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So bekommen Sie ausreichend Schlaf

von NFI Redaktion

Atopic dermatitis (AD) has been a long-standing challenge for Claire Park, a pediatric nurse and mother of a two-year-old in Atlanta. In the past 5 years, the condition has become so severe that nighttime itching keeps her awake.

Park can distract herself from the itching during the day, but it becomes harder to ignore when she’s trying to sleep. „I think about it constantly, and it keeps me awake,“ she says.

She is not alone. Research has shown that up to 80% of children with atopic dermatitis suffer from sleep disturbances due to eczema, along with between a third and 87% of adults.

„People with atopic dermatitis often experience more intense itching at night, disrupting their sleep,“ says Dr. Melissa Piliang, a dermatologist at the Cleveland Clinic in Ohio.

The itching alone can wake you up, or you may wake from scratching in your sleep. In extreme cases, Piliang says, you may wake up covered in blood from scratching.

Why Sleep Matters with AD

Sleep is a crucial part of a healthy life. It is incredibly important for your mental function and emotional well-being. If you don’t sleep well, your work or school performance may suffer. Being chronically tired feels terrible, and sleep deprivation can change the way you interact with others. All of this can elevate your stress levels, which in turn has „negative effects on your eczema and your skin,“ says Piliang.

Experts are not completely sure why stress worsens AD, but it may be related to a link between the stress hormone cortisol and the level of inflammation in your body. At the same time, stress affects the efficiency of your immune system. When stressed, you may also not eat properly or exercise regularly.

It creates a vicious cycle because stress worsens your eczema, says Piliang. And that makes sleeping more difficult, which increases stress. Studies show that people with atopic dermatitis whose sleep is disturbed report lower quality of life.

It can also affect you if your bed partner or child frequently wakes up in pain or with intense itching. Research shows that parents of children with atopic dermatitis also sleep poorly.

Improving Sleep with AD

Use a Humidifier

Dry skin worsens atopic dermatitis. Therefore, using a humidifier that generates cool or warm mist can help prevent your skin from drying out. If you don’t have a humidifier, Piliang recommends placing a bowl of water in front of a vent.

Stay Cool and Comfortable

Sweating exacerbates itching. A lower body temperature helps keep skin inflammation under control. Therefore, turn down your thermostat at night to stay cooler.

If allergens in your environment trigger eczema, use dust mite covers on your mattresses and pillows. Choose bedding that is easy to wash and feels soft and cooling, such as linen, cotton, or bamboo. The same applies to your pajamas. „Look for something that is soft, comfortable, and loose,“ says Piliang.

Relieve Itching

Use a good moisturizer or a medical ointment at night. Ask your dermatologist for ideas. Then put on your pajamas right away to allow the moisture to soak in better.

Cold packs can also help relieve intense itching, as the sensations of cold and itching are on the same nerve fibers, says Piliang. Your body cannot experience both at the same time and therefore focuses on the cold. Piliang recommends using small frozen ice packs for children or bags of frozen peas.

One of the things that works best for Park is to soak her hands in ice-cold water before bed, which seems to „reset“ her itchy skin. Then she applies a thick moisturizer to her hands and sleeps with cotton gloves when her AD is really severe.

Control the Scratching

Scratching releases the chemical histamine, which intensifies the itching. Over time, skin thickens from scratching, increasing the likelihood of atopic dermatitis. Scratching can damage your skin and expose you to a risk of infection. To control it:

  • Wear cotton gloves or socks on your hands at night to remind yourself not to scratch and to create a barrier between your skin and your hands.
  • Trim your nails so that it is less likely for histamines to be released or for your skin to be damaged when you do scratch.

Follow Good Sleep Hygiene

Follow these routines for the best chances of getting restful sleep:

  • Stay away from screens an hour before bedtime.
  • Limit your caffeine intake to the morning.
  • Find a deep breathing exercise to help you relax before bed; the 4-7-8 breathing technique is a good try.
  • Try guided meditations to help you relax.
  • Maintain regular wake-up and bedtime periods so your body knows when it’s time to sleep.

Consult a Dermatologist if You Still Can’t Sleep Well

Your doctor may prescribe a sleep aid or medications to treat your atopic dermatitis or relieve itching, including:

  • Antihistamines to take at night. They relieve itching and help you sleep through the night.
  • Oral steroids that can reduce inflammation.
  • Other non-steroidal medications that help with skin inflammation caused by AD.
  • Light therapy.
  • Medications or supplements for sleep, such as melatonin. An Atlanta mother, Roxanne Buckman, uses it when she is under a lot of stress.

Your doctor may also try a new type of lab-made medication that influences the causes of eczema at a cellular level. The first one to come on the market was Dupilumab (Dupixent), says Michelle Pelle, MD, medical director of MedDerm Associates in San Diego, California. It calms interleukin-4, one of the main cytokines (proteins that help your cells communicate with each other) responsible for itching in eczema. „With one dose, many people shut off their eczema reactions,“ she says.

The medication is so good at „eliminating the itch-scratch-sleep cycle, it has completely changed people’s lives.“

The side effects are minimal, says Pelle. The medication does not suppress your immune system and is approved for children aged six and older. „Dupixent is currently the superhero when it comes to eczema and preventing sleep disturbances,“ she says.

„It is important to recognize how severe itching is,“ says Piliang. „For some people, it is almost worse than pain, and it is essential to do everything to relieve the pain and sleep well.“

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