From everydayhealth.com
From itchy skin to ongoing stress and anxiety, psoriasis symptoms can make getting a good night’s sleep difficult.
Taking steps to better control your symptoms and make your sleep space as comfortable as possible may help reduce night-time flare-ups and help you get better shut-eye. Here’s a look at dermatologist-backed tips for managing psoriasis and improving sleep quality.
Optimize Your Skin Care Routine Before Bed
Adjust Your Treatment Plan
If plaques or rashes are keeping you awake, it may be time to review your medications. Your doctor may adjust your medications or introduce a new one, whether they’re topical creams, medicines taken by mouth, or biologics, says Chris Adigun, MD, a board-certified dermatologist in private practice in Chapel Hill, North Carolina. “As a dermatologist, I’m going to focus on the skin disease component of your care first. The best thing I can do in my role is optimize disease control,” she says.
When psoriasis is under control, it should affect 1 percent or less of your skin, says Steven Daveluy, MD, a professor and director of Wayne State University School of Medicine's dermatology residency program in Detroit. He specializes in treating patients with skin diseases such as psoriasis and eczema. “We have such great options for psoriasis, that everyone's skin should be clear or almost clear. The right treatment plan can significantly reduce night-time itch and help you sleep better,” Dr. Daveluy says.
Take a Warm Bath or Shower Before Bed
A warm — never hot — shower or bath can help loosen and remove scales, which may otherwise make itchiness worse. This can be especially helpful if you have visible plaques or build-up on your skin, says Lawrence Green, MD, a clinical professor of dermatology at George Washington University School of Medicine in Washington, D.C.
Moisturize Immediately After Bathing
Timing matters, and you should apply moisturizer right after bathing, says Dr. Green. He recommends using thick, heavy creams or ointments — think jar-based products rather than pump lotions — to help seal in moisture and reduce itching overnight.
Petroleum-based moisturizers, like Vaseline, tend to work best for psoriasis, particularly on stubborn or itchy areas. “These heavier-cream moisturizers help prevent the scales from building up because that, again, can be causing a lot of itch,” he says.
Some people do well with using salicylic acid, lactic acid, or urea creams or lotions to help soften thick scales, says Mary Wu Chang, MD, an associate professor of dermatology and paediatrics at the University of Connecticut.
Look for “sensitive-skin,” or “fragrance-free” labelling, since these products have the least risk of irritation, too, Daveluy says.
Use Topicals That Target Itch Relief
Using prescription topical treatments, including topical steroids, should also help to soothe your psoriasis itch, Daveluy says. But for lingering itch, use of some over-the-counter anti-itch products may offer short-term relief, like pramoxine and menthol, he says.
Take an Oral Antihistamine or Sleep Aid if Needed
Antihistamines don’t treat psoriasis-related itch, because this itch isn’t driven by histamine, a chemical your immune system releases. But taking antihistamines can help some people fall asleep. Look for over-the-counter sedating antihistamines or natural sleep aids like melatonin, Dr. Chang says. “This would be more of an add-on medication to use from time to time, rather than a cure for problematic sleep from psoriasis,” she says.
Dr. Adigun says you can take an antihistamine for just a few nights as you bridge the gap with your new treatment plan, which could take up to two weeks.
Keep Fingernails Trimmed
As an extra layer of protection, wear cotton gloves if you find you’re scratching yourself at night, Daveluy says. “[Gloves] can also help keep creams or ointments on the hands, if you have psoriasis there,” he says.
Create a Psoriasis-Friendly Sleep Environment
Even with well-controlled psoriasis, your sleep environment can soothe your skin — or make night-time itchiness worse. Dermatologists recommend creating a sleep space that stays cool, breathable, and gentle on skin through small adjustments:
Keep the Room Cool
Sleeping in a cooler room — aim for around 68 degrees F — can help prevent overheating and sweating, which can make itching worse and disrupt sleep, says Chang. A fan gently blowing across the bed may also feel soothing. This is especially important for children with psoriasis, who can become hot and uncomfortable if they’re over-bundled at night, she says.
Choose Breathable Fabrics
Wear lightweight, breathable fabrics such as cotton or bamboo, because they're less likely to irritate psoriasis-prone skin, Daveluy says. He notes that natural fabrics are generally better than synthetic ones, which can trap heat and moisture.
Unlike atopic dermatitis, psoriasis is generally less sensitive to fabric types or thread count, Green says. Your goal is to pay attention to which fabrics may be rubbing against plaques or triggering itchiness, he suggests.
Do Laundry With Gentle Detergent
Scented detergents and fabric softeners contain chemicals that can irritate sensitive skin, Daveluy says. Dermatologists recommend using fragrance-free, dye-free products like Tide Free and Gentle or All Free Clear, Chang says. “Also skip the fabric softener and use dryer balls to bounce around in the dryer and soften fabrics,” she says.
Practice Good Sleep Hygiene and Relaxation Techniques
When you’re facing symptoms like itchiness, anxiety, or stress at night, your bedtime routine is going to make a difference. That’s why dermatologists talk to their psoriasis patients about sleep hygiene, Green says. “It’s about creating an environment that is in your favour when you're already working against something,” he says.
- Set up — and stick to — a consistent bedtime and waking schedule.
- Make sure your room is dark and quiet.
- Limit your exposure to bright lights in the evening.
- Turn off your electronics about an hour before bedtime.
- Keep the room at a comfortable, cool temperature.
- Unwind with quiet reading, low-impact stretching, or listening to soothing music.
- Limit caffeine and avoid having it later in the day.
- Don't eat large meals for dinner.
- Adjust your current topical or systemic treatment plan.
- Recommend a different type of medication.
- Talk with you about healthy sleep habits in more detail.
- Refer you to specialists who can check for underlying sleep disorders.
- Fine-tuning your skin care routine with dermatologist-recommended psoriasis treatments and consistent moisturizing can help reduce night-time itching and improve your sleep quality.
- Creating a comfortable sleep space may also help you sleep better. For instance, lower the bedroom temperature and choose breathable fabrics.
- Practice habits that can help sleep. For example, wake up and go to sleep at the same times each day, and try relaxation techniques. Good sleep hygiene can positively impact your overall psoriasis management and sleep.
- Don't hesitate to talk with your dermatologist or healthcare providers if your psoriasis symptoms continue to disturb your sleep. Your doctor can provide tailored treatment options and remedies to address any underlying sleep disorders you might have.
- https://www.everydayhealth.com/psoriasis/how-to-get-better-sleep-when-you-have-psoriasis/
See Your Doctor if Sleep Problems Persist
If itching or pain are keeping you awake, talk with your dermatologist, Green says. “Everything that psoriasis is doing to your body besides being visible on the skin, you should mention to your dermatologist. They can help you through it,” he says.
They may:
