Quick answer: Sleep problems with arthritis are not always caused by joint pain alone. Common causes include night pain and stiffness, more active inflammatory arthritis, medicines such as steroids, needing the toilet at night, restless legs, sleep apnoea, worry or low mood, and fibromyalgia. Work out what is waking you, then ask the right person: your GP, pharmacist or rheumatology team. Do not change prescribed medicines yourself.
"I can't sleep" can have several causes when you live with arthritis, and joint pain is not always the only one. Working out what is actually waking you makes it much easier to fix, and to ask the right person for help. Use this page as a checklist. For tonight's routine, see our main how to sleep with arthritis guide, and for the link between bad nights and worse pain, read poor sleep and arthritis pain.
Common causes, what helps and who to ask
1. Night pain and stiffness
Joints often ache when you are still, and turning over can hurt. What helps: settle pain before bed and support sore joints with pillows; see our sleep positions guide and pain relief guide. Who to ask: your GP or pharmacist about your pain relief plan.
2. More active inflammatory arthritis
In rheumatoid arthritis, pain and stiffness are often worse in the morning and after rest, and morning stiffness often lasts longer than 30 minutes. Night pain, swelling or long morning stiffness that is new or getting worse can mean your arthritis is more active. Who to ask: your rheumatology team or advice line, as your treatment may need reviewing. See the rheumatoid arthritis hub and the flare-up guide.
3. Medicines
Some medicines can affect sleep. For example, the NHS advises taking prednisolone in the morning, with breakfast, so it is less likely to affect your sleep. Some painkillers can cause drowsiness in the day, which can upset your sleep pattern. Who to ask: your pharmacist or GP. Do not stop, skip or change the timing of prescribed medicines yourself, and never stop steroid tablets suddenly.
4. Needing the toilet at night
Getting up to pee is harder with stiff joints, and night trips in the dark raise the risk of falls. What helps: a night light and a clear path; see our night-time toilet trips guide and falls prevention guide. Who to ask: your GP if night-time peeing is new or getting worse.
5. Restless legs
Restless legs syndrome causes a strong urge to move your legs, often with tingling, throbbing or pain, and is usually worse at night when resting. It can be linked to iron deficiency anaemia, kidney disease and some medicines. What helps: the NHS suggests a regular sleep routine, a warm bath or stretching before bed, and no caffeine after midday. Who to ask: your GP if it is stopping you sleeping.
6. Snoring and daytime sleepiness
Loud snoring, gasping or choking noises in your sleep and feeling very tired during the day are the main signs of sleep apnoea. Who to ask: your GP. Read our sleep apnoea guide. If you drive and feel very sleepy in the day, check the driving advice with your GP.
7. Worry and low mood
Stress, anxiety and depression are among the most common causes of insomnia, and they are common with long-term pain. Who to ask: your GP, or in England you can refer yourself to NHS Talking Therapies. See our arthritis and mental health guide and depression guide.
8. Fibromyalgia
Fibromyalgia can stop you sleeping deeply enough to feel refreshed, so you may wake tired even after plenty of sleep. Who to ask: your GP. See our fibromyalgia overview.
9. Your bedroom and habits
The NHS lists noise, a room that is too hot or cold, an uncomfortable bed, and alcohol, caffeine or nicotine among the common causes of insomnia. What helps: try one change at a time. There is no single best mattress for arthritis; something supportive that does not sag suits many people, and a topper is a cheaper first step.
Before you see your GP
- Keep a two-week sleep diary noting what woke you each night; our sleep and pain guide has a simple template
- Bring a list of all your medicines and supplements, with the times you take them
- Ask: "Could any of my medicines be affecting my sleep?", "Could this be restless legs or sleep apnoea?" and "Is CBT for insomnia available here?"
- If a carer or partner notices snoring, gasping or kicking, bring them or their notes
When to get urgent help
- Call 999 or go to A&E for chest pain, severe breathlessness or sudden confusion
- Get urgent advice from NHS 111 or your rheumatology team if a joint becomes hot, red and very swollen, especially with fever
- If you feel you cannot keep yourself safe, call 999. You can also call Samaritans free on 116 123
Frequently asked questions
Can I take an over-the-counter sleep aid?
Ask a pharmacist first, as some can interact with arthritis medicines or leave you drowsy the next day, which raises the risk of falls. Our sleeping tablets and falls guide explains more.
Is it my arthritis or something else keeping me awake?
It can be both. Pain is a common cause, but restless legs, sleep apnoea, toilet trips, medicines and worry are all worth ruling in or out with your GP.
I care for someone who sleeps badly. What can I do?
Note what you see at night, help them keep a regular get-up time, and make the route to the toilet safe and well lit. A carer's assessment can help if your own sleep is suffering.
Sources and further reading
- NHS: Insomnia
- NHS: Restless legs syndrome
- NHS: Sleep apnoea
- NHS: Prednisolone
- NHS: Symptoms of rheumatoid arthritis
- NHS: Symptoms of fibromyalgia
- NHS Talking Therapies
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- How to sleep with arthritis — what to try tonight
- Poor sleep and arthritis pain — break the cycle with a diary
- Sleep positions — joint by joint
- Sleep apnoea — snoring and daytime sleepiness
- Night-time toilet trips — safer nights
- Arthritis and mental health — worry and low mood
- Flare-up guide — when night pain spikes
- Newly diagnosed — first steps