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Is there a Link between lack of sleep ( working nights ) and symptoms made worse??

Hi everyone, happy new year! My name is Antony, I've had RA for 4 years, I'm on enbrel and mtx! Am also on nortriptyline as I get fibro pain too, and struggle sleeping for over an hr at a time. I work in a warehouse on a forklift truck doing shift work! I do really struggle and had my hours reduced from 12 hrs to 8 hrs by asking for reasonable adjustments under the disability act. I still have to make my 12 hours up at other times. For the winter I have been taken off shift work, due to the cold etc and stiffness and pain! My manager wants me back on shift come April time but I really struggle on night shift, lack of sleep and fatigue etc etc, but I asked him if I could stay on a day shift instead of nights if I can find some medical evidence that, working nights and lack of sleep is detrimental to my health and could potentially make my condition worse? I get 3-4 hrs sleep on a night shift and that is waking every hour too!! He will consider this so this is where u guys come in? Have anybody come across any articles or heard anything personally that supports my claim, I have heard that stress can make our symptoms worse but can't find about lack of sleep!! Hope you can help??

Thanx everyone

Ant. X

9 Replies

Hi Antony,

I was really interested in your post as I have just taken the very difficult decision to give up work completely for a while because I am convinced stress and lack of sleep makes my RA worse. I am a teacher and I can no longer physically and mentally work the 10-12 hour days that the job required, as well as look after my family.

My RA is not hereditary and I am convinced that it is my stressful lifestyle, which also leads to interrupted sleep, that has brought the disease on so rapidly. I rarely sleep more than 4-5 hours and I am awake for much of that time! I am taking sulfasalazine, hydroxychloroquine, methotrexate and naproxen and the disease is more active than ever so I am about to start Cimzia - and just try to rest!

I really hope you can find more evidence that stress and lack of sleep (and cold weather) make the condition worse. And I wish you all the very best in trying to change your working conditions and some pain free days xxx


Hi Waylade

I got ill-health retirement from teaching because I wasn't up to the pace of the job any more - I was pretty broken by the end. However since I haven't been teaching my health is vastly improved. I am absolutely sure though that if I went back to that way of life I would soon be right back to square one.

Good luck with changing your life.

Dotty x


Many thanks for your encouraging comments, Dotty. Today is the first day of the new term ... and I haven't had to spend the weekend preparing etc. I am beginning to feel better already! xxx



One problem with RA type problems is tiredness the other are the medications that we take so the DMARD and BIOLOGIC will also cause some problems as will the AD. You have not said if you are taking the NSID type medication also. You seem to be well and truly coked up, know wonder you are tired.

The work you do, at the moment is during the day, the weather is cold and you are driving a forklift truck I suppose the seat will be shallow and not really give support. While the steering may be a taxing on shoulder and spine Your lower back will be effected by the seat. The shoulders and neck will be effected by the steering

Sorry for above thinking out loud.

One first thing you could try is take your daily medications at night with exception of the NSID this will help you sleep.

do that as well with any pain control. The reason for this is to help you sleep, this works. If you go back on night shift reverse that medication for when you go to bed.

At work try and give more support to the spine and shoulders by extending your seating position. Sit nearer to the steering wheel by adjusting the seat if possible so that your arms are not extended and this will give some extra support to the shoulders.moving the seat forward will also take some pressure of the buttoks, hips and thighs.

Try putting a length of foam on the seat between seat, knee and thigh. to relieve the lower spine you can purchase a type of cushion that is cut away fro wher the old tail used to be. Try and extend the back of the seat to support the spine.

Above is only suggestions I have no real idea what your condition is, although I take it it is something to do with the back and shoulders

With above you know where the problems are so things need to be done to support your condition.

Try the medications, that is what I do and it works to some extent, I sleep for at least 6/7 hours each night and can actually go back to sleep if required.

Remember we take medications to help us, if they are causing problems, try taking them at different times this makes the tablets work for your lifestyle

All the best



I googled "RA and shift work" and found this:


which is from a medical journal. I think shift work damages your white cells or at least, your immune system.

I have read that quality sleep is needed for a healthy immune system.

So, yes, there is evidence out there.

Also. lack of daylight affects the immune system, and the lack of Vitamin D that the daylight might give you.

I find this all very interesting, as I have lost the ability to sleep and its doing me no good at all!


Hi Ant, so sorry you're suffering but sounds like your manager is reasonably supportive. I don't know about any articles, but if you ring the nras helpline they might be able to help? They have so much information and knowledge and are always amazing whenever I've called them.

From personal experience, if my sleep pattern is disturbed for more than 4-5 nights it does make me flare and I've experienced this a couple of times now. My sleep does seem to be very directly connected to my disease activity and it's the main thing I work really hard at ensuring doesn't get disturbed. My husband knows to sleep in the spare room if he's been to the pub and will snore excessively!!

Good luck and it hope your work continues to support you in staying at work. I would of thought that there ought to be some health and safety regs about operating machinery?

Let us know how you get on. Rx


Ant, I've also just googled 'is RA made worse by poor sleep and I got an interesting article from Arthritis Today arthritistoday.org/news/sle... It's suggest that Poor Sleep is Linked With More Disability in RA. Might be worth a look. Rx


Cheers everybody for ur help there does seem to be a lot of info out there, so il keep investigating and hopefully get off my nightshifts all the time!!

Thank u

Ant x


Hi ant, I was told by my consultant that a poor sleep pattern would definitely make my ra worse. She gave me amitriptyline to help me sleep through the night. I too have a stressful job as a college lecturer and my consultant said I had to choose the job or my health.

Sorry I have no research evidence, but my consultant was very sure of the impact so mayb ur consultant could write a letter to ur boss stating this - mine offered to.

good luck in ur search



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