Is Insomnia A Symptom Of Psoriatic Arthritis
As if thats not enough, chronic pain can also make it hard to sleep. While psoriatic arthritis does not directly cause insomnia, the tendon, ligament and joint pain can interrupt your sleep and lead to restless nights. Whats more, psoriatic arthritis is associated with an increased risk of other illnesses that are linked to sleep disturbances or fatigue, including:
S To Managing Your Mental Health
1. Manage your stress
Obesity and weight gain have been identified as risk factors for PsA,
2. Be honest
People with PsA who get social support be it from friends, family, co-workers, or even from fellow patients on a forum feel better day-to-day, and are likely to be happier.
3. Take it one day at a time
When youre feeling low, you might find it easier to deal with the mental health implications of your PsA if you stop worrying about the future and the hurdles you might face. Try to focus on the present moment, rather than the bigger picture.
4. Refresh your knowledge
You might know a lot about PsA already, but whether youre an expert or someone whos just found out about psoriatic arthritis, keep yourself educated with the latest news and whats on the horizon. You can find more about currently available treatments in the What treatments are out there section.
5. Get your symptoms under control
A life-long condition like psoriatic arthritis may make some people feel as if theyre not in control.
6. Get some sun
Being outside, even on a cloudy day, exposes you to light, which could help reset your biological clock and help you sleep better.
7. Speak to people who understand
8. Seek professional help
Everyone has times where they feel a bit low, but depression is different,
Other Ways To Reduce Stress
Stress is a common trigger for PsA flare-ups. Incorporating the following stress-reducing habits into your daily routine can go a long way in helping manage your condition:
- Exercise and meditation. When you exercise, you increase your production of endorphins, chemicals that boost your mood and energy. Try low-impact exercises that are easy on your joints, such as swimming or cycling. Meditation can calm racing thoughts and relieve anxiety.
- Follow a healthy diet. A healthy diet can not only make you feel better physically, but it can also have positive effects on your mental health. Consider avoiding alcohol and smoking as well, as these may make your symptoms worse.
- Find a support network. Develop a circle of close family and friends who are able to help when called on, especially when youre struggling with fatigue. You can also reach out to others living with PsA on forums and support groups online.
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What Is Rheumatoid Arthritis
While OA is considered a degenerative disorder, rheumatoid arthritis is a systemic autoimmune disease in which the mechanisms that normally protect your body attack your own joints and tissues. RA causes inflammation at the joints and surrounding tissue, typically affecting the body symmetrically . It usually involves multiple joints at the same time, beginning with the small joints of the hands and eventually progressing to larger joints, such as the hip and knees.
RA is caused by a combination of genetic and environmental factors, with smoking and obesity being two of the most common modifiable risk factors. RA is both chronic and progressive, meaning theres no cure and it usually worsens over time, with years of inflammation at the joints leading to erosion of the cartilage and eventually bone, but there are treatments available.
Add Stretching Relaxation And Vitamin D To Your Routine To Stave Off Flares And Have More Feel
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A chronic, inflammatorydisease of the joints, psoriatic arthritis can often cause pain and tenderness, according to Zhanna Mikulik, M.D., a rheumatologist at The Ohio State University Wexner Medical Center in Columbus, OH, who specializes in psoriatic arthritis. This pain usually affects the connection points for tendons and ligaments, and it can either advance slowly with increasing intensity, or come on quickly. Whatever the progression, managing pain is an important part of dealing with PsA.
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Stick To A Relaxing Bedtime Routine
A good nights sleep is essential for combatting fatigue. A relaxing routine at night can set you up for success.
Try taking a warm bath to ease your joint pain each night before bedtime. If possible, go to bed and get up at the same time every day.
Here are a few more tips for a healthy sleep routine:
- Avoid alcohol, nicotine, and caffeine.
- Keep your bedroom cool and dark.
- Turn off computer, cellphone, and TV screens before bedtime.
- Keep electronics out of the bedroom.
- Avoid large meals before bedtime
Tips To Manage Psoriatic Arthritis Fatigue
If you have psoriatic arthritis and need a nap to get through the day, some simple changes can boost your energy and make you feel better.
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What Psoriatic Arthritis Fatigue Feels Like: What Patients Say
We asked several of our CreakyJoints Psoriatic Arthritis Patient Council members to help us paint a picture of what PsA fatigue feels like. Read on and see which descriptions resonate with you.
Fatigue is:
- Overwhelming the littlest tasks take the most effort. Ashley K.
