Eczema And Sleep

Introduction

If you are suffering from eczema, there is a high chance that you are facing sleep-related problems. In people with eczema, sleep loss is common. Sleep disturbance affects up to 60% of children with eczema, which increases to 83% during exacerbation. 

What is eczema?

Eczema, also known as atopic dermatitis, is a complex disease. It occurs after interaction between our genes and the environment. It is a common, relapsing skin disease which is characterised by itchy skin (pruritus), disrupted epidermal barrier function, and sensitivity n to food and environmental allergens. Eczema belongs to a type of dermatitis, which is a group of conditions that cause inflammation. Eczema can develop at any age, and it can often occur when you have a history of family allergies or dermatitis.  The first symptoms of eczema often present as itchiness, dry skin, inflammation, and swelling.  Infants and children are more prone to developing eczema.

Symptoms

The symptoms of eczema include: 

• Swelling 
• Dry skin
• Thick and leathery patches on the skin
• Flaky, scaly or crusty skin
• Bumps on the skin
• Itchy skin
• Skin rash

The symptoms of eczema tend to appear on your hands, neck, elbows, knees, and face. 

Lack of sleep often worsens eczema symptoms

Sleep has positive effects on wound healing. The healing of wounds is linked with the growth of tissues, and wounds heal when tissue growth occurs. Our tissue growth occurs when we are in the 3rd and the 4th stage of our sleep, or around 70% of our rest. Therefore, we can say that the more peaceful the sleep, the more our tissues will grow, leading to more effective wound healing. 

Pro-inflammation

Sleep deprivation is linked to inflammation. When a person does not have a supportive sleep cycle, they experience an increased level of inflammatory markers such as interleukin 6, C-reactive protein, and cytokines. These inflammatory markers lead to inflammation, and are also a sign of pro-inflammation. Similarly, when we sleep, our blood pressure declines and the blood vessels relax. It has been suggested that when our  sleep is disturbed, our blood pressure does not decrease. The cells in the walls of the blood vessel become triggered and cause inflammation.

Hormonal dysregulation

Lack of sleep can have negative effects on hormone levels. According to studies, hormones such as melatonin, leptin, and growth hormones are closely related to sleep and circadian rhythm, meaning they are affected by sleep deprivation which can then lead to hormonal dysregulation. 

The cycle of eczema and lack of sleep

According to studies, in 47 to 80% of children and 33 to 93% of adults, eczema is believed to be the major reason for sleep disturbance. It is listed as 1 of the 3 major trouble-causing symptoms in patients with eczema. The sleep disturbances in eczema patients are often related to the intense itching that eczema sufferers experience. Frequent nighttime awakenings, inability to fall asleep, and daytime sleepiness are the most common sleep-related problems faced by eczema patients in both adults and children. Itchiness can disrupt sleep because the itch  is often at its worst at night. It is also believed that melatonin secretion in eczema patients areis lowered, which contributes to sleep-related problems. Doses of melatonin supplements can improve the quality of sleep in patients. 

What can you do to improve sleep quality during an eczema flare-up?

You can improve the quality of sleep during an eczema flare-up in the following ways:

Moisturise before bed

The reason to use moisturisers is to maintain skin hydration. Moisturisers consist of a mixture of oil and water. Other than lotions, moisturisers can also be found in the form of ointments, creams, and skin barriers. The greater percentage of oily content in the moisturiser, the more it will help in treating eczema. 

Wet wrapping

Wet wrapping can be an effective way to treat eczema. Combined with moisturiser, it provides prolonged contact with the affected surface. This will ensure increased absorption of medication alongside prolonged hydration. Furthermore, it will help you in preventing frequent scratching. Wet wrapping should be used cautiously in patients. Prolonged use of wet wrappings can lead to secondary infections and impact skin functions. A combination of wet wrapping, a moisturiser, and a corticosteroid can provide abrupt relief from itching. 

Find out whether your eczema prefers warmth or cold at night

Sometimes eczema is triggered by warmth or cold at night. It is recommended  that you find out which temperature your eczema is triggered by, and avoid that temperature at night. For example, if heat causes your eczema to flare up at night and cause itching, then avoid high temperatures at night. 

Smooth sheets

As mentioned above, eczema has the appearance of leathery patches. There are chances that a rough bed sheet might cause  itching or irritation on the affected part of your body. Cotton and other natural materials tend to trigger eczema in winter. Therefore, it is recommended to sleep on  smooth, polymer fabric bed sheets that do not contain allergens so as to avoid nighttime eczema flare-ups. 

Conclusion

Eczema is a skin condition that causes  your skin to become inflamed or irritated. It most often affects your ankles, knees, faces, and hands. The symptoms may include skin rash, dry skin, and thick, leathery patches on the skin. It is believed that sleep deprivation can lessen our wound-healing abilities, as  the growth of tissues takes place in our sleep.  Not having enough sleep will automatically halt the healing of our wounds. Lack of sleep can also cause inflammation due to an increase in inflammatory markers. Furthermore, it also affects  our hormones and leads to hormonal dysregulation. Due to itching and scratching movements that are worse at night, patients with eczema may have trouble falling asleep, causing daytime sleepiness, and frequent nighttime awakenings. Melatonin levels are also believed to be lower in eczema patients. Moisturisers such as lotions and ointments containing oily content are used to treat eczema flare-ups at night. Bed sheets are also believed to trigger an eczema flare-up due to their rough surfaces therefore smooth sheets are recommended.  A combination of moisturisers, wet wrapping, and steroids is also effective in treating and providing relief from eczema flare-ups.