Arthritis pain and stiffness that is tolerable during the day may prevent you from getting good sleep at night. This is bad news, because poor sleep can cause pain to be worse—creating a frustrating cycle of pain and poor sleep.

Joint stiffness and discomfort from osteoarthritis can make it difficult to sleep at night. See Osteoarthritis Symptoms and Signs

If pain and stiffness from osteoarthritis are keeping you from falling asleep or staying asleep, try following these 9 tips:

1. Use heat therapy before bed

Ease a painful joint by using a heating pad for 15 to 20 minutes before bed. You can also take soothing bath for the same effect—just give your body a little time to cool down afterward, because it’s hard to get to sleep if you’re overheated.

See When and Why to Apply Heat to an Arthritic Joint


2. Consider your mattress

A good mattress can make a big difference in your level of comfort and support as you sleep. If you have arthritis, your mattress should be supportive but not too hard. If you can’t invest in a new mattress right now, consider adding a mattress topper.

See 11 Unconventional Tips for Better Sleep

3. Use pillows strategically

How you use pillows can be just as important as your choice of mattress. If you have hip or knee arthritis and like to sleep on your side, you may benefit from a pillow between your knees. If you have shoulder arthritis you may be most comfortable using a wedge pillow and sleeping on your back.

4. Rule out sleep apnea

Being overweight increases the risk of developing osteoarthritis as well as a condition called sleep apnea, which causes sleep to be interrupted throughout the night. It’s possible to have sleep apnea and not know it. If you snore or wake up feeling tired even after a full night’s sleep, talk with your doctor about undergoing a sleep study.

5. Exercise and stretch

People who have arthritis are often hesitant to exercise because they’re afraid of making their pain worse. 1 Gunn AH, Schwartz TA, Arbeeva LS, et al. Fear of Movement and Associated Factors among Adults with Symptomatic Knee Osteoarthritis. Arthritis Care Res (Hoboken). 2017; , 2 Hurley M, Dickson K, Hallett R, et al. Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev. 2018;4(4):CD010842. Published 2018 Apr 17. doi:10.1002/14651858.CD010842.pub2 However, regular exercise tends to decrease joint pain and help maintain joints’ range of motion. 3 Fransen M, McConnell S, Bell M. Therapeutic exercise for people with osteoarthritis of the hip or knee. A systematic review. The Journal of rheumatology. 2002;29(8):1737–45. , 4 Cuesta-Vargas AI, González-Sánchez M, Casuso-Holgado MJ. Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders. Health Qual Life Outcomes. 2013;11:19. Published 2013 Feb 16. doi:10.1186/1477-7525-11-19 , 5 Hurley M, Dickson K, Hallett R, et al. Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev. 2018;4(4):CD010842. Published 2018 Apr 17. doi:10.1002/14651858.CD010842.pub2 Plus, people who exercise regularly tend to sleep better in general. If you’re unsure how to begin a safe exercise program, check with your doctor or physical therapist.

See Knee Stretches

6. Avoid eating after 9 PM

Eating at night is generally associated with poorer sleep. 6 Yahia N, Brown C, Potter S, Szymanski H, Smith K, Pringle L, Herman C, Uribe M, Fu Z, Chung M, Geliebter A. Night eating syndrome and its association with weight status, physical activity, eating habits, smoking status, and sleep patterns among college students. Eat Weight Disord. 2017 Sep;22(3):421-433. doi: 10.1007/s40519-017-0403-z. Epub 2017 Jun 2. PubMed PMID: 28573425. , 7 O'Reardon JP, Ringel BL, Dinges DF, Allison KC, Rogers NL, Martino NS, Stunkard AJ. Circadian eating and sleeping patterns in the night eating syndrome. Obes Res. 2004 Nov;12(11):1789-96. doi: 10.1038/oby.2004.222. PubMed PMID: 15601974. It is also associated with gastrointestinal reflux, 8 Fujiwara Y, Machiada A, Watanabe Y, et al. Association between dinner-to-bed time and gas-tro-esophageal reflux disease. Am J Gastro- enterol 2005;12:2633–6. which can worsen sleep quality even further. Try to stop eating 2 or 3 hours before bedtime to give your body time to digest.

7. Practice good sleep hygiene

Follow habits that promote good sleep, such as:

  • Going to bed at the same time every night
  • Establishing a night routine to prepare your mind and body for sleep
  • Putting away phones, computers, TVs, e-readers, and other light-emitting devices an hour before bedtime

See Therapies for Treating Insomnia

8. Start meditating

Regular meditation has two potential benefits: it may improve sleep 9 Greeson JM, Zarrin H, Smoski MJ, et al. Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated in Stress-Related Disorders: Understanding Relationships between Changes in Mindfulness, Sleep Quality, and Physical Symptoms. Evid Based Complement Alternat Med. 2018;2018:4505191. Published 2018 May 13. doi:10.1155/2018/4505191 and it may decrease chronic pain. 10 Hilton L, Hempel S, Ewing BA, et al. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Ann Behav Med. 2017;51(2):199–213. doi:10.1007/s12160-016-9844-2 There are many ways to meditate. You can sit or lie down. You can experience silence, repeat a word or sound, or try guided meditation, in which another person helps guide your meditative thoughts. Many phone apps, online videos, and DVDs offer recorded guided meditation.


9. Take a nighttime pain reliever

There are several types of over-the-counter and prescription pain relievers specifically intended to both relieve pain and help you sleep better.

Taking a medications daily can put you at greater risk for other health problems, so consider these only if other approaches for reducing pain and getting good sleep do not work. Also, talk to your doctor or pharmacist to make sure your sleep aid does not interact with any other medications or supplements you take.

See Pain Medications for Arthritis Pain Relief

Remember: arthritis, chronic pain, and sleep problems are all treatable. If you’re struggling with poor sleep because of arthritis pain, make an appointment to see your doctor and explore solutions.

See Arthritis Treatment Specialists

Learn more:

Coping with Chronic Pain and Insomnia

2 Ways to Treat Insomnia Caused by Chronic Pain

Dr. Brian Lee is an orthopedic surgeon specializing in the treatment of elbow and shoulder conditions at the Kerlan-Jobe Institute at Cedars Sinai. Dr. Lee has authored research papers, abstracts, and book chapters in the field of shoulder and elbow surgery.