Insomnia and Psoriasis: Tips for Better Sleep

Nearly 90 percent of people diagnosed with psoriasis, psoriatic arthritis, or other psoriatic disease have trouble sleeping. As one MyPsoriasisTeam member put it, “I’m on the ‘Insomnia Train.’ It’s just part of having psoriasis.”

Not sleeping is difficult enough on its own. When you also have a psoriasis diagnosis, it can be even more challenging and make the condition worse. In fact, lack of sleep is considered a risk factor for developing psoriasis.

It’s important to understand how insomnia and psoriatic disease are connected and what you can do to get the sleep you need.

How Do People With Psoriasis Experience Insomnia?

There are a few ways psoriasis affects your ability to fall and stay asleep. The main symptoms of psoriasis — including dry, itchy skin and joint pain — might be keeping you up at night.

Difficulty Sleeping Due to Psoriasis Symptoms

Many people diagnosed with psoriasis report having difficulties getting to sleep because of discomfort and itch. As one MyPsoriasisTeam member wrote, “I can't sleep at night because no matter what way I lie, my psoriasis becomes affected.”

Another member shared, “I didn't fall asleep till 3 a.m. because my joints and skin were so sore. I was so itchy that I scratched until I was raw, which I know doesn't help, but I couldn't stop.”

Interrupted Sleep

Even if you can fall asleep with psoriasis or psoriatic arthritis, it can be hard to get a full night’s rest. Some people find that although they don’t have trouble falling asleep initially, they struggle to stay asleep.

One MyPsoriasisTeam member explained, “I only manage four to five hours of sleep before pain wakes me, and I already have a really good mattress that doesn’t put pressure on the joints or spine.” Another wrote, “I was in bed by 10 last night, then up at 3 a.m.”

What Causes Insomnia in People With Psoriasis?

There are a few reasons why psoriasis might cause sleep issues.

Comorbid Sleep Disorders

Some people discover they have a sleep disorder in addition to psoriasis, which can make falling asleep even more difficult.

Sleep Apnea

Sleep apnea is a sleep disorder in which a person’s breathing repeatedly stops and restarts throughout the night. The relationship between psoriasis and sleep apnea appears to go both ways.

Psoriasis is associated with an increased risk of sleep apnea, whereas sleep apnea can also increase a person’s risk for developing psoriasis. Researchers are not sure why this is the case, although both conditions have been linked to higher levels of inflammation throughout the body.

One MyPsoriasisTeam member with sleep apnea said, “I can say, for myself, that since I got treated for sleep apnea, I've noticed a big improvement in my psoriasis.”

Another member with sleep apnea and insomnia wrote, “My psoriasis was very bad for months. I found out there is a connection between my sleep apnea and insomnia. Once my sleep improved, the psoriasis got better.”

Restless Legs Syndrome

Restless legs syndrome (RLS) is another sleep disorder that often occurs in people with insomnia and psoriatic disease. RLS is more common in people with a diagnosis of psoriasis than those without the disease. Research has found that 15 percent to 18 percent of people with psoriasis also struggle with restless legs, compared to just 5 percent to 10 percent of the general population. Once again, researchers are not yet sure how the two conditions are connected.

Pain and Itching

Some people diagnosed with psoriasis or psoriatic arthritis cannot sleep because of severe or persistent discomfort. Psoriatic disease can cause swelling, itching, and burning — all of which can make it hard to get comfortable enough to fall asleep. Research has even supported the fact that itching and pain in people with psoriasis contributes to sleep deficiency.

As one MyPsoriasisTeam member wrote, “My skin keeps me up, as it is itching so much.” Another explained, “As my psoriasis spreads, it’s more difficult to keep up with the pain and itch. In the past week, I've had about eight hours of sleep total, as it's difficult to sleep when the itch keeps me up.”

Poor Sleep Habits

Poor sleep habits only make it harder for people diagnosed with psoriatic disease to get the sleep they need. These habits include not having a regular bedtime, consuming caffeine too late in the day, using electronic devices too close to bedtime, and having a bedroom environment that’s not conducive to good sleep.

Although these examples may not be the main reason why a person diagnosed with psoriasis cannot sleep, they can make falling and staying asleep even more difficult.

Treatments for Insomnia in People With Psoriasis

Relieving psoriasis-related insomnia involves finding ways to manage and improve the reasons behind a person’s sleep difficulties.

Treating Underlying Sleep Disorders

Treating sleep apnea can help people diagnosed with psoriasis get a better night’s sleep. And, as some MyPsoriasisTeam members have shared, treating sleep apnea can also improve symptoms of psoriatic conditions. Similarly, treating restless legs syndrome could help people improve their rest.

Treating Itching and Pain

Treating the itching and pain characteristic of psoriatic disease can help improve rest and sleep quality. These treatments range from using topical creams before bedtime to taking prescription biologic medications. Oral antihistamines may help people fall asleep by alleviating itching. The newer biologic medications are very effective at targeting the overactive inflammatory pathways that lead to itching and pain.

One MyPsoriasisTeam member shared, “Thick ointments help keep my skin moist for hours.” Another explained, “Lidocaine cream helps me with the itching,” and yet another offered, “Benadryl in the evenings helps me.” One member even said, “I soak in the bathtub to help myself [fall] sleep.”

Learning Better Sleep Habits

Improving your sleep habits can make it easier to fall asleep and stay asleep long enough to get the rest you need.

Reducing caffeine use (especially late in the day), setting a regular bedtime that you adhere to even on the weekends, avoiding electronics or using blue-light blocking glasses before bedtime, and making sure you have a dark, quiet place to sleep can make a big difference in how long it takes you to fall asleep and how well you sleep.

Get Support Today

On MyPsoriasisTeam, the social network and online support group for those living with psoriasis and psoriatic arthritis, members talk about a range of personal experiences living with psoriasis. Insomnia is a frequently discussed topic.

What helps you fall asleep? Do you have advice on sleeping with psoriasis or psoriatic arthritis? Join MyPsoriasisTeam today and share your experience with insomnia in the comments, or start a conversation on your Activities page. You'll be surprised just how many others may share similar stories.

References

1. Sleep Problems Common in Psoriasis — Dermatology Times
2. Sleep Loss and Cytokines Levels in an Experimental Model of Psoriasis — PLOS One
3. Psoriasis and Sleep Apnea: A Danish Nationwide Cohort Study — Journal of Clinical Sleep Medicine
4. Psoriasis and Sleep Disorders: A Systematic Review — Sleep Medicine Reviews
5. Sleep Deficiency and Psoriasis: Implications for Clinical Practice — The Journal for Nurse Practitioners
6. Biologics and Biosimilars for Psoriasis — National Psoriasis Foundation