Sleep and Eczema

Sleep issues are common in people with eczema, a condition that causes itchy, inflamed, or irritated skin. And lack of sleep can aggravate eczema, as well. About 47% to 80% of children and 33% to 87% of adults with eczema report having problems falling and staying asleep.

Good sleep is vital for healthy brain function and general physical health. It has much to do with how you perform during the day and your overall quality of life.

This article discusses how sleep and eczema are related, how to promote better sleep, and when it's time to talk with your healthcare provider.

The Connection Between Sleep and Eczema

The link between sleep and eczema goes both ways. It's also possible to have eczema and an unrelated sleep disorder.

Does Eczema Affect Your Sleep?

There are multiple reasons why someone with eczema would have trouble sleeping.

Itching (pruritus) and scratching are major factors in sleep disturbances. Studies show that itching is associated with poorer sleep quality and more frequent and longer awakenings. And scratching may keep you in a more superficial, less restorative stage of sleep.

Do Sleep Problems Affect Eczema?

Poor sleep quality can affect immune function, exacerbating eczema and creating an unhealthy cycle. However, more research is needed to fully understand this relationship.

Types of Sleep Issues Likely Caused by Eczema

A study involving more than 34,000 adults found that eczema in adults is associated with several sleep problems, including insomnia, which is characterized by trouble falling asleep, trouble staying asleep, or both.

Having eczema may lead to sleep problems such as:

• Difficulty falling asleep: Your body loses heat in the hours leading up to bedtime due to the body's sleep-wake cycle. Warmer skin can increase itchiness when you're ready to nod off.
• Nighttime waking: Most people wake up briefly several times a night, and doing so can make you more aware of eczema's itch and prompt the urge to scratch.
• Shorter sleep duration: Waking up often and having trouble getting back to sleep can affect your overall sleep health. Getting back to sleep can be much harder when you wake up close to morning.
• Daytime sleepiness: Poor sleep or lack of sleep at night can make it hard to function during the day. While your skin may feel better during the day, and napping can help you feel temporarily refreshed, it can also make it harder to sleep at night.
• Fatigue: Poor sleep quality can lead to fatigue. It can involve weakness and problems with concentration and memory. It can also affect your emotional health.

Treatments for Eczema-Related Sleep Issues

Managing eczema is the first step in improving eczema-related sleep problems. Treatments include topicals, medications, and home remedies.

Topicals

Itching and scratching appear to be a big contributor to eczema-related sleep problems. Using topical creams just before bedtime may help soothe the skin, ease inflammation and itching, and help you fall asleep. Medications include:

• Topical corticosteroids: These over-the-counter (OTC) medications come in various strengths. If they don't work, ask your provider if prescription-strength corticosteroids would be a better option.
• Topical calcineurin inhibitors: Your healthcare provider may recommend these if you've already tried corticosteroids.

Other Medications

When topicals aren't effective, stronger medications might be the next step. These are typically for short-term use to get severe eczema under control:

• Immunosuppressants: Available in oral and injectable forms, these medicines tamp down the immune system, which can help control flare-ups (times of increased symptoms).
• Oral corticosteroids: These anti-inflammatory medicines may help when symptoms are severe.
• Antibiotics: These medications treat or prevent bacterial infections due to broken or damaged skin.
• Antihistamines: Antihistamines can help relieve the itch, plus they have a sedative effect that may help you fall asleep.

Home Remedies

Here are a few home remedies for eczema that may help:

• Apply moisturizer at bedtime.
• Use a humidifier in the winter and set the temperature at 68–72 degrees F.
• Use an air-conditioner in the summer to prevent sweating, which can lead to excessive itching and rashes.
• Avoid long, hot showers and baths. Keep showers short and at a lukewarm temperature. This helps protect the skin's natural barriers against irritants. Apply moisturizer immediately.
• Avoid products that contain fragrances or preservatives.
• Choose clothing made from breathable fabrics rather than potential irritants like wool and tweed.

Lifestyle Changes for Sleep Issues

There are some natural ways to help you sleep better, including:

• Make a sleep schedule: Try to go to bed and get up at the same time every day, on weekends too.
• Get physical: Aim for some daily exercise, but it's best to do it early. Exercise in the hours before bedtime can make it harder to fall asleep.
  
• Skip the nap: If you need a rest, keep it short and only sleep until midafternoon.
• Seek out natural light. Try to get outside for at least half an hour of natural light daily.
• Eat and drink light: Large meals or alcohol before bedtime can interfere with sleep.
• Avoid stimulants: Caffeine and nicotine can contribute to sleep problems.
• Create a sleep sanctuary: Banish electronics from the bedroom or turn them off well before bedtime. Keep the room dark and quiet. Do something quiet and relaxing in the hour before sleep.
• Get up if you can't sleep: Trying too hard can make matters worse. If you can't sleep, get out of bed and do something relaxing. Go back to bed when you start to feel sleepy again.
  

When to See Your Healthcare Provider

You probably don't need to see a healthcare provider for an occasional bad night, but never underestimate the benefits of a good night's sleep. If eczema is regularly robbing you of restorative sleep, it can quickly become a quality-of-life issue. Consider seeing your provider if:

• You've tried managing eczema, but the itching and scratching keep you up at night.
• You've tried lifestyle methods of improving sleep, which is not helping.
• Lack of sleep affects the way you function during the day. You're more prone to mistakes and accidents.
• Sleep issues are creating additional physical or emotional problems.

See a provider immediately if you have signs of skin infection, such as fluid oozing from the skin, swelling, or fever.

Summary

Sleep problems are common among people with eczema, and nighttime itching and scratching may be the biggest reasons. It may also be that insufficient sleep contributes to worsening eczema symptoms. The first step is to get eczema under control.

Treatment options include topicals, immunosuppressants, and home remedies. You can also make certain lifestyle adjustments, such as creating a sleep routine, which may improve sleep. If sleep problems persist, see your provider.

A Word From Verywell

If you have eczema-related sleep problems, you're certainly not alone. And you don't have to accept it as inevitable. Good sleep is far too important to your physical and mental well-being to dismiss. Your provider can help you manage the symptoms of eczema and help you sleep better. If necessary, they can also refer you to a sleep specialist.