Part of self-care involves treating yourself from time to time. But it can be confusing to know what’s more important: strictly following your RA-friendly diet, or allowing yourself to indulge in comfort foods every now and then. Ultimately, because there’s no one-size-fits-all diet for RA, you should mostly focus on eating a balanced, healthy diet. One caveat: Suleman Bhana, MD, FACR, rheumatologist at Crystal Run Healthcare in Middletown, New York, recommends avoiding simple or processed sugars — including things like high-fructose corn syrup — which can exacerbate inflammatory conditions like RA. But that doesn’t mean you can’t enjoy a sweet treat once in a while. “I like my cheesecake and my cup of tea,” says Shilpa Venkatachalam, PhD, associate director of patient-centered research at CreakyJoints and co-principal investigator of ArthritisPower, who also has RA herself. “I have my cheat days and indulgences, too.” It helps to keep a food diary to see which specific types of foods may trigger your RA symptoms, so you know what to generally avoid, says Dr. Bhana. “Don’t just eliminate for the sake of eliminating.” For some, RA pain is what keeps them up at night. “We’ve learned about this term called ‘painsomnia.’ When pain is interfering with sleep, you don’t have insomnia, it’s ‘painsomnia,’” says Dr. Venkatachalam. It’s a vicious cycle, says Partha Nandi, MD, chief health editor of WXYZ-TV ABC Detroit. “When you don’t get enough sleep, you have greater pain severity, more fatigue, high levels of depression, and greater difficulty functioning with RA,” he explains. Even if you don’t have trouble falling asleep, anything from joint pain to racing thoughts may prevent you from staying asleep and getting the rest you need. But there are steps you can take to try to get the quality sleep you need. For starters, it helps to practice good sleep hygiene, says Bhana. This includes things like:
Avoiding caffeine after 4 p.m.Avoiding screen time before bedInvesting in a comfortable mattress and pillowUsing a white noise machineGoing to bed and waking up at the same time every day
“It’s very helpful to build a ritual before you sleep,” says Venkatachalam. “Don’t go from working on a document or a deadline that you’re really stressed about to immediately going to bed. It has to come gradually.” Certain activities can help you wind down each night, like practicing meditation and mindfulness, says Bhana. “Do a little bit of deep breathing, read a book, dim the lights, have a herbal cup of tea…these are things that I do,” adds Venkatachalam. “Sleep and I are not very good friends,” says Maureen Morely. “Over the past couple of months, I’ve developed a [wind-down] routine that I do every night,” which she says helps her fall asleep. “The key is doing all this before my husband — because he snores, and he falls asleep in, like, two seconds, so I have to coordinate it so I’m asleep before he comes to bed.” If you’ve tried improving your sleep hygiene and wind-down routine and are still having trouble falling asleep or getting quality sleep, make sure you talk to your doctor. “It could be a breathing issue — you may have an underlying sleep disorder, like sleep apnea,” says Bhana. “Seeing a sleep medicine provider and having a sleep study may be helpful to analyze that.” “Hope is a very precious commodity, and worry is its enemy,” says Venkatachalam. “I worry about it myself, as a patient. I worry about the long-term prognosis, and if the treatments are going to continue working. But there is hope.” “I feel very optimistic,” adds Morely. “There’s a lot of stuff out there that can help me on my journey through this. I’m very hopeful that I can live a long and prosperous life.” Between new treatments and more on the horizon, as well as emerging knowledge of steps you can take at home to help you manage your physical, mental, and emotional well-being, there’s never been a better time to have RA, says Dr. Nandi. “We have disease-modifying agents that have really revolutionized treatment and can really help you take ownership of your life.” And more research is on the horizon, too. “There are a lot of smart people around the world who are working very diligently not just on treatments, but also on the underlying fundamental causes of what is hyperstimulating the immune system, how is the immune system hijacked, and how can someone regain back permanent control,” says Bhana. Meanwhile, it’s important for RA patients to also advocate and make their voices heard, says Venkatachalam. “We need more treatments. ‘Fine’ is not fine. We’re not willing to settle for fine. We need to feel better than fine. To do that, we have to work together with clinicians and researchers. There’s a partnership here that’s really important.” And with ongoing collaboration and research, there may someday be a cure for RA. “I’m hopeful that one day we’re not just taking about maintenance treatments,” says Bhana, “but we’re talking about curative treatments.”