- A really heavy feeling that I cant shake. Im awake, I cant focus, and I cant fall asleep. Jaime H.
- Like getting a blood draw, but instead of taking blood, the energy slowly gets pulled from my body. Diane T.
Fatigue makes me:
- Just sit in my chair for two hours. I cant summon the will to get up and move. Eddie A.
- Not have control of my day and my body. You wake up and you dont know if youre going to be functional, or do what you had planned for, and that in itself is a journey that Im still working through. Ashley
- Feel guilty, like I should have been there for this or that, I should have left earlier, or I should have done more. Eddie A.
- Feel like I have the flu. Im utterly tired and have to lie down or sleep. Frances D.
If fatigue were an animal, it would be:
To live without fatigue would mean:
Mental Health Effects Of Psa
Along with its physical symptoms like painful, swollen joints, back and neck pain, and skin rashes, psoriatic arthritis can also affect your mental health.
You may feel frustrated with how the pain makes it harder to manage your day-to-day life and perform tasks. You may worry about the costs of treatment, or how youll manage in the future as the disease progresses. If you also experience psoriasis, the plaques on your skin may be a source of embarrassment and cause low self-esteem.
You may also experience brain fog that makes it difficult to concentrate and causes memory loss. In other words, living with PsA is often a tremendous mental burden.
Its important to treat your mental health as you would your physical health. Talk to your healthcare provider to discuss treatment options, and take time for self-care.
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Descriptive Study Of Studied Sample
The main epidemiological, clinical and treatment data are on Table 1. In this sample the median Beck inventory was of 14 : minimal anxiety was found in 20/54 , light anxiety in 17/54 , moderate in 9/54 and severe in 8/54 . The median CES-D was 18.5 and 4/54 had minor depression and 24/54 had major depression. In 28/54 an association of anxiety and depression was seen.
Table 1: Descriptive study of 54 psoriatic arthritis patients. View Table 1
The median SF-12 mental domain was 50.0 and the physical of 35.4 .
Psoriatic Arthritis And Brain Fog
Some people find that psoriatic arthritis leads to another kind of fatigue: brain fog. People have reported problems with concentration, memory and other thinking skills.
In part, this fuzzy-headed feeling may be the result of not getting enough sleep at night because of chronic pain. Its also possible that the inflammation caused by psoriatic arthritis may affect brain function in some way.
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A Recent Study Examined The Association Between Skin And Musculoskeletal Involvement And Sleep Fatigue And Depression And Found The Need To Look Beyond Objective Measures Of Disease Activity
Clinicians need to look beyond objective measures of disease activity to address the full burden of psoriatic arthritis on an individual patient, according to co-authors of a recent study on the prevalence of sleep disturbances, fatigue, and anxiety/depression in patients with PsA.1
Take Note
- “We need to screen every patient in rheumatology for these issues, which are often hidden but can contribute to their disease. Inflammation status remains high when there is inadequate rest.” –Nilanjana Bose, MD, MBA
In this cross-sectional study of 137 patients with PsA seen at a Norwegian outpatient clinic, none of the variables studiedsleep disturbance, fatigue, and anxiety/depressionwere independently associated with any objective measures of musculoskeletal involvement or skin involvement.1
Notably, however, patients perceptions of pain and physical impairment were strongly associated with sleep disturbances and fatigue, and fatigue was significantly associated with anxiety/depression.1
This study is so pertinent to our day-to-day practice, Nilanjana Bose, MD, MBA, a practicing rheumatologist in Houston, not involved in the study, told MedPage Today. It brings to light important issues we see in our patients, and it shows how important it is that we take the time to ask our patients about sleep issues.
Key findings
In the univariate linear regression analysis, using Z scores for the independent variables, the investigators found1:
Managing Fatigue With Psoriatic Arthritis
Unlike feeling tired, a good nights sleep isnt a simple fix for fatigue, but it can help. In fact, developing good sleep habits is an important part of dealing with fatigue. Depending on the underlying cause of your fatigue, your rheumatologist may also recommend the following:
- Lifestyle changes
- Medication adjustments
- Therapy and mental/emotional help through support groups
Fatigue is complicated and feeling better is a gradual process, says Dr. Ogdie. It may take time, but it is possible to get back on track and feel better.
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Talking To Someone You Trust Can Make A Big Difference
Whether its to a relative, friend, partner or healthcare professional, never be afraid to open up about how youre feeling.
There are lots of professionals to help you through the tough times, this could be your local GP or someone at beyondblue, SANE or Lifeline. If you think you need it, asking for help could be the most important thing you do today.
