The Effect of Steroids for Inflammation on My Insomnia

My body is no stranger to inflammation. As a kid, it was high sed rates and other inflammatory markers. After college, it was constant physical fatigue far beyond that I’d come to know (and hate) living with insomnia, along with severe GI distress and increased joint pain.

In and out of doctor's offices, I was willing to try any suggestion to help reduce my symptoms. Unfortunately, an often blanket fix offered involved some sort of steroid-like prednisone, budesonide, and/or methylprednisolone – cast a wide net, find some sort of luck.

The high price of relief

I learned quickly that these medications were capable of bringing decent size rewards, but they also came with high prices. In a matter of a few days, I would feel some sort of symptomatic relief – from decreased pain to the slowing of my GI tract, less diarrhea and trips to the bathroom, and a little more energy.

But I’d also feel emotional, anxious, constantly starving, and some intense version of wired. It was clear that when I was on steroids, I also wasn’t quite “myself.”

Wired during the night

It’s no coincidence that the feeling of being wired, or amped up, spilled over into the nights, too. I've joked in the past that when I'm on prednisone, you can either find me cleaning my kitchen or writing a novel around 3 AM. It’s not funny, but I have to just laugh in order to keep my sanity. Something about the way the medication works in my body prevents me from sleeping well, and sometimes at all.

A long road back

As a lifetime insomniac, my sleep schedule and patterns get thrown off easily and take a very, very long time to rebound. While I might only be on a high dose of steroids for a few weeks before tapering off, my sleep is wrecked for at least double or triple that time.

After weaning off steroid medication, I struggle even harder to fall asleep at night. Knowing that the medicine is out of my system, I have nothing to blame but myself (or my insomnia) for my lying awake at night, increasing my frustration and further preventing me from nodding off.

Diagnosed with 2 autoimmune diseases

In 2016, I was finally diagnosed with both Crohn’s disease and rheumatoid arthritis. Both autoimmune diseases feature – you guessed it – inflammation in the body.

Crohn’s disease is a type of inflammatory bowel disease and involves inflammation in the GI tract, anywhere from mouth to anus. Rheumatoid arthritis is a chronic inflammatory disorder involving my tissues and joints.

Understanding my body

After trying a few different medications, my doctors and I finally landed on a biologic which manages both autoimmune conditions. I receive this medication via infusion every 5 weeks, and it keeps my health mostly stable, for which I am unendingly grateful. However – flare-ups and symptom increases do happen with both of my diseases.

And, you guessed it – prednisone is usually the first line of defense offered by my physicians. Today, I understand my body and its responses enough to know when I need to say yes to steroids and when I can pause and ask for other options, or even say no.

Managing expectations and doing what I can

When I agree, I work extra hard to manage my expectations for sleep disruptions and the way they cascade into my mood, mental health, and longer-term effects on my insomnia.

Being proactive

I double down on practicing the best forms of sleep hygiene that work for me, and I build in naps when I’m able. I also talk to my physicians about counteracting the side effects of prednisone with medication to support my sleep in the interim.

Giving my body rest

I’ve found that short-term, taking something like Benadryl or Ambien gives me the opportunity to get rest while allowing my body to heal and prevents the spiral into the depths of insomnia that can leave me unsettled for months on end.

If you've been on and off steroids to manage other health conditions, have you noticed an effect on your sleep disorder? I'd love to hear your experience below.