In this blog I discuss the issues and some solutions for disturbed sleep with Ankylosing Spondylitis (AS). This also applies to Axial Spondyloarthritis (axSpA), Spondylitis, and any other form of Spondyloarthritis.
- My experience of living with AS for 50 years and lessons about sleep
- What are the issues with sleep and AS?
- 10 tips from Yoga for AS for sleep.
I've lived with AS for nearly 50 years, first symptoms in November 1973. From about the mid 1990s, I used to fall asleep during the day and also wake up in the middle of the night. My circadian rhythm, daily cycle, was all over the place.
My pressure to sleep was intense, at the wrong times.
It’s only been in recent years that I’ve found how yoga can help with sleep problems. Breaking out of the downward cycle of pain, sleep loss, fatigue is a huge issue for me.
- Regular safe practice of yoga modified for your individual AS.
- Breath work.
- Deep relaxation.
What the issues with sleep and AS?
1. Pain from lying on areas of the body affected by inflammation. That is what is waking us up at night.
I didn't know that it was the pain that was waking me up at night, and for many years I didn't even know I had AS.
According to the NICE Guidelines: “Waking during the second half of the night because of symptoms”, is common in AS. Nighttime waking is one of the NICE Guidance criteria for referral to a UK Rheumatologist.
Learn more here
At night we are lying on areas of inflammation anywhere in the body, especially the sacroiliac joints and the neck. This pressure hurts! That pain can be relieved by spreading the load.
For example, the science of memory foam is that it spreads the load, which is why many of us have memory foam mattress toppers.
The NICE Guidance says another reason for seeing a Rheumatologist is there is: “Improvement with movement”.
There is also plenty of science behind some of the yoga practices that can help you with your sleep.
2. Getting back to sleep
My wife says there were many years when she would wake up and I was not in bed. I had woken up, given up and gone to sleep on the settee, eventually. But there are solutions that work in Yoga for AS.
3. Pain and fatigue led me to daytime sleeps at the wrong times
This in turn affected my getting to sleep at night. This downward cycle is typical of a lot of long term health conditions like AS.
It may be that sleep disturbance and disturbance of circadian rhythm are contributors to AS fatigue.
10 tips from Yoga for AS for sleep
1. Regular safe practice of Yoga for AS tailored to your individual AS.The NICE Guidance section (1.4), “Non-pharmacological management of spondyloarthritis” says people with AS should start
This free 20 minutes yoga class is simple, easy and can help to reduce your pain and stiffness. Go to our Free Resources Page and check out:
2. Wind down before bed with some yoga breathing
And also when you can’t get back to sleep. Learn more about the
3. Try a yoga nidra for getting back to sleep
4. Get morning sunlight before 10.00AM
So in the morning try to get sunlight especially before 10 AM, even if it’s overcast, just getting outside that can help to set our circadian rhythm (the body's inner sleep clock). This is a point from Jamie. In a future blog post, Jamie will discuss what we can do throughout the day to improve sleep quality. Stay tuned!
5. Daytime naps can help, if between 1pm and 3pm
Recognise that we all have a daily rhythm called the circadian rhythm. This rhythm can be very fixed or very flexible and everything in between.
Napping in these times is much less likely to disturb your night time sleep.
Lastly try to keep these naps to under 90 minutes.
6. Improving your posture can help you get comfortable in sleep
Go to our Free Resources Page and check out:
"Quick tips to improve your posture with Ankylosing Spondylitis"
7. Educate yourself about sleep and AS
Watch this free, 23 minutes NASS sleep tips video, with AStretch
In summary, Emily Clarke, formerly AS Specialist Physiotherapist at the Royal National Hospital for Rheumatic Diseases in Bath, England, reports evidence about sleep and AS:
8. Use a Yoga Nidra recording to make up for lost sleep at night
Learn more about Yoga Nidra here.
9. Yoga can be effective in relieving the fatigue from broken sleep
Try out this session Jamie did with NASS:
10. Watch this free Yoga for AS video on solutions for AS sleep problems
Toolkit for Sleep https://hubermanlab.com/toolkit-for-sleep/ September 19, 2021