What to Do When Severe Atopic Dermatitis Disturbs Your Sleep

By helitra·October 31, 2026·7 min read

With its itchiness, soreness, weeping patches, and pain, severe atopic dermatitis (AD) can be even more difficult to deal with at night than during daylight hours.

“Itching and sleep go hand in hand, so the more patches you have, the itchier you become and the more sleep you lose,” says Emma Guttman-Yassky, MD, PhD, the director of the occupational dermatitis clinic at Mount Sinai in New York City.

So, why is nighttime more fraught for people with severe AD, also known as eczema? There could be several factors at play that are tempting you to scratch all night. Luckily, there are also several ways to get the relief you crave and the rest you need.

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How Atopic Dermatitis Affects Your Sleep – and Vice Versa

Daytime offers plenty of distractions, from your job to errands to watching that binge-worthy series. Once you shut your eyes at night, those distractions disappear, making it more likely you’ll focus on your itchy skin.

While giving into temptation relieves the itch for an instant, it’s only temporary. What’s more, scratching the skin can unleash a vicious itch-scratch cycle: Your skin gets even more irritated and itchy, which leads to more scratching and less sleep.

Sleep and AD have a bidirectional relationship, according to research, which means that they influence each other. So, your symptoms may prevent you from getting quality sleep, and the lack of good sleep may in turn hamper the skin barrier’s ability to repair itself, increase how much water is lost through the skin, change how the nervous and immune systems signal itch, perpetuate scratching and stress, and reduce the likelihood you’ll stick to treatment.

Eventually, the cumulative effect of poor sleep affects your work, personal relationships, and mood. “If you don’t sleep, you’re likely to be shorter with people, have more accidents, and become less productive, all while the body’s general inflammatory burden increases,” says Dr. Guttman-Yassky.

Medications That Ease Nighttime Atopic Dermatitis Symptoms

Many topical, oral, and prescription medications are marketed to treat and manage severe AD and rehydrate your skin. How well they work can vary from person to person, though. Check with your doctor to see which solutions might best relieve the itchiness for you.

Topical Moisturizers

The National Eczema Association (NEA) has a directory of products meant to protect and fortify skin without harmful ingredients. From topical steroids to herbal formulas, products that are awarded the NEA Seal of Acceptance are free of formaldehyde, bacitracin, fragrance, and other irritants. Many of the formulas are rich in natural emollients, which help treat dryness and irritation.

Over-the-Counter Topical Medications

Often, a regular moisturizer won’t cut it to ease nighttime eczema symptoms. Over-the-counter (OTC) medications, including some antihistamines, can calm inflamed skin and increase drowsiness for some people. Long-term use of these so-called first-generation antihistamines like diphenhydramine (Benadryl) is discouraged, however, due to the likelihood of drug tolerance, as well as concerns about an association with dementia.

Prescription Drugs

“If all these things don’t help, we can ramp things up by trying a new oral or injectable therapy,” says Jonathan Silverberg, MD, PhD, a professor of dermatology and the director of clinical research at the George Washington University School of Medicine & Health Sciences in Washington, DC.

Most of the time, doctors start people with AD on a topical prescription product, such as a steroid or calcineurin inhibitor. In cases of severe eczema, however, oral or injectable systemic therapies that work to treat itch may be needed. Talk to your doctor about which medication would fit best in your treatment plan.

Other Ways to Get More Rest With Atopic Dermatitis

Topical treatments and other meds can provide almost instant relief, but there are also a few lifestyle changes that can ease the itch, improve your sleep, or both. These include good sleep hygiene – the behaviors and environmental factors that can affect how well you sleep.

For better shut-eye:

Put your devices away. Shut off your phone and laptop before you get ready for bed. The light from these devices disrupts the sleep-wake cycle. A good way to do that is to leave them charging in a separate room.
Darken your room. Consider blackout shades and a sleep mask to eliminate light. You can also use a white-noise machine to block out sleep-disrupting sounds.
Skip the late-night snack. Try to avoid heavy foods and alcohol right before bed. Instead, sip on herbal tea to prepare for sleep.
Work out during the day. Too much physical activity close to bedtime can disrupt your sleep. If possible, try to squeeze in your workout in the morning or a few hours before you hit the hay.
Say no to afternoon coffee. According to a research review of 24 studies on caffeine and sleep, if you want to avoid having the stimulant reduce your total sleep time, you need to stop consuming it about nine hours before bed. That means no caffeine after 2 p.m. if your bedtime is 11 p.m., for example.
Unwind and relax. Try adding yoga, meditation, or another calming practice to your nighttime routine. It helps lower your stress levels, too, which can also help your atopic dermatitis.

There are a few things to keep in mind that are specific to atopic dermatitis itch.

Avoid drastic temperature changes. Alterations in temperature can trigger eczema flares, so it’s better to keep the room temperature stable. That may mean keeping your bedroom cooler than the rest of your home, running fans, or investing in heavier bedding.
Skip the scalding shower. Amping up the heat in your shower is going to strip your skin of much needed moisture, so it’s best to keep your water warm, rather than hot.
Go for products that aren’t scented. Scented moisturizers and other skin products can make you itchier – this includes those marked “unscented,” so make sure the label says there are no added fragrances. The NEA’s product directory, as mentioned, contains only fragrance-free options.
Opt for washable linens. Rugs, curtains, and bedspread fabrics that can’t be tossed in the washer easily can start collecting dust and allergens. Mite-proof materials, when washed frequently in hot water with hypoallergenic detergent, are better for people with severe eczema.
Wear gloves to sleep. Put white cotton gloves on your hands when you go to sleep to reduce damage if you scratch during the night.
Wear breathable fabrics. Stick to soft cotton and loose clothing when climbing into bed. Tight and stiff pajamas only make the itching worse.

Because each case is unique, Guttman-Yassky carefully tailors her protocols to the person’s needs – even taking into account race or ethnicity when it’s relevant.

“People of African descent and Asians tend to develop more eczema with more severe and resistant lesions, so we adjust to ensure all patients achieve relief,” she says.

Finally, many dermatologists encourage people with chronic AD to fully understand their triggers and treatments, share any updates, and learn to advocate for themselves.

“We now have so many effective options that patients shouldn’t settle for a treatment or a doctor who can’t provide relief,” says Guttman-Yassky. “We aim for 100 percent symptom clearance.”

The Takeaway

Severe eczema can cause intense itchiness, which can make it difficult to get a good night’s sleep.
This can lead to sleep deprivation and even more skin inflammation.
Topical, oral, and prescription medications, as well as habits that help you sleep, will ease the itch.

EDITORIAL SOURCES

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Resources

Kaliciak I et al. Sleep Disturbance and Atopic Dermatitis: A Bidirectional Relationship With Clinical and Therapeutic Implications. Cureus. July 6, 2026.
Welch E. Atopic Dermatitis (Eczema): Tips for Better Sleep. Mayo Clinic. May 14, 2026.
Gardiner C et al. The Effect of Caffeine on Subsequent Sleep: A Systematic Review and Meta-Analysis. Sleep Medicine Reviews. March 3, 2023.
How Lifestyle Changes and Self-Care Can Improve Your Atopic Dermatitis. Cleveland Clinic. November 29, 2023.

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