Does joint pain keep you up at night? At least half of people with osteoarthritis (OA) have trouble falling asleep or staying asleep throughout the night. In fact, research shows that people with hip and knee OA are more likely to have insomnia and daytime sleepiness than those without osteoarthritis.

The OA-Sleep Connection

The relationship between OA and sleep might seem obvious—your arthritis pain makes it hard for you to fall asleep, or it wakes you up in the middle of the night. Pain is definitely an important part of the equation, but researchers are finding that the connection is more complex--and reciprocal. Rather than OA causing insomnia, the two conditions are thought to coexist.

A 2012 study published in the journal SLEEP looked at sleep quality in people who were in chronic pain, including those with osteoarthritis. Here’s what researchers found:

  • The amount of pain that people were in before they went to bed had little to do with how well they slept.
  • A person’s sleep quality predicted how much pain they were in the next day. People who slept poorly had more pain the following day.

How might insomnia lead to more joint pain? Researchers think a lack of sleep may trigger inflammatory pathways that exacerbate arthritis pain. Poor sleep can also make you more sensitive to the feeling of pain, says Michael V. Vitiello, PhD, professor of psychiatry and behavioral sciences at the University of Washington in Seattle. “It’s not that the disturbed sleep makes you achy per se, but the disturbed sleep changes your perception of pain,” he says.

Bothering Your Bed Partner

When osteoarthritis interrupts your sleep, chances are it disrupts your partner’s sleep, too. Lynn Martire, PhD, associate professor of human development and family studies at Penn State University, studied sleep patterns in the spouses of 138 patients with knee OA. She found that when a patient with OA had knee pain at the end of the day, his or her spouse did not sleep as well that night and felt less refreshed the following day.

While the obvious assumption might be that the partner with OA tossed and turned all night, keeping their spouse awake, that wasn’t what Martire found. “We were not able to identify the mechanisms by which a person’s pain affects his or her spouse’s sleep. This is an important goal for future research,” Martire says. She did find that spouses got less sleep when they were in a close relationship, which suggests that empathy for their partner’s pain might play some role in sleep quality.

Studying OA and Sleep

Researchers at the University of Alabama at Birmingham (UAB) have embarked on a study to learn more about the relationship between sleep and pain in people with OA. They will use overnight sleep studies to look at the associations between sleep-inhibiting behaviors, sleep, and pain among people with OA of the knee.