Many PV symptoms can make it hard to sleep. So can the stress and anxiety that often come with a diagnosis.
“Patients living with PV often struggle with sleep due to severe nighttime symptoms, including heavy night sweats, intense skin itching, painful sensations, and restless legs,” says Mohamad Khasawneh, MD, a hematologist and medical oncologist with Loyola Medicine in Tinley Park, Illinois.
Addressing sleep issues may take a multipronged approach that involves treatment of the underlying disease and lifestyle measures.
1. Create a Relaxing Environment
Make the bedroom a calming space. “Focus on establishing a relaxing bedroom environment that is cool and dark,” says Dr. Khasawneh. Use a fan or turn down the temperature, and consider blackout curtains if too much light comes through your windows. Make sure your bed is comfortable: Replace your mattress if it doesn’t give your body the support it needs.
2. Practice Relaxation Techniques
It helps to calm and clear your mind before bedtime with activities such as deep breathing, meditation, or journaling. “Developing a calming pre-bedtime routine and addressing physical discomfort right before sleeping can help you fall asleep easier and stay asleep longer,” says Khasawneh.
3. Avoid Blue Light
The type of light that comes from electronic devices can affect your sleep. Studies show that it can disrupt your natural sleep cycle or circadian rhythms, and also suppress the production of melatonin, a hormone that regulates sleep.
“If you have trouble falling asleep, turn off electronic devices at least 30 to 60 minutes before bedtime and avoid any exposure to bright lights,” says Jennifer Martin, PhD, a clinical sleep psychologist based in Miami and a spokesperson for the American Academy of Sleep Medicine. “When awake at night, avoid electronics, keep your phone out of reach, and use dim light if you need to get up during the night.”
4. Stick to a Routine
A consistent schedule is one of the most important sleep-promoting strategies. “This is especially important in the morning,” says Dr. Martin. “Getting up at the same time each morning encourages strong circadian rhythms, and can help with solid sleep.”
Try to keep both your bedtime and waking time the same every day, including weekends. But if you have trouble falling asleep, it’s better not to stay in bed tossing and turning. Get up and do something relaxing like reading or listening to music, then return to bed when you feel sleepy.
5. Keep Naps to a Minimum
6. Avoid Heavy Meals, Alcohol, and Caffeine Near Bedtime
You don’t want to go to bed hungry, but eating too close to bedtime can be disruptive to sleep. One study found that nighttime awakenings increased by about 40 percent when a meal was eaten within three hours of bedtime.
7. Manage Night Sweats
“Night sweats are a symptom patients with PV might experience,” says Martin. “This is due to the body producing excess levels of cytokines, a type of protein that causes inflammation, which leads to excessive sweat.”
You may find relief by practicing good sleep hygiene and consulting with your healthcare provider about the best management options for your specific situation. “Keeping the room cool is especially important,” says Martin. “Keep an extra set of pajamas nearby in case they are needed.”
8. Keep Itching Under Control
Itching is a common symptom of PV, especially itching that is triggered by contact with water. It can be challenging to manage, and in some people, itching can become severe enough to interfere with sleep. Treatment may include lifestyle measures, over-the-counter drugs, and prescription medicines.
If itching is triggered by water, avoid bathing in the evening before you go to sleep. Other measures include taking shorter baths or showers, using cooler water, moisturizing your skin immediately after bathing, and using anti-itch creams or oral antihistamines.
Treating the underlying disease is often the most effective strategy to relieve itching, and the medications or other treatments your doctor prescribes to control PV may also soothe your skin and help you sleep. In some cases, antidepressants such as selective serotonin reuptake inhibitors are prescribed for PV-related itching.
9. Control Pain
Many people with PV experience pain and discomfort at one time or another, and in various ways. “Physical PV symptoms such as numbness, tingling, burning, or weakness in the hands, feet, arms, or legs, and painful swelling of joints can make it difficult to settle in for a good night of sleep,” says Martin.
Pain-management strategies depend on the type and cause of pain. The first step is to discuss the situation with your healthcare team and get the okay before you take any medications or supplements.
Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter and are usually effective for mild to moderate pain. If your pain is more severe, your doctor may prescribe an opioid. It’s important to take this type of medication as directed. Anti-seizure drugs like gabapentin can help with nerve pain.
Aside from medications, there are other interventions that can be used for both pain and to help you sleep, including acupuncture, hypnosis, meditation, relaxation techniques, music therapy, yoga, and massage therapy.
10. Get Screened
It’s possible that some of your sleep disruptions may be related to an underlying sleep disorder, such as insomnia. If you have symptoms like trouble falling asleep at night, trouble staying asleep, waking up earlier than you want in the morning, or feeling tired during the day, talk to your doctor about treatment options. “This can include optimizing PV symptom management or directly addressing insomnia symptoms with cognitive-behavioral therapy approaches,” says Martin.
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