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Itchy skin at night

IN THIS ARTICLE:

General reasons why skin may become Itchier at night:

There are a few physiological reasons why itchiness may increase during sleep. Here are a few of them.


  1. During sleep, your skin may release more water which could cause dryness and irritation.
  2. The skin is an outlet for certain toxins which may be released when the body is at rest.
  3. If you have a skin condition increase in skin temperature may irritate that condition. During sleep the skin temperature naturally raises.
  4. A decrease in other simulations may simply cause you to pay more attention to itchy skin that has been itchy all day.
  5. Sometimes certain types of sheets or pajamas can cause and increase in skin sensitivity.
  6. A study showed that it is not the itching itself that wakes people but the scratching movement. (1, 6)

Possible causes for Itchy skin at night with and without rash:

With the above section in mind, you may have any of the following diagnosis and they may increase in sensitivity at night:

  1. Psoriasis
  2. Urticarial
  3. Hives
  4. Atopic dermatitis
  5. Lichen simplex chronic  (1, 6)

how the brain is alerted through the nervous system that you feel an itch.image

Figure 2 : This image is a great representation of how the brain is alerted through the nervous system that you feel an itch.
Picture Source : www.researchgate.net

Itchy skin can have many causes and treatments, but if the itchy skin only happens at night this could help to narrow down the search for an appropriate diagnosis.

If you have been experiencing night time itchy skin that may even keep you awake at night you are not alone. Many people have experienced or are experiencing this type of itchy skin.

What types of diagnosis should I know about?

Pruritus

The literal definition is itchy skin. It is not a diagnosis but for the purpose of this article, it is important to understand the vocabulary. It can be a symptom of the following diagnosis:

  1. Lymphoma
  2. diseases of the thyroid, kidney, and liver
  3. Diabetes mellitus. (2)

Renal pruritus

Most patients do feel the itching day and night. The night time itching may feel worse for some of the reasons noted in the section above. This type of itching may be noted a lot in the scalp. It has been noted to be more intense at night or just after falling asleep as well as in summer months. (3, 6)

Cholestatic pruritus

This type of itching is noted mostly on the extremities or hands and feet. It can also be associated with other symptoms such as tiredness and inflammatory bowel disease. (3)

Endocrine pruritus

This is usually caused by yeast infections in the vaginal or anal areas. At times itchy scalp may also be a symptom. It is accompanied by thyroid issue symptoms. (3)

Psychogenic issues

There are various ideas or conclusions that psychological issues could cause itching and restlessness to begin during sleep hours. Test have been done to show that this may be the case more often than not. (6, 7, 8)

Scabies

With this type of itchy skin, a rash will be seen. It is caused by parasitic mites and must be treated. It is highly contagious and should be contained. The itch from scabies typically increases in intensity at night. (5)

Possible cures for Itchy skin at night:

Here are some possible changes that can help to prevent night time itching.

  1. Shower before bed
  2. Tight fitting pajamas made from cotton
  3. Do not use antibacterial or scented soaps before bed.
  4. Use good ventilation at night
  5. Change your sheets daily
  6. Check mattress often for bed bugs
  7. Prevent pets from getting in the bed.
  8. Use good lotion on your skin(1)

Here is a list of possible medical treatments that may be given depending on the diagnosis made.

  1. Corticosteroids
  2. Antihistamines
  3. Calcineurin inhibitors
  4. Antidepressants
  5. Gabaergic
  6. Benzodiazepines
  7. K-opioid agonists
  8. Hormones
  9. Psychological interventions (1, 6)

the effectiveness vs a placebo when using fexofenadine HCI to prevent pruritus.photo
Figure 3 : This image is showing the effectiveness vs a placebo when using fexofenadine HCI to prevent pruritus.
Picture Source : www.researchgate.net

Further more info …..

Here we will discuss a bit of the anatomy of the skin and also some of the reasons that may cause you to feel itchy at night.

Skin anatomy

a clear view of how complex the skin anatomy is.image

Picture 1 : A clear view of how complex the skin anatomy is.
Photo Source : www.mayoclinic.org

The skin includes the following areas:

  • Epidermis
  • Dermis
  • Dermoepidermal junction
  • Epidermal appendages
  • Cutaneous blood supply
  • Lymphatic tissue

Why is night time Itching such an issue?

Well, night time itching causes a lack of sleep which is a necessary for proper neurological function.  It has been noted that the following issues can be caused by lack of sleep:

  1. Mood disturbances
  2. Being sleepy all day
  3. Neurocognitive impairment
  4. Decrease in productivity
  5. Increase in work or school accidents
  6. Decrease in metabolic functioning
  7. Increase in appetite and therefore poor nutrition
  8. Immune system impairment
  9. Poor judgment (6)

Each of the stages of sleep is very important and if one of them gets interrupted then the person may experience some if not all of the above issues. Here is a fast review of the sleep stages.

  1. NREM Non-rapid eye movement is the first stage and has a few subdivisions. When sleeping a person should go through these phases in sequence. These phases lead into the REM cycle
  2. REM rapid eye movement takes up about 20% of one’s sleep. It happens after the other three phases of NREM and ends by entering into the first phase of NREM. This cycle happens about 5 times in one night. (6)

Resources:

  1. http://www.healthhype.com/nighttime-itching-reasons-causes-remedies-treatment.html
  2. http://www.aafp.org/afp/2011/0715/p195.html
  3. http://emedicine.medscape.com/article/1098029-clinical
  4. http://www.aafp.org/afp/2003/0915/p1135.html
  5. https://www.ncbi.nlm.nih.gov/pubmed/23808128
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813276/
  7. https://www.ncbi.nlm.nih.gov/pubmed/2778111
  8. http://www.mayo.edu/research/departments-divisions/department-neurology/programs/sleep-disorder-program?_ga=1.79436500.1717306767.1484667538
  9. http://www.mayoclinic.org/skin-layers/img-20006163
  10. http://emedicine.medscape.com/article/1294744-overview

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