Atopic dermatitis (AD) is a type of eczema and skin condition that causes dry, itchy skin that can make it difficult to sleep through the night. With AD, your immune system triggers inflammation that damages the protective skin barrier. AD affects approximately 16.5 million adults in the United States.

Many people with AD struggle to fall or stay asleep because of itching, also known as pruritus. In fact, disrupted rest is typical for members of MyEczemaTeam, who often struggle to fall asleep due to itchy, dry skin. The sensation is so strong that they’re often woken up by it.

“No sleep due to severe itching last night,” one member wrote. “I’m probably getting three hours of sleep on a good night,” shared another. Another member commented, “I couldn't sleep last night. I stayed up itching and changing the ice pack every couple of hours for my scalp.”

“No sleep due to severe itching last night.”

— A MyEczemaTeam member on sleeping with atopic dermatitis

The broader health impact of poor sleep can be significant for people living with atopic dermatitis. Sleep disturbance can result in changes in mood, daytime fatigue, difficulty thinking clearly, and decreased motor performance, all of which generally worsen your quality of life and well-being. Sleep disturbance can also increase the risk of psychological disorders, car accidents, workplace injuries, and cardiovascular issues.

There are several lifestyle changes and treatments that may provide relief from AD itch and sleep problems. This article will explore a few tips to find relief and get better sleep. Keep in mind that what works for one person may not work for another. Always talk with your health care provider before making any changes to your current care regimen.

1. Create a Nighttime Skin Care Routine

Developing a gentle skin care routine before bed may help calm your skin and improve your sleep. One way to help alleviate dry skin is to properly hydrate your skin through bathing and moisturizing. Sometimes, this method is referred to as “soak and seal,” and it consists of:

1. Taking a lukewarm (not hot) bath with a gentle cleanser

2. Patting the skin dry

3. Applying prescribed topical treatments and moisturizers while the skin is still damp

When you do it before bed, this routine can help your skin lock in moisture, which may prevent your skin from getting dry and itchy throughout the night. You may also consider using stronger topical moisturizers or emollients at night to soothe your skin.

A few MyEczemaTeam members have shared the bedtime routines that have worked to improve their chances of enjoying a restful night. “Coconut oil as a moisturizer at night helps me sleep through the night without itching,” said one member. Another suggested pouring one mug full of Epsom salts into a warm bath before bed: “Stay in the bath for 20 minutes. Use a clean flannel to gently rub away dead skin.”

2. Make Your Bedroom Sleep-Friendly

The National Eczema Association recommends keeping bedrooms cool, dark, and comfortable. Your sleep environment should be slightly cooler than other living spaces, which might mean sleeping with a fan or the air conditioning on. The optimal sleeping temperature is around 60 to 67 degrees Fahrenheit (15 to 19 degrees Celsius).

You may also want to use bedding that’s 100 percent cotton, which is cool and soft on the skin. Cotton bedding also absorbs excess moisture and is typically easier to wash and care for. Try not to use feather bedding and pillows because they could be allergenic and cause itching.

Use bedding that’s 100 percent cotton because it’s cool and soft on the skin.

3. Limit Distractions

Your bedroom should be a place for rest, but many people with atopic dermatitis may engage in behaviors that work against them when it’s time to sleep. Specifically, if there are televisions or smartphones in your bedroom, you will have a more difficult time getting to sleep.

The light that emanates from these devices can disrupt your circadian rhythm and prevent your body from releasing melatonin, a hormone that regulates your sleep cycle. For that reason, the National Eczema Association recommends turning these devices off at least 30 minutes before bed.

It could also be helpful to remove excess furniture from your bedroom and put distracting items out of sight. Minimize as much clutter as possible, and try to associate your bedroom with just sleep, not other activities like studying or entertaining.

4. Wear Comfy Sleepwear

As far as what to wear to bed, look for sleepwear made with breathable materials like cotton, silk, or bamboo. You might want to wear long-sleeve sleepwear to cover your skin and keep you from itching.

