“Cotton clothing is commonly recommended for atopic dermatitis patients but can be irritating when dyed or wet and is also prone to bacterial growth. Specially treated silk, such as Dermasilk, is loosely knitted and coated with silver or other antimicrobial agents, such as triclosan, and has been found to have a positive therapeutic effect in atopic dermatitis patients,” Dr. Shi writes.
Following good sleep hygiene, Dr. Shi also suggests keeping a constant sleep schedule, avoiding daytime naps and caffeine in the afternoon, and ensuring the bedroom is a cool, calm place. Keeping skin temperature down may play an important role as decreased skin temperature leads to vasoconstriction, which can decrease inflammation and pruritus. In addition to keeping the bedroom cool, patients can also use cooling pillows and mattress covers, and sleep with fewer blankets.
Keeping computers and mobile phones switched off or out of the bedroom is also recommended as exposure to higher wavelength blue light emitted from these devices has been shown to decrease non-REM sleep.3
Massage therapy has been shown to relieve insomnia by relaxing muscles and reducing anxiety, according to the paper.4,5 It is believed that massage therapy increases peripheral blood circulation which counteracts the discomfort caused by vasoconstriction. Adding certain natural oils, relaxing music and ambient lighting can intensify the benefits of massage therapy.6 Virgin (cold-pressed) sunflower oils and coconut oils which have anti-inflammatory and antimicrobial properties respectively are particularly beneficial in atopic dermatitis, but olive oil can disrupt the skin barrier function and essential oils promote allergic contact dermatitis.7,8,9
“Insomnia is a significant and often underrecognized consequence of atopic dermatitis,” Dr. Shi concludes.
“Nonpharmaceutical techniques, including behavioral therapy, are especially important for children with atopic dermatitis to encourage development of long-term healthy sleep habits.”
1. Hendricks AJ, Manivannan M, Shi VY. Clinical Pearls on Sleep Management in Atopic Dermatitis. Dermatitis. 2019;30(5):287-293.
2. Cork MJ, Eckert L, Simpson EL, et al. Dupilumab improves patient-reported symptoms of atopic dermatitis, symptoms of anxiety and depression, and health-related quality of life in moderate-to-severe atopic dermatitis: analysis of pooled data from the randomized trials SOLO 1 and SOLO 2. J Dermatolog Treat. 2019;:1-9.
3. Chellappa SL, Steiner R, Oelhafen P, et al. Acute exposure to evening blue-enriched light impacts on human sleep. J Sleep Res. 2013;22(5):573-80.
4. Kaye AD, Kaye AJ, Swinford J, et al. The effect of deep-tissue massage therapy on blood pressure and heart rate. J Altern Complement Med. 2008;14(2):125-8.
5. Schachner L, Field T, Hernandez-reif M, Duarte AM, Krasnegor J. Atopic dermatitis symptoms decreased in children following massage therapy. Pediatr Dermatol. 1998;15(5):390-5.
6. Vaughn AR, Clark AK, Sivamani RK, Shi VY. Natural Oils for Skin-Barrier Repair: Ancient Compounds Now Backed by Modern Science. Am J Clin Dermatol. 2018;19(1):103-117.
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9. Anderson C, Lis-balchin M, Kirk-smith M. Evaluation of massage with essential oils on childhood atopic eczema. Phytother Res. 2000;14(6):452-6.
10. Sidbury R, Davis DM, Cohen DE, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327-49.
11. Hundley JL, Yosipovitch G. Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study. J Am Acad Dermatol. 2004;50(6):889-91.
12. Kelsay K. Management of sleep disturbance associated with atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):198-201.