Sleep Tips for Severe Eczema

Create the Right Sleep Environment

Start with this general rule: Hard surfaces like wood floors are better than soft surfaces. That’s because softer things like carpet and curtains are more likely to hang on to allergens that could trigger a flare-up of your eczema. For window treatments, this could mean wooden or metal blinds instead of curtains.

Keep it simple if possible. The less stuff — knickknacks, piles of books, cupboards, couches, desks — the less opportunity for dust and other allergens to settle. For closets and other storage, look for furniture like cupboards and armoires you can close.

Beyond that, it helps to keep your bedroom quiet, dark, and cool. Around 65 F seems to be best for sleep.

Get the Right Bed and Sheets

As your mattress ages, it takes on wear and tear and absorbs loads of fluid from your body along with millions of dead skin cells. As the years pass, this makes it a cozy place for dust mites to hang out. That’s why it’s a good idea to plan for a new mattress every 7 years or so.

Avoid foam mattresses that mold to your shape. They can lessen air circulation, warm you up, and lead to a flare-up. If a child with eczema has a bunk bed, try to give them the top bunk so dust doesn’t fall on them from the upper mattress.

Natural feather filling in pillows or comforters can trigger flare-ups, too. Look for synthetic fillings that are nonallergenic (some manufacturers give information about this on packaging and websites).

In general, the safest path is bedding that is 100% cotton. It absorbs moisture and you can wash it in hot water to get rid of dust, mite droppings, dirt, sweat, dead skin, pollen, and other possible allergens.

Keep a Clean Bedroom

This means regular cleaning. Start with a deep clean of your bedroom. Look for “soft” surfaces like curtains, cushions, comforters, and sheets. These should be washed or dry cleaned.

Where you see dust, especially on hard surfaces like windows and door frames, it may be better to remove it with a damp cloth rather than dry-dusting it into the air where it may cause more irritation.

Don’t forget to give some attention to the light fixtures, blinds, desks, molding, baseboard, and floors. Even ceilings and walls can benefit from a wiping down. Make sure to keep any carpet in the room clean and consider a hard surface like wood for floors where possible.

Practice Good Sleep Hygiene

Good habits before bed can do a lot to help you get to sleep and stay that way. Each person is different, but there are some things that doctors may tell you about to help you sleep better. These include:

• Try not to eat too much heavy food close to bedtime.
• Avoid alcohol and caffeine later in the day.
• Unplug from electronics like your phone and computer at least an hour before bed.
• Start a calm pre-bedtime routine: bathe, stretch, read, meditate, relax, wind down.
• Go to bed and wake up at the same time every day.
• Get outside in the sunlight early in the day (sunlight helps set your sleep patterns). But be sure to protect your skin from the sun year round.
• Exercise — but not too close to bedtime because that can disrupt your sleep.

Listen to Your Doctor

It’s important to stick to the treatment plan you make with your doctor. That might include:

• A schedule for bathing and moisturizing: It might help to bathe and moisturize closer to bedtime. (See above for details.)
• Topical meds to control eczema outbreaks: These might include corticosteroid creams, calcineurin inhibitors, and others.
• Oral drugs: Meds in pill form, like abrocitinib (Cibinqo), azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), methotrexate (Rheumatrex, Trexall) or upadacitinib (Rinvoq) can help control serious inflammation. Doctors may also suggest corticosteroids like prednisone, but usually only for short periods because of the possibility of serious side effects.
• Drugs for infection: Because dry, splitting, and scratched skin often gets infected, your doctor may prescribe antibiotic cream or drugs to treat infection.
• Monoclonal antibodies: Doctors sometimes use a relatively new injectable “biologic” medication called dupilumab (Dupixent) or tralokinumab (Adbry) for the most serious cases of eczema.
• Mild sedation, like antihistamines, to help with sleep: This could be especially helpful for children.