Interrupted Sleep and Fatigue Due to Atopic Dermatitis

Atopic dermatitis (AD) can cause an intense itch that is difficult to impossible to ignore. Scratching the itch only leads to temporary relief as the scratching causes the skin to feel even itchier. This sequence has been labeled the “itch-scratch cycle” of AD and is believed to be a key component to the continuation of the skin condition.¹

Unfortunately, the itchiness doesn’t take a break at night, and the itching and scratching during the night can be a source of significant sleep problems for the person with AD, as well as their family members or sleep partners. Parents of children with AD are impacted by the interrupted sleep just as much as their children, and the lack of sleep and fatigue take a toll on everyone’s daily life.

Measuring the burden of fatigue and sleep interruptions

A recent survey aimed to determine the burden of sleep loss and fatigue on adults with AD. More than 5,500 U.S. adults with AD were given a questionnaire about their history of AD, their sleep disturbance, and how fatigue impacts their daily activities. The survey found that adults with AD have significantly impaired sleep and are greatly impacted by the accompanying fatigue.

Compared to healthy people without AD, survey respondents have higher rates of sleep disturbances, shorter sleep duration, trouble falling asleep, and early morning awakenings. Adults with AD were also found to have significantly higher odds of feeling unrested and unable to perform daily activities. While AD interrupts sleep, the survey found there is not an association between having AD and having a diagnosis of a sleep disorder (like insomnia or sleep apnea). Despite survey respondents being more likely to report their sleep disturbances to their doctors, the research team concludes that sleep disturbances may be underdiagnosed among people living with AD.²

Techniques for a good night’s sleep

If you’re suffering from lack of quality sleep and fatigue due to AD, try these strategies to help you sleep better:

• Talk to your doctor. Make sure you tell your doctor about the severity of your symptoms of AD, like itch, and how it’s impacting your sleep.
• Use your medications properly. The medications used to treat AD, including topical corticosteroids, topical calcineurin inhibitors, and immunomodulators, can help reduce the symptoms of AD, including itch.
• Try antihistamines. In addition to your other medications for AD, talk to your doctor about using antihistamines before bedtime. Antihistamines often have a sedating effect, and they may help with itch.
• Soak in a bath. Taking a short (about 10 minute), warm bath before bedtime can hydrate your skin, reduce the itchiness due to dry skin, and help you relax.
• Use plenty of moisturizer. Apply a generous amount of moisturizer to your skin after bathing. Moisturizers are critical for people with AD and can help reduce dry skin, another trigger for itching.
• Snuggle up in comfy pajamas. Choose pajamas that are made from fabric that is comfortable and not itchy. Many man-made or synthetic fabrics (like rayon, acrylic, nylon, or polyester) can be irritating to skin affected by AD and may trigger itching.
• Use a humidifier. A humidifier can add moisture to the air, which is critical in dry environments and during winter months when the ambient humidity is lower.³