Early Signs And Symptoms Of Psoriatic Arthritis
Early signs and symptoms of PA include pain and swelling just like other forms of arthritis, but what distinguishes psoriatic arthritis symptoms is the sausage-like swelling of the fingers and toes, says Dr. Graham. PA can also cause skin rashes on the extensor surfaces of the body , which can lead to the development of silver-like plaques. Pitted or dry nails are common presentations as well, according to Dr. Graham.
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Fake It Until You Make It
Even if youre not in the mood, try pushing yourself to do things that once brought you pleasure, says Dr. Bartlett, paraphrasing the well-known quote: Its a lot easier to behave yourself into a new way of thinking than to think yourself into a new way of behaving. Get up and go for that walk or get yourself dressed and meet a loved one in the park.
Managing anxiety, depression, fatigue, and other mental health issues on top of an already challenging conditions like psoriatic arthritis is not easy but it is essential and acknowledging that its necessary is a great first step. The mind-body connection is so important, says Ashley K. Many people dont realize how much emotions can affect the body.
There are no quick fixes or easy answers, but you can take comfort knowing that your health care providers and the greater chronic illness community are there to help along the way.
Dont Let Stress Build Up
Lets face it, stress is pretty unavoidable in hectic lives. Add PsA to the mix of potential worries such as money, work and relationships, and stress is bound to rear its ugly head from time to time.
Its important to know what really puts pressure on you. Think about ways to avoid those situations occurring in the first place, and the best ways of dealing with them if they do.
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Maintain A Healthy Weight
Being overweight means your body has to work harder just to accomplish the simplest of tasks. Throughout the day, this can make you feel more tired than if you were at an ideal body weight. Being overweight can also make you less likely to exercise and feel more depressed. Your weight might not be the cause of your fatigue, but losing as much excess weight as possible could improve your overall energy level.
Is Your Psa Under Control
Getting the right medical treatment for PsA is important. Not only can it slow or stop permanent joint damage, but it also helps relieve swelling and pain.
Need another reason to make disease control a top priority? When you have swollen or painful joints or visible signs of psoriasis, you may be more likely to have symptoms of depression. If you have moderate to severe psoriasis, drugs that target your immune system may also help your depression. Ask your doctor if they might be right for you.
On the flip side, depression — and its siblings, stress and anxiety — can cause PsA symptoms to flare. So be sure to tell your doctor about your emotional symptoms as well as your physical ones. Whether you need medicine, advice to manage stress, a âprescriptionâ to exercise, or all of these, odds are good that the right treatment for one condition will improve the symptoms of both.
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The Complex Relationship Between Psoriatic Disease And Mental Health
Judith Duncan, 28, had a really difficult time accepting her psoriatic arthritis diagnosis in 2018. I was really struggling with the fact that I was 25 and my body was completely failing me, she tells SELF.
Prior to her diagnosis, Duncan lived with depression and anxiety that she was managing well enough to stop taking medication. When she was diagnosed with psoriatic arthritis, she decided to get back on medication. The constant pain and drastic changes in her health and life made her feel really down and anxious, and she had a hard time coping. I couldnt handle the emotional toll it was taking on me and the embarrassment of it. At 25, you should be able to do everything, and I could barely walk five steps without crying. It was really tough.
These arent simply isolated anecdotes. There is a well-established link between psoriatic arthritis and mental healthparticularly anxiety and depression. A 2020 systematic review published in the journal Clinical Rheumatology found a high prevalence of depression and anxiety among people with psoriatic arthritis.1 In fact, according to that research, one in three patients with psoriatic arthritis has at least mild anxiety, and one in five has at least mild depression.
Treating Psoriatic Arthritis And Chronic Fatigue
Treating psoriatic arthritis can help reduce fatigue as well as pain. There are several medications doctors use to treat the disease:
- Nonsteroidal anti-inflammatory medications reduce pain and swelling.
- Cortisone injections and oral steroids can quickly reduce inflammation in the short term.
- Disease-modifying antirheumatic drugs protect joints by decreasing inflammation.
- Biologics target specific parts of the immune system and block the inflammation.
Still, medications may not eliminate fatigue completely, especially during a flare. Thats a tough pill to swallow when weariness is keeping you from doing what you love.
But there are ways you can maximize the time youre feeling good. While fatigue in people with psoriatic arthritis cant be cured, it can be managed, Dr. Rosian says.
These tips can help you fight fatigue.
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