(LifeWire) - When talking about psoriasis, so much attention is put on getting through the day with itchy, inflamed skin. But nighttime is often problematic for many people with psoriasis, too. In fact, for the 30% of psoriatics who have a moderate or severe form of the skin disease, bedtime may actually be greeted with a certain degree of dread.
Sleep is a time of little self-control. So, while you may be able to stop yourself from scratching your skin during wake hours, you may unconsciously rake your itchy, red skin patches while you sleep. As a result, you -- like many others with psoriasis -- may wake to blood stains or white flecks (skin scales that have shed) on your sheets.
What's worse, though, is that flare-ups can also result from nighttime scratching, which prompts a response known as the Koebner phenomenon in some people with psoriasis (anywhere from 11% to 75% of individuals, according to studies). The Koebner phenomenon occurs in many forms of skin disease, but it manifests in psoriasis patients when skin injuries, such as scratches or sunburns, cause the disease to worsen.
And there's more to it. "Not getting enough sleep builds stress, which is a factor in psoriasis because our body repairs itself when we sleep," says dermatologist Doris J. Day, MD, clinical assistant professor of dermatology at New York University Medical Center. "Sleep is so important and so under-respected."
In other words, Day says, a vicious cycle may develop for psoriasis sufferers who are sleep deprived. The stress that results can be a major trigger for psoriasis flare-ups, and the worsened condition itself can cause further sleep difficulties, and therefore even more stress.
If you have psoriasis and are experiencing trouble sleeping, a combination of good general sleep hygiene and skin-targeted tactics can help:
Wear cotton gloves to bed
Socks on the hands will do as well. "[Use] whatever puts as much distance between your nails and psoriasis as possible," Day advises.
Keep your worst patches covered
Coating the area(s) with a rich moisturizer and covering it in plastic wrap not only prevents scratching but can also help remove psoriasis scales during bathing the next morning, as the skin will be softer.
Psoriasis patients can experience great itch relief from antihistamines. Some antihistamines also have a sedative effect that aids sleep. While it is not wise to rely on these medications, an occasional antihistamine taken at night during bad psoriasis outbreaks is perfectly acceptable, Day says. Of course, speak to your doctor before giving this a try.
Avoid alcohol before bedtime
Heavy alcohol consumption is a psoriasis trigger, and evening drinking often leads to wakefulness during the night.
Caffeine can be found in chocolate and cola, as well as coffee and tea. Its stimulant effects can keep you up.
Set a normal bed and wake time
Often suggested as a good sleep hygiene habit, this simple step helps your body learn what to expect no matter what other symptoms you are dealing with.
Doris J. Day, MD, New York University Medical Center. Phone interview. 16 May 2008.
"Sleep Disorders Center: Sleep Hygiene: Helpful Hints to Help You Sleep." University of Maryland Medical Center. 2 Nov. 2007. University of Maryland Medical Center. 19 May 2008. <http://www.umm.edu/sleep/sleep_hyg.html>.
Thappa, Devinder Mohan. "The Isomorphic Phenomenon of Koebner." Indian Journal of Dermatology, Venereology and Leprology. 70.3. 2004. 187-189. 23 Apr. 2008. <http://www.ijdvl.com/article.asp?issn=0378-6323;year=2004;volume=70;issue=3;spage=187;epage=189;aulast=Thappa>.