Six months out and my new knee still wakes me at 3am, stiff as a board and aching. When did you finally get a full night back?

Writing this at ten past six because I've been up since three, again. Left knee done in January, I'm 66, and daytime me is doing great, you all talked me down over the swelling last month and that's settling. Nighttime me is a wreck.

Here's the pattern. I fall asleep fine, on my back, wedge under the leg. Somewhere around 2 or 3 I wake up and the knee has gone stiff like it's been set in concrete, deep ache right through the middle of it, and it takes ten minutes of bending and shuffling to get it to loosen. Then I'm awake. If I try to roll onto my side, which is how I slept for 66 years, the weight of the top leg pulling on it is a no, and lying on the operated side feels like lying on a doorknob. I've tried the pillow between the knees, I've tried no pillow, I've tried a heating pad, I've tried going to bed later. My husband has moved to the guest room "for a while" which was three weeks ago.

Is this still normal at SIX MONTHS? The PT said sleep comes back "eventually" and I want a number. And is there a trick I'm missing, because I am genuinely getting worn down and it's making the daytime worse too.

Bev, I had both of mine done and the nights were the last thing to come right both times, later than the walking, later than the stairs, later than driving. The 3am concrete knee was my exact experience. What I worked out, eventually, is that it went stiff BECAUSE I'd finally slept still for a few hours. During the day I never stayed in one position long enough for it to set.

Side sleeping came back for me around 8 or 9 months the first time, closer to 7 the second, and the thing that unlocked it was a thicker pillow than I thought I needed, a proper firm one, so the top knee was fully supported and not hanging. The doorknob feeling on the operated side never fully went, so I sleep on the other side. Not the answer you want, I know.

Get up and do six slow bends over the edge of the bed the second you wake, don't lie there fighting it. Took my knee from a ten minute ordeal to about two. Four years out now and I sleep any way I like, for what that's worth at 3am.

Bev, you asked for a number, so here's the range as best the women on this site and the recovery literature agree on it. Broken sleep is close to universal in the first six to eight weeks after a knee replacement. By three months most women are sleeping better than they were before surgery. By six months the majority are sleeping through most nights, but a real minority, and I'd put it at maybe one woman in four or five, are still getting woken by the knee, and it usually keeps easing through the second half of the first year. Sleep being the very last thing to come right, after walking and stairs and driving, is the normal order, exactly as Sue said. So six months and still waking is on the map. It is not the part of the map anybody enjoys.

Why it happens is worth knowing because it tells you what to do about it. Sue has it right: the knee stiffens because you finally held still. A healing joint pools fluid and tightens when it's not moving, which is why the first hour of the morning is stiff too, and a few hours of sleep is the longest stretch of stillness your knee gets all day. So Joan's advice is the good stuff: bend it a handful of times before you try to sleep, and bend it gently the moment you wake instead of lying there tensed against it. The deep ache in the middle at night is the healing bone and soft tissue, and the doorknob feeling on the operated side is the skin and the nerve around the scar, not the implant. That patch stays sensitive for a long time, and for some of us it is why the other side becomes the sleeping side for good.

The things that actually moved the needle for me, at about the same point you are now: getting the swelling down earlier in the evening, feet up after supper rather than at bedtime, because a knee that goes to bed puffy wakes you up; an ice pack for 15 to 20 minutes right before lights out; a firm pillow that holds the whole top leg level when side lying, not a squashy one; and no heating pad on a swollen knee, which made mine worse. And I stopped being a hero about the pain relief plan my surgeon's office had given me for nights; that is a conversation for you and them, not for a forum, but a knee that wakes you every night is a reason to ask them for one, not to tough it out. Sleep loss makes pain louder the next day and then the pain wrecks the next night, and the emotional side of living with joint pain article covers that loop because it matters more than people think.

The line where it stops being a forum question: night pain that is getting worse rather than better month on month, a knee that is hot or red, a fever, or new calf pain. That list is short and it is not what you've described. What you've described is a stiff, tired, six month old knee and a woman who needs her husband back in the bed. The week by week recovery guide has the long tail of this laid out if you want to see where you are on it.

One more for the pile: I couldn't sleep on my side for months and it turned out part of it was the mattress. It was old and I sank into it, which pulled the knee inward. New firmer one and the side sleeping came back within a couple of weeks, at about 8 months. Didn't do it for the knee, did it because my husband finally snapped, but it fixed the knee too.

Report from three and a half weeks later, written at a civilized hour for once.

What changed: feet up straight after supper like Diane said, ice at lights out, the six bends the second I wake, and I called the office and they gave me a proper plan for nights instead of me white-knuckling it, which I should have done in June. Bought the firm pillow. Did NOT buy a mattress, Patty, though I've stopped ruling it out.

Result is I'm still waking up, but it's maybe two nights in five instead of five in five, and when I do wake it's two minutes of bending and back to sleep instead of an hour of lying there furious. Slept on my good side for the first time on Tuesday with the big pillow and the top leg fully propped, about four hours, felt like a holiday. The operated side is still a doorknob and I've made my peace with that. Husband is back. Marking this one solved enough.