Itching at night can leave you tossing and turning. Nighttime itching, also known as nocturnal pruritus, can disrupt even the soundest sleepers. A lack of sleep in turn can cause fatigue, lack of focus, mood changes, a weakened immune system, and an overall reduced quality of life.
That’s why it’s so important to get nocturnal pruritus under control. Luckily, after determining the cause of your nighttime itch, it can often be treated with at-home remedies and over-the-counter medications.
Why Do I Itch at Night Only?
There are several reasons you may be itchier at night. Here’s why:
Increased Transepidermal Water Loss
Transepidermal water loss (TEWL) is the process where water exits the inside of your body through the skin and evaporates into the air. Research shows that transepidermal water loss is minimal during the day and increases at night. When your skin loses water, it gets dry—and dry skin often causes itch.
Increased TEWL could also signify a weakened skin barrier. If you have eczema, your skin barrier is compromised, which makes it harder for the skin to retain moisture. When people with eczema-prone skin come into contact with irritants and allergens, it can trigger a reaction and cause your skin to flare.
Increased Body Temperature
Your circadian rhythm—your body’s natural 24-hour clock—influences when you’re hungry, when you’re tired, and when you want to go to sleep. It also plays a role in nighttime itch. Our circadian rhythms cause our body temperature to rise just before bedtime. When our skin gets hotter, we get itchier. Researchers believe increased nighttime temperatures are one reason why itch gets worse at night, and why people with eczema itch more at night and wake up frequently.
Spikes in Cortisol Levels
Cortisol, your body’s stress hormone, naturally rises and falls throughout your 24-hour day. Cortisol reaches its highest point at 8:30 a.m. and then lowers throughout the rest of the day. It hits its lowest level at around midnight.
However, the stress hormone begins to rise again around 2 a.m. to 3 a.m. While this is helpful to wake up in the morning and go to work, spikes in cortisol can set off an inflammatory reaction. For people with eczema, this increase can lead to more severe symptoms, including itching.
What Causes Itching at Night?
Itchy skin at night can be caused by:
Age
Itch is extremely common among people over 65. That’s because our skin changes as we age. Our sebaceous glands become less active and our skin barrier loses the ability to maintain moisture. The result: itchier skin.
Stress
Itch, stress, and anxiety go hand-in-hand. Just like embarrassment can trigger a blush or nervousness can contribute to hives, stress and anxiety can trigger itching. When stress and anxiety cause your body to go into fight-or-flight mode, the immune system releases histamines, which are known to play a role in itching.
Inflammatory Skin Conditions
Itch is a common symptom of several inflammatory skin conditions, including eczema and psoriasis. It can also be a symptom of rosacea. The reason why eczema itches: People with eczema-prone skin tend to have dry, sensitive skin. When environmental irritants or allergens come into contact with the outer layer of skin, free nerve fibers get stimulated by nerve endings in the epidermis and cause itching. This chain reaction can also become activated by dry skin alone. Research shows adults with eczema sleep less and wake up twice as often throughout the night due to itching, compared to adults without eczema.
Bed Bugs or Scabies
Bedbugs are parasitic insects that can infest areas where people sleep. Scabies are mites that burrow into the skin and lay eggs. Both can cause itchy rashes. If you believe you may have bed bugs or scabies, or have unexplained itching all over your body at night, contact your healthcare provider.
Other Health Conditions
Itch isn’t just a symptom of skin conditions. Diabetes, liver disease, kidney disease, multiple sclerosis, lymphoma, multiple myeloma, and other conditions can all cause skin to itch.
How to Stop Itching at Night
While itching may naturally increase at night, you don’t have to let it cause restless nights and lost hours of sleep. We’ve written a comprehensive guide to eczema and sleep on our blog, but here’s a quick list of ways you can combat the itch:
Lower your thermostat. The general recommended indoor temperature for sleeping is 65 degrees Fahrenheit. For people with eczema, keeping the bedroom cool (between 60 and 67 degrees Fahrenheit, in general) is crucial. Heat and sweat trigger itching and overall eczema symptoms.
Apply moisturizer. Moisturizing your skin helps repair your skin barrier and reduces dryness that can contribute to itch. Opt for fragrance-free, hypoallergenic moisturizers that are microbiome friendly.
Choose breathable sheets. Skip polyester, nylon, or fleece sheets. These materials aren’t breathable. Instead, cotton, linen, and bamboo sheets offer more breathability to help you regulate your body temperature at night and avoid sweating.
Use a humidifier. While there’s no concrete evidence to show using a humidifier at night helps reduce itching and improve eczema symptoms, anecdotal evidence suggests it may.
Try meditation. Research suggests meditation for eczema and other itch-causing skin conditions may help reduce itching. Implementing a meditation practice before bed could help you fall and stay asleep.
Talk to your doctor. If you’ve tried lifestyle changes at home with no improvements to your sleep quality, don’t hesitate to talk with your primary healthcare provider. You may be experiencing an underlying health condition that requires treatment. If you’re experiencing unexplained itching all over the body at night, talk to your doctor right away.
Keep Gladskin By Your Bedside
Itching at night, no matter the cause, can disrupt your sleep and leave you feeling drained. With some adjustments, you can sleep soundly again.
For anyone three months or older managing eczema symptoms, we recommend Gladskin Eczema Cream. Hypoallergenic and steroid-free, it’s clinically proven to reduce eczema symptoms including itch. Gladskin Eczema Cream works differently than other skincare products: its patented protein Micreobalance® restores balance to the skin microbiome, creating a healthy environment for good bacteria to thrive. It's also deeply moisturizing.
Learn more about how the unique science behind Gladskin.