How JA Can Affect Sleep

Getting enough sleep is important for any child’s well-being and development. But for children with juvenile arthritis (JA), getting enough sleep so they're well-rested can be difficult.

Compared to kids without the condition, research shows that children with arthritis have more difficulty falling and staying asleep, says Sharron Docherty, a pediatric nurse practioner anc assistant professor at the Duke University School of Nursing in Durham, North Carolina. They’re also more likely to wake up too early in the morning and have trouble falling back asleep, she says.

Docherty was a part of a research study that found children with arthritis had less slow wave sleep than kids without arthritis.

Slow wave sleep, also known as “deep sleep,” is the restorative phase in a sleep cycle. Not getting enough can cause brain fog and impaired memory.  For children, slow wave sleep is especially important for normal growth and development, says Docherty.

There are a few reasons why children with arthritis might experience poor sleep. Psychology researchers at the University of North Carolina at Chapel Hill found that depressed mood was linked to poor sleep quality in children with juvenile idiopathic arthritis (JIA).

Children who reported feeling sad or down during the day reported poor sleep quality at night, says Maggie Hood Bromberg, PhD, the leader of the study and a clinical child and adolescent psychologist in Seattle, Washington.

The study also found a strong relationship between pain and sleep quality . Children who experienced more pain, on average, also reported poor sleep. Interestingly, other factors, including the number of joints affected and overall disease severity, did not correlate with sleep quality, says Bromberg.

What the study doesn’t explain is whether pain and depressed mood are a cause or result of poor sleep. Bromberg suspects it’s probably a combination of both. Children with pain and sadness may have worse sleep quality, which in turn, can lead to even more pain and sadness the next day, says Bromberg. But more research is needed to better understand this complex relationship, she says.

Additionally, teens who have hectic schedules filled with challenging classes, lots of homework or after school activities may have trouble getting enough sleep.

“Teens may get into a cycle where they come home from school exhausted, take a two- or three-hour nap, then stay up late and don’t get enough sleep,” says Marisa Klein-Gitelman, MD, professor of pediatrics at Northwestern University Feinberg School of Medicine and division head of rheumatology at Children’s Hospital of Chicago.

To help your children get better rest, Bromberg recommends trying the following:

• Discourage your child from taking daytime naps.
• Prohibit caffeine consumption in the afternoons and evenings.
• Encourage a relaxing bedtime routine — such as taking a warm bath or listening to relaxing music instead of watching TV, playing video games or focusing on social media or their phone.
• Make sure your child gets regular cardiovascular exercise, which has been shown to improve sleep, mood and pain. But Bromberg cautions: “If your child has activity limitations, speak to her doctor about the appropriate type and amount of exercise.”

Other tips include:

• Encourage your child to go to bed and get up at the same time every day, even on the weekends.
• Make your child’s room a no-electronics zone. Some research says using electronics before bed can interfere with sleep quality.
• Avoid serving your child big meals right before bedtime.
• If possible, have your child take sleep-disturbing medications (like prednisone and hydroxychloroquine), earlier in the day rather than in the evening.

If it seems like you and your child have tried everything, and sleep problems persist, talk to your child’s doctor about other ways to get better rest.

Reviewed 3/15/22