I have atopic dermatitis and am having problems sleeping. What can I do about it?

Unfortunately, people with atopic dermatitis (eczema) often report difficulty getting to sleep and staying asleep. As a result, many people with eczema suffer daytime fatigue that affects their quality of life.

Itchiness and symptoms of eczema tend to be worse at night. That's because about an hour or two before bedtime, the body prepares for sleep by cooling down and lowering the core temperature. During this process, heat escapes through the skin, which contributes to increased itchiness right before bedtime. It's normal to wake up at least 2 to 6 times a night, although you may not remember it the next day. For people with eczema, this nightly sleep-wake cycle may cause itching to start, which leads to reflex scratching during the night.

Having good techniques to manage your eczema is the first step to ensuring a good night's rest. When your eczema improves, so does sleep. If you're having trouble sleeping, try these tips:

  • Use bedding that breathes. Choose sheets and bedding that are made of 100% cotton or other breathable material. This will help regulate your body temperature at night and reduce flare-ups.
  • Take an antihistamine. Antihistamines such as diphenhydramine (Benadryl) may not completely reduce itching caused by atopic dermatitis, but they do cause drowsiness, which may help you sleep.
  • Take a bath or shower before bedtime. A great way to relax, moisture the skin and reduce itching is to take a warm (not hot) bath or shower and then apply a rich moisturizing cream immediately afterward. Limit your bathing time to 10 to 15 minutes.
  • Create a sleep-friendly atmosphere. Keep your bedroom dark, cool and quiet. Dim your household lights several hours before bedtime — exposure to indoor light can suppress melatonin in your body, a hormone that promotes sleep.
  • Go to bed and get up at the same time every day. Your body has an internal clock (circadian rhythm) that regulates many functions, including the sleep-wake cycle and hormone release. Consistency makes it easier for your body and brain to fall asleep and wake up feeling refreshed. Try to stick to the same sleep schedule, even on weekends.
  • Limit screen time before bedtime. The blue light emitted from a screen (computer, tablet, cellphone, TV) can suppress melatonin. Establish a nightly routine of turning off all electronics one hour before bedtime. Wind down with a quiet and relaxing activity such as gentle stretching, writing in a journal or reading.
  • Reduce information overload. Watching negative news before you go to bed can put your mind in an anxious state that can lead to bouts of insomnia or other sleep problems. Set limits on how much news programming you watch during the day and make your bedroom a tech-free zone.
  • Exercise regularly, but time it right. Regular exercise helps you fall asleep and get better quality sleep. But revving your heartbeat too close to bedtime can wind you up, instead of down. Save more-vigorous exercise routines for the morning or afternoon. Plus, moderate-intensity exercise in the morning promotes deep sleep.
  • Manage stress. Try to resolve your worries or concerns before bedtime. Experiment with aromatherapy, deep breathing, journaling or meditation.

If you continue to have problems sleeping, talk to your doctor to discuss possible treatments that might help you get better sleep.

June 29, 2021 See more Expert Answers