Does a lack of sleep affect eczema?

It seems particularly unfair that a lack of sleep would affect eczema. Often it is itchy skin that is causing insomnia in the first place! This article looks at why sleep deprivation may worsen skin symptoms and suggests tips that may help soothe the skin and improve sleep.

Does lack of sleep affect eczema?

Not only can eczema and its symptoms interfere with sleep, not getting enough sleep can also make the condition even worse. Lack of sleep affects eczema by hindering how well the skin barrier and the immune system works. Chemical processes that increase inflammation, sensitivity and pain are also influenced by sleep deficiency.

Lack of sleep and its impact on eczema

All of us have experienced days when a lack of sleep made us feel cranky, irritable or under the weather. Sleep deprivation has been linked to poor health; stress, psychiatric disorders, depression, heart disease, diabetes and digestive complaints including IBS.(1)

Eczema is called the 'the itch that rashes.' It is associated with poor sleep and no wonder! It is super-uncomfortable, with patches of the skin that can be sore, red, dry, cracked and itchy. Eczema symptoms can worsen at night and disturb a good night's rest. The end result - sleep deprivation can then trigger changes in the skin that can worsen the overall condition, and here is why.......

A lack of sleep increases skin sensitivity

Eczema sufferers who have disturbed sleep are more likely to be super-sensitive to sensations of discomfort or pain.(2) Even one night of sleep loss can amplify the perception of discomfort, whether pain, cold or pressure.(3)

Add to that, those who suffer from chronic eczema or atopic dermatitis are also more likely to be sensitive to itch. They call this alloknesis, when even the lightest touch of something like clothing provokes extreme itchiness. Hyperknesis is when something is itchy but feels far more intense than is normal.

It's very difficult to find a distraction from itchiness, particularly when trying to fall to sleep. Meditation and deep breathing may help ease some of this stressful situation and relax the body.

A lack of sleep affects the skin’s protective barrier

A lack of sleep will worsen eczema symptoms because it interferes with how well the skin barrier and the immune system work.(4) During the night, many regeneration processes happen while we are asleep. DNA is repaired during sleep and wounds are healed. Disturbed sleep will therefore interfere with the skin's ability to mend any eczema scratches and irritations. It causes the keratinocyte cells in the skin to become more active and to increase inflammatory immune reactions. The skin will become itchier and slower to heal.

Insomnia can become more prevalent as a person ages and adults may develop eczema later in life. As their immune system becomes less efficient, their skin becomes drier.

Skin permeability is at its highest during the night, which ultimately may mean that the skin is at its driest during the night. The drier the skin is, the more irritated and itchier eczema will tend to be. The fringe benefit of this permeability is that the skin will be better at absorbing moisture and studies have suggested that before bed is the most effective time for eczema patients to apply moisturisers and topical medications.(5)

Simply having a cool-ish shower before bed and moisturising while the skin is slightly damp can further improve the penetration and water content of the skin. I like to use plant-based, rich creams, such as Neem Cream, to calm any soreness, redness or irritation. A chef I knew, years ago, first put me on to neem products. He swore that it was good for everything from sweat rashes to chapped knuckles, and has been used by mankind since prehistory to treat an astonishing range of ailments.

Tips for getting to sleep

A large American population-based study concluded that treatments improving sleep would improve the lives of eczema patients.(6) Sleep has beneficial effects on skin and overall health, and the following tips may help establish a regular sleep pattern that may ease eczema symptoms.

Go to bed at the same time every night, preferably before 11pm. Getting up at the same time every day helps too. I set a reminder on my phone for 10pm to help me stick to a routine. I do enjoy that last hour.
Put away all electronic devices, screens, phones for one hour before you turn in. The blue light in these screens has been shown to disturb the body's ability to produce melatonin (our sleep hormone). Interestingly, melatonin dysregulation has been associated with eczema.(7) Curl up with a book or have a cuddle: old-school fun.
Try a herbal sleep remedy such as Dormeasan to help restore a natural sleep cycle.
Ensure that your bedroom is at the right temperature, not too hot. Use clean, natural bedding made from natural plant fibres like cotton - as recommend for troublesome skin conditions.