Rheumatoid arthritis patients' experiences of night pain

Night pain is a significant problem for many patients with rheumatoid arthritis (RA), but clinicians often overlook it. This study aimed to explore the issue of night pain among patients with RA both at home and in the hospital setting.

This was a qualitative study involving in-depth interviews among 8 hospital inpatients with established RA. Each interview was recorded, transcribed, and underwent framework analysis.

The following themes were identified: Night pain in RA is a significant problem both at home and in hospital. All patients had established routines that they used in the home setting when disturbed by night pain. This often included getting out of bed and walking around, making hot drinks, and/or taking extra painkillers. These activities were often curtailed in the hospital setting for fear of disturbing other patients or the nurses. The effect of disturbed sleep and night pain on other people, be it partners or family members at home or patients and nurses in the hospital, was raised by all interviewees.

Night pain in particular appears harder to control in the hospital setting than at home, and some of this may stem from lack of a tailored routine and fears of disturbing others. Information could be provided when patients are first admitted to the ward. This could describe or orient patients to the facilities available, which may be beneficial in the management of night pain. Further work on identifying influences upon night pain needs to be undertaken.