Wanted: A Good Night’s Sleep

Atopic dermatitis (AD) is a common skin condition among infants and children, and it causes an intense itching that can lead to interrupted sleep, as the child wakes throughout the night to deal with the uncomfortable sensations and to scratch. As any parent knows, when your child doesn’t sleep well, you don’t either, and the sleep disruption from AD can affect the whole family. In school-age children, sometimes the lack of sleep can lead to behavior problems and poor school performance.1-3

In addition to the goal of a good night’s sleep, treating and managing the itch-scratch cycle associated with AD is also important to minimize the disease, reduce the risk of infections, and reduce the chance of long-term scratching causing lichenification, a thickening of the skin that is chronically itchy.4

Tips for a good night’s sleep for children with AD

Here are some tips to help your child with AD sleep better:

  • Bathing – A short (about 10 minutes) bath before bedtime can help hydrate skin that is irritated by AD and also helps remove bacteria from the skin that can lead to infections in children with AD. The bathwater should be warm, but not hot, as hot water can trigger itchiness. Use non-soap cleansers or a soap that has a neutral pH and isn’t drying to the skin. After the bath, gently pat the skin dry with a towel (it’s okay to leave a little dampness as that helps replenish the skin’s needed moisture).
  • Moisturizing – The use of moisturizers is one of the most important steps in treating and managing AD, and applying moisturizer just after a bath is critical to lock in the moisture from the water. If possible, apply the moisturizer within 3 minutes.
  • MedicationsTopical medications are often prescribed for AD and should be applied to affected skin before the moisturizer is applied to all skin.
  • Wet-wrap therapy – One technique that is helpful in treating flares of AD is the use of wet-wrap therapy, in which a wet dressing is placed over the medicated skin. The wet dressing can be moistened gauze, cotton, bandages, or wet pajamas, which are covered by a layer of dry pajamas. Wet-wrap therapy helps the medication for AD to absorb better and provides a physical barrier against scratching.
  • Antihistamines – Your doctor may recommend using antihistamines, which have a sedating effect and may help manage the itchiness at nighttime.
  • Comfy pajamas – Scratchy fabrics can be a trigger for AD, making comfy pajamas more important than ever. Many man-made or synthetic fabrics, such as rayon, acrylic, nylon, polyester, spandex, or modacrylic (often used in children’s sleepwear to be flame-resistant), can be irritating to kids with AD. Look for pajamas made from natural fibers, like cotton or silk.
  • Humidifier – The lowered amounts of humidity in the air during the winter months can worsen the dryness of the skin and aggravate or trigger AD. Try using a humidifier in the room to put some moisture back in the air.
  • Identify and avoid triggers – In addition to scratchy fabrics and dry skin, it’s important to identify what triggers your child’s AD. AD damages the skin’s natural barrier, which can make the skin more sensitive to substances in the environment. It’s important to identify and avoid irritants, such as wool, some soaps or laundry detergents, cleaning solutions, dust, sand, cigarette smoke, or chemicals. Other common triggers include allergens, sweat or excess saliva left on the skin, and stress.5-6

Get expert advice

Not all children with AD experience difficulty sleeping, but if your child is having trouble sleeping because of his or her skin condition, talk to your dermatologist, who can recommend a treatment plan to manage the symptoms of AD and help your child – and you – get a better night’s sleep.

View References
  1. Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology, and treatment. Immunol Allergy Clin North Am. 2015;35:161-183.
  2. Mayo Clinic. Accessed online on 7/11/17 at http://www.mayoclinic.org/diseases-conditions/eczema/basics/complications/con-20032073
  3. National Health Service (UK). Accessed online on 7/11/17 at http://www.nhs.uk/Conditions/Eczema-(atopic)/Pages/Complications.aspx
  4. Yarbrough KB, Neuhaus KJ, Simpson EL. The effects of treatment on itch in atopic dermatitis. Dermatol Ther. 2013;26:110-119.
  5. American Academy of Dermatology. Accessed online on 7/11/17 at https://www.aad.org/public/diseases/eczema/eczema-resource-center/what-to-watch-for/sleep-loss
  6. Barham KL, Yosipovitch G. It’s a wrap: the use of wet pajamas in wet-wrap dressings for atopic dermatitis. Dermatology Nursing. 2005;17(5):365-367.

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