People with AD should also avoid wearing clothes to bed made of wool or synthetic fibers like acrylic, nylon, or polyester. These fabrics may make you overheat or sweat, causing you to itch. Be mindful of zippers or seams too, as they may irritate your skin.

One MyEczemaTeam member even mentioned wearing cotton gloves to bed, adding, “I use moisturizer after my prescription cream with cotton gloves, and that’s pretty much the only time I don’t itch. Once I wake up and remove them, I start scratching.”

“I use moisturizer after my prescription cream with cotton gloves.”

— A MyEczemaTeam member on their nighttime routine with atopic dermatitis

5. Practice Good Sleep Habits

Getting a good night’s sleep doesn’t just start at bedtime. You can engage in good sleep hygiene habits throughout the day to promote sleepiness at night, which includes:

• Limiting caffeine — If you consume anything with caffeine, like coffee, tea, and some sodas, it remains active in your brain for as long as six hours and may keep you awake.
• Creating a routine — Bedtime routines allow people to gradually relax into a state in which they’re more likely to fall asleep. Setting aside 15 to 30 minutes every night to repeat the same habit-reinforcing behaviors can lead to a restful night.
• Waking and sleeping at the same time each day — Getting on a consistent sleep schedule on both weekdays and weekends will make it easier to fall asleep and wake up every day.

The Centers for Disease Control and Prevention (CDC) recommends avoiding large meals and alcohol before bedtime to promote sleep hygiene. The CDC also suggests people get regular exercise, as daytime physical activity can cause more sound sleep at night.

6. Manage Stress

Stress can affect both AD symptoms and sleep. Before bed or throughout the day when you feel stressed, try relaxation exercises like gentle breathing or progressive muscle relaxation to bring attention to your body. Simple breathing exercises can help slow down your heart rate and calm your mind.

You may also want to incorporate other activities like reading or light stretching as part of your bedtime routine to help you destress.

7. Take Notes

Consider creating a sleep journal to track what does and doesn’t work for you. Write down anything that might be helpful – your sleepwear, body temperature, routine before bed, sleep duration, sleep patterns, and bedroom temperature. Taking note of everything can help you identify patterns and hopefully help you find your ideal sleep conditions.

With AD, taking notes in general can be extremely helpful. You may also want to consider keeping track of allergens, environments, stresses, and other triggers that make your AD symptoms flare up or your stress levels spike.

8. Talk to Your Doctor About Treatment Options

If you’re struggling to control nighttime itching and get enough sleep, talk to your health care provider to see if you need to make changes to your current treatment plan. On top of lifestyle changes, your doctor may suggest interventions like:

• Topicals — Your doctor may recommend specific products like lotions, ointments, or anti-itch creams to control symptoms. Some products may be available without a prescription, while you may need a prescription for stronger topicals.
• Oral allergy pills — Antihistamines like hydroxyzine (Atarax) and diphenhydramine (Benadryl) can be used to relieve itching. Some allergy medications also have sedative side effects that cause drowsiness, making it easier for you to fall asleep.
• Injectables — Injectable biologic treatments like dupilumab (Dupixent) and tralokinumab (Adbry) may be prescribed in more severe cases of AD when other options aren’t effective. In a randomized study from 2024, dupilumab notably improved sleep for people with AD by reducing symptom severity and itchiness.

Remember, always talk to your health care provider or dermatologist before taking new medicines or making changes to existing treatment regimens. Getting good sleep with AD can be challenging, but there are many strategies and treatment options. By working with your dermatology provider, you can find the right combination for you.

9. Supplements

Some safe, over-the-counter supplements can help with sleep and stress management. These products include GABA (gamma-aminobutyric acid), Valerian root, L-theanine, magnesium, chamomile (or apigenin extract), and many others. Of course, always begin with the lowest effective dose to assess tolerance, and speak to your doctor before you begin taking any new supplement.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 54,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Are you living with eczema? Do you have any tips for getting better sleep? Share your experience in the comments below, or start a conversation by posting on your Activities page.