@liz26 I asked my rheumatologist for recommendations for the insomnia, and he didn't have any. I experimented and found that 5 mg of time release melatonin helped me to sleep 5 hours a night. I would be a little groggy during the day afterwards, but it was worth it to get some sleep. You could try a lower dose first, such as 1 or 3 mg.

Regarding another drug, I have had a very good experience with Actemra. It doesn't work completely for everyone, but it does for me. It's expensive though and isn't covered by some insurance plans. Tyenne is a different version of the same drug as Actemra, tocilizumab, and it costs a little less and seems to be covered by more insurance plans.