fully rest and repair itself. For people with psoriatic arthritis, this can mean heightened inflammation, increased pain, and intensified flare-ups. Poor sleep can set off a vicious cycle where pain causes sleep disturbances, and lack of sleep exacerbates pain.
Although psoriatic disease has been studied for decades, there is still much to learn about how it affects sleep quality. For example, we know that fatigue is a telltale sign of a psoriatic arthritis flare-up but what causes it still eludes experts. Inflammation, pain, anxiety and depression, PsA medications, and other health conditions could all contribute to fatigue.2
At ARBDA, we have a team of licensed specialists who work with patients one-on-one. We understand that there is no one-size-fits-all solution when it comes to chronic pain management, and we’re here to provide you with the best psoriatic arthritis treatment. If you have PsA and suffer from recurring fatigue, read on to learn more.
Psoriatic Arthritis Fatigue Affects Quality of Life
Psoriatic disease is characterized by fatigue, which may be difficult and debilitating to deal with. In fact, exhaustion is often cited by patients as one of the most bothersome symptoms — right after joint pain.3
According to a recent study published in The Journal of Rheumatology, greater fatigue levels can negatively affect physical health, work productivity, and overall quality of life.4 Additionally, anxiety and depression were more common among patients with higher levels of fatigue severity, which is affected by:
- Patient’s pain levels
- Patient’s age or disease duration
- The severity of the patient’s psoriatic arthritis
- The total body area affected by PsA
- The number of tender or swollen joints
Living with chronic fatigue due to psoriatic arthritis is no walk in the park, but it can be manageable with the help of a caring physician. Unfortunately, the study found that doctors reported lethargy in only 32% of patients.5 To put that into perspective, fatigue was reported by almost 80% of people with psoriatic arthritis who participated in this study. This shows that fatigue is underacknowledged as a symptom of PsA, which can affect the patient’s treatment plan.
Psoriatic Arthritis Fatigue Not Frequently Treated
Another study reported at ARC Convergence 2022 found that 46.5% of patients with poor sleep quality were not receiving treatment for insomnia.6
Among those affected, women with higher disease severity, a higher total body area affected, fatigue, as well as anxiety and depression, were more likely to have poor sleep quality. This correlates with the findings from the previous study.
However, the big takeaway is that fatigue research and management need to be prioritized in the psoriatic disease field to give patients the best care.
Common Sleep Disorders Associated with Psoriatic Arthritis
Sleep disorders are all too common among PsA patients, with fatigue and sleep disruption being a common complaint. Understanding these disorders can help patients and healthcare providers develop better strategies to manage them.
Here are some of the most common sleep disorders associated with psoriatic arthritis:
1. Insomnia
Insomnia, characterized by difficulty falling or staying asleep, is a prevalent issue among individuals with psoriatic arthritis (PsA). A 2022 study published in Rheumatology shows that sleep disturbances are highly common in PsA patients, with a significant portion experiencing clinical insomnia. Factors contributing to insomnia in PsA patients include symptoms from higher baseline disease activity.7
2. Sleep Apnea
Obstructive sleep apnea (OSA) occurs when breathing stops and starts during sleep. OSA is more common in people with psoriasis, and since psoriasis and PsA share inflammatory pathways, PsA patients may also be at increased risk. According to a study in the Journal of the American Academy of Dermatology, poor sleep quality — including conditions like OSA — was significantly associated with higher psoriasis severity.8 For PsA patients, untreated sleep apnea can worsen fatigue and inflammation.
3. Restless Legs Syndrome (RLS)
Restless legs syndrome causes an uncontrollable urge to move the legs, which can disrupt sleep quality.
A 2019 study published in the Z Rheumatol showed that restless legs syndrome is notably more prevalent among individuals with psoriatic arthritis, with 64% of PsA patients experiencing RLS compared to 14% in the control group.9 Furthermore, moderate to severe RLS cases were more common in PsA patients than in those with psoriasis. The presence of RLS in PsA patients was also associated with poorer sleep quality, increased fatigue, reduced physical health, and higher depression scores.
4. Pain-Related Sleep Disturbances
Chronic pain is one of the most common reasons people with psoriatic arthritis (PsA) struggle to get quality sleep — but the relationship goes both ways. According to a recent study published in Joint Bone Spine, patients with PsA who reported poor sleep had significantly higher levels of pain, fatigue, and disease activity than those who slept well. Even among patients with no swollen joints, typically a marker of disease remission, who reported poor sleep had pain scores three times higher than those who reported good sleep.10
How to Manage Fatigue With Psoriatic Arthritis
Most people with psoriatic arthritis find that combating fatigue is one of their biggest challenges. It can be extremely difficult to prioritize your health and happiness when you’re constantly feeling tired. The best treatment for PsA fatigue is, of course, speaking with a specialist. Your doctor can adjust your treatment plan to help minimize fatigue. As a matter of fact, you shouldn’t make any changes to your lifestyle without consulting your doctor.
What you can do is eat healthy, stay active, and stick to a sleep schedule.
Strategies to Improve Sleep for Psoriatic Arthritis Patients
Improving sleep quality can feel like an uphill battle, but incorporating a few strategic changes can make a difference. Here are some practical tips for PsA patients looking to get better rest:
Develop a Sleep Routine
Sticking to a regular sleep schedule helps train your body to wind down at the same time each night. Go to bed and wake up at the same time, even on weekends. Your body’s internal clock will adjust, making sleep more consistent.
Create a Comfortable Sleep Environment
Investing in a supportive mattress and pillows can alleviate joint pain and improve comfort. Keep your bedroom cool, dark, and quiet to minimize disturbances. You should also consider using blackout curtains and white noise machines.
Practice Relaxation Techniques
Incorporate relaxation methods like deep breathing, meditation, or gentle stretching before bed. These activities can reduce muscle tension and signal your body that it’s time to rest. Mindfulness practices have also shown promise in reducing pain perception and promoting more restful sleep.
Limit Caffeine and Electronics
Don’t drink caffeine or alcohol before bedtime. Perhaps the hardest tip to follow is this: avoid your cell phone, computer, and TV! Find other ways to relax that don’t involve electronic devices.
The Importance of a Multidisciplinary Approach
Psoriatic arthritis affects more than just joints — it impacts every aspect of a patient’s life, including sleep. That’s why a multidisciplinary approach to treatment is essential. Addressing both the physical and emotional components of PsA with a comprehensive care plan can significantly improve sleep quality and overall well-being.
At ARBDA, we believe in creating tailored treatment plans that consider every aspect of your health. Our team of rheumatologists works to address pain, fatigue, and sleep disturbances simultaneously. We also encourage patients to voice their sleep concerns openly during consultations, as this can significantly impact treatment outcomes.
Living with PsA doesn’t have to mean surrendering to sleepless nights. By partnering with a multidisciplinary team, patients can learn how to manage their symptoms more effectively and improve their quality of life.
Visit the Top Psoriatic Arthritis Specialists at ARBDA
Are you suffering from the pain and fatigue caused by psoriatic arthritis? You don’t have to go through it alone. Our team of psoriasis disease specialists is only one phone call away, and we would be happy to determine the best treatment plan for you. Contact us to schedule an appointment at any of our six New Jersey locations.
7https://academic.oup.com/rheumatology/article/61/Supplement_1/keac133.272/6573198
8https://pubmed.ncbi.nlm.nih.gov/19944485/
9https://pubmed.ncbi.nlm.nih.gov/30421034/
10https://www.rheumatologyadvisor.com/news/poor-sleep-linked-to-pain-in-ra-and-psa/
