How to Sleep Better With Psoriasis

I have blurred memories of my children as infants who would sleep at all different hours of the day and night. Fortunately, the kids eventually grew out of those early days of mixing up sleep times, but unlike them, I’ve struggled much of my life to develop and maintain a regular sleep schedule.

I tell people I’m a night owl, but in actuality, I feel frustrated when I’m lying awake in bed gripped by insomnia.

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 my pillow and bedsheet confirm I’ve been scratching at night. Waking up in the morning for work feels that much harder when my skin is itchy and I don’t feel rested.

Insomnia and Psoriasis: A Vicious Cycle

Like most people, I don’t feel as productive or focused after a night of broken sleep. Making things even worse is that lack of sleep is a trigger for my psoriasis and eczema. I feel trapped in that vicious cycle of wakefulness that sparks skin inflammation, and vice versa.

In doing a bit of reading online I found that I’m not alone in the battle for a good night’s sleep, and that more than 85 percent of people with psoriasis struggle with this issue.

Researchers at the University of California in San Francisco surveyed more than 3,000 patients through the National Psoriasis Foundation’s Citizen Pscientist online forum and found that the more severe the psoriasis, the greater the sleep disruption and the poorer the sleep quality. They published their findings in the Swiss journal Dermatology and Therapy in September 2019.

A study published in April 2018 in the British Journal of Dermatology further confirmed a link between psoriasis and sleep problems. The authors looked at almost 300 people with and without psoriasis and found that 25 percent of those with psoriasis reported clinical insomnia, versus 10.5 percent of those without psoriasis. In addition, almost 54 percent of those with psoriasis were poor sleepers, versus close to 22 percent of those without psoriasis.

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

Other research points to the importance of reducing overall psoriatic inflammation and itching as keys to better sleep. One recent investigation, published in the Archives of Dermatological Research in October 2019, found that about a third of the psoriasis patients who experienced sleep issues said the problem was itchiness, and that the result of these problems was lowered quality of life.

Techniques to Address the Itch

Over the years I’ve developed a few ways to reduce my level of itchiness and improve my sleep.

Using effective psoriasis treatments naturally reduces psoriatic symptoms like itch. For stubborn problems like my scalp psoriasis, my dermatologist gave me a topical treatment to apply after showering, 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 from psoriasis and eczema.

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

Longer fingernails do more damage when I scratch my skin, so I routinely cut and file my nails 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 doctors have prescribed oral antihistamines to both induce sleep and reduce itch. Over the years, I’ve tried a few different choices. 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.

Establishing 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, like the ongoing pandemic, I need to practice effective ways to address the underlying issue, such as talking things out with my wife or quieting down in prayer and meditation.

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

Another good habit for better sleep is to start routines early. For instance, I prefer to exercise after work and even later in the evening when it’s cooler, but going on a run then tends to wake me up. My skin-care regimen takes time, so if I start off by showering late it throws my sleep schedule off.

I love coffee and have made it a hobby in recent years, roasting, grinding, and brewing 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 for better sleep.

Other sleeping tips I’ve tried include making sure the room where I sleep is dark and cool; setting a regular sleep schedule; turning off screens like televisions, computers, and cell phones earlier; and reducing ambient noise.

I do like naps after a long day at work, but since it can lead to insomnia, I do my best to resist.

More Advice From Experts

Be sure to discuss any problematic sleep patterns with your healthcare provider, because there could be a medical issue involved.

For more tips on sleeping better with psoriasis, sign up to receive the Healthy Sleep Guide from the National Psoriasis Foundation.

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

Important: The views and opinions expressed in this article are those of the author and not Everyday Health.

The Psoriasis-Insomnia Connection and How to Get the Sleep You Need

6 Easy Snacks for Your Anti-Psoriasis Diet