Q&A 346 - Sleeping, Dermatitis, Psoriasis, Tinnitus, Ringworm



Help, I Can’t Sleep! The Psoriasis-Insomnia Connection

Stop the vicious cycle by practicing good habits for managing symptoms and getting a better night’s sleep.

author-avatarBy Howard Chang

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Itching and pain can lead to poor sleep, and that can make your symptoms worse.
Itching and pain can lead to poor sleep, and that can make your symptoms worse.
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I have blurred memories of my children as infants sleeping at all different hours of the day and night. Fortunately the kids eventually grew out of those early days of mixing up sleep times. Unlike them, though, I’ve struggled much of my life to develop and maintain a regular sleep schedule.

I tell people I’m a night person and like to stay up late. But in actuality, I feel frustrated when I’m lying awake in bed gripped by insomnia. I envy my wife, who can sleep at any time, especially when I wake up in the middle of the night and can’t fall back asleep.

Many of those times, it’s my unrelenting skin irritation and itchiness that keep me from getting a good night’s sleep. Skin flakes scattered on the bedsheet confirm I’ve been scratching at night. What makes things even worse is how lack of sleep is a trigger for my psoriasis and atopic dermatitis. I feel trapped in that vicious cycle of wakefulness that sparks skin inflammation and vice versa.

Recent research shows that I’m not alone.

Insomnia and Psoriasis: A Vicious Cycle

In a National Psoriasis Foundation article about sleeping better with psoriatic disease, Kristina Callis Duffin, MD, MS, an assistant professor of dermatology at the University of Utah in Salt Lake City, describes the insomnia-psoriasis connection.

I can relate to Dr. Callis Duffin’s description of a vicious cycle. “Itching and pain can lead to poor sleep, and poor quality sleep can lead to exhaustion and stress, which can make psoriasis and psoriatic arthritis symptoms worse,” she says.

A study published on April 28, 2019, in theBritish Journal of Dermatologyconfirms how those with psoriasis tend to have more problems sleeping than the general population. The study’s authors enrolled 179 patients with psoriasis and 105 others without psoriasis to compare their sleep habits. They sought to reveal how psoriasis is associated with sleep disturbance and the impact it might have on quality of life.

The researchers found that 25 percent of the people with psoriasis reported clinical insomnia, versus 10.5 percent of those who didn’t have psoriasis. In addition, 53.9 percent of those with psoriasis were poor sleepers versus 21.9 percent of those without.

The authors cited itch as “the main predictor of impaired sleep,” and suggested “improved control of psoriasis with decreased itch may improve sleep disturbance in psoriasis.”

Techniques to Address the Itch

The latest research clearly points to the importance of reducing overall psoriatic inflammation and itching as keys to better sleep for those whose psoriasis negatively affects their sleep quality. Over the years I’ve developed a few ways to reduce my level of itchiness and improve my sleep quality.

Using effective psoriasis treatments naturally reduces psoriatic symptoms like itch. My dermatologist gave me a topical treatment for my scalp, which eased the itch and allowed me to rest. Other treatments, like phototherapy and wet-wrap therapy, have also helped with itchy flares on my skin.

As much as I love a long, hot shower in the winter, I’ve learned to take shorter showers with lukewarm water. If I moisturize immediately after toweling off it keeps my skin from excessively drying out from bathing. I’ll reapply moisturizers a couple of times during the day as needed.

Longer fingernails do more damage when I scratch my skin. I routinely cut my fingernails and file them so no sharp edges remain. At night, wearing cotton gloves also reduces the impact my nails might have on my skin while I sleep.

My dermatologists also have prescribed oral antihistamines to both induce sleep and reduce itch. Over the years, I’ve tried a few different ones. It took trial and error to find the one that works best on itch while not making me too groggy to drive or work the next morning.

Establish Good Sleep Habits

Besides reducing itch, I’ve developed other habits to improve my sleep quality. One major sleep disturbance for me is stress. If I’m experiencing a lot of conflict at home or at work, am behind on deadlines, worrying about my health, or making a major life decision, then my mind won’t rest.

During stressful times, I need to practice effective ways to address the underlying issue, such as talking it out with my wife or quieting down in prayer and meditation.

I’ve learned not to start a project too late in the evening, as it overstimulates my mind when I need to start relaxing.

Another good habit for better sleep is to start routines early, such as exercising earlier in the day. I prefer to exercise later in the evening when it’s cooler or after work. But going on my run later tends to wake me up. My skin-care regimen takes time, so if I start off by showering later in the evening I won’t be ready for bed until later.

A newer hobby for me is coffee. I roast, grind, and brew espresso with beans I purchase online. But drinking coffee after the early afternoon is a recipe for a long night of wakefulness. Saying no to that evening cup of coffee is a choice to sleep better.

Other sleeping tips I’ve tried include making sure the room where I sleep is dark and cool; avoiding long naps close to bedtime; setting a regular sleep schedule; turning off screens like televisions, computers, and cell phones earlier; and reducing ambient noise. I do like my naps after a long day at work, so that’s one I continually struggle with.

Finally, be sure to discuss your sleep patterns with your healthcare provider if you have any concerns, because there could be something else affecting your sleep.

For more tips on sleeping better with psoriasis, see 10 Tips for Overcoming Sleepless Nights With Psoriasis or Sleep Better With Psoriasis on the National Psoriasis Foundation’s website.

You can read more about my experiences in my blog for Everyday Health and on my website.

Last Updated:9/19/2018
Important:The views and opinions expressed in this article are those of the author and not Everyday Health.
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Date: 14.12.2018, 12:25 / Views: 71534