Let’s face it, sleep is one of the most important components to an overall healthy body and mind. Not only does a lack of sleep make us feelunwell, but science has been able to show various ways that sleep is integral to healthy immune function, metabolism, memory and cognition, learning, and more.
When it comes to skin health, does sleep play a significant role? Researchers are eager to understand the roles sleep may play in our skin function and health. Overall, few trials exist exploring how sleep affects certain dermatological conditions. While the scientific community continues to explore what sleep does do for our skin, preliminary evidence points out that lack of sleep may do some damage.
Sleep Patterns and Associations to the Skin
Because of the link between sleep and improved immune function found in many research studies, scientists have begun exploring the effects of sleep in specific inflammatory skin disorders. One of these disorders, psoriasis, is associated with disturbed sleep and poor sleep quality, as well as psychiatric disturbances like anxiety and depression, according to a study of 102 psoriatic patients. A second study supports the association between poor sleep quality and psoriasis, which the study’s authors attribute to the itch and pain caused by psoriatic lesions.
Other studies have assessed skin disorders such as systemic sclerosis, a multisystem autoimmune disease (where the body attacks itself) causing hardening of tissues in the skin and internal organs, for their associations with sleep disturbance. In one study, systemic sclerosis patients were found to have poorer sleep quality than subjects with rheumatoid arthritis or with neither condition. It was also found that among patients with systemic sclerosis, those taking medications that suppress the immune system from reacting against itself showed improved sleep quality scores compared to subjects not on therapy. This association highlights the role the immune system may play in sleep regulation and warrants researchers to further explore the topic.
Interestingly, one research group evaluated data from the Nurses Health Study II and assessed the relationship between rotating night shift work, sleep duration and skin cancer risk. The study yielded surprising results. Those that worked a longer duration of rotating night shift work and had shorter sleep duration (≤6 hours per day) had a lower risk of melanoma and basal cell carcinoma, two of the most common skin cancer types. Those working night shifts were likely getting less sun exposure, a known risk factor for skin cancer, and this may be an important factor for the decreased skin cancers rather than shorter sleep durations.
Possible Mechanisms for How Sleep Affects the Skin
Scientists measure successful sleep initiation by various parameters, including a decrease in core body temperature due to heat loss through the skin of the hands and feet. Scientists also believe that scratching at night may lead to poor sleep quality.[3,4,6] Clinically, it has been determined that those with atopic dermatitis (eczema) and psoriasis may experience disordered sleep.
One research team studied whether the disordered sleep patterns in those with eczema may be due to impaired temperature regulation. They conducted a study and found several associations between impaired sleep patterns, scratching, and uncoordinated control of their body temperature. They found that children with eczema stay awake at night for twice as long as children without eczema and had an average of four times more “scratching events” that would result in waking than children without eczema. The researchers identified that children with eczema would have cooler arm and leg temperatures and thought that this may be due to greater inflammation and heat loss in the skin of their arms and legs. The researchers of the study identified that the relationship between body temperature and sleep is complex and thus requires further research into the subject.
As was mentioned briefly before, an association exists between having psoriatic or eczematous lesions, increased itching and scratching episodes, and poorer sleep quality.[2,3] Studies have reported that patients diagnosed with psoriasis report poorer sleep quality than healthy controls. The current theory stands that the itching experienced by those with psoriasis or eczema resultantly scratch more frequently, causing waking from sleep. However, researchers studying this association indicate that further experimental studies are needed to explain these associations. Therefore, both temperature changes and scratching may be responsible for the poor sleep seen in those with eczema and psoriasis.
Overall, there exist some associations between disordered sleep patterns and inflammatory skin disorders such as psoriasis, systemic sclerosis, and atopic dermatitis (eczema). Possible mechanisms explaining poor sleep quality include lack of thermoregulation through the skin during sleep and the enhanced itching seen in those with eczema and psoriasis.[3,6] Many of these correlations are from small or few studies, and more research is needed. While studies continue to build, it would be worth focusing on good sleep hygiene as a vital part of health and skin care.
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Luca M, Luca A, Musumeci ML, et al. Psychopathological Variables and Sleep Quality in Psoriatic Patients. Int J Mol Sci.2016;17(7); PMID: 27455241.
Balta I, Karadag AS, Selek S, et al. General psychiatric symptoms, quality of sleep, and coping strategies in patients with psoriasis vulgaris. Int J Dermatol.2016;55(1):60-64; PMID: 25945942.
Bagnato GL, Fiorenza A, Cordova F, et al. Clinical, autoimmune, and psychiatric parameters correlate with sleep disturbance in patients with systemic sclerosis and rheumatoid arthritis. Clin Exp Rheumatol.2016;34 Suppl 100(5):49-55; PMID: 27192425.
Heckman CJ, Kloss JD, Feskanich D, et al. Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants. Occup Environ Med.2016;10.1136/oemed-2016-103783; PMID: 27663986.
Camfferman D, Short MA, Kennedy JD, et al. Thermoregulation, scratch, itch and sleep deficits in children with eczema. Sleep Med.2016;25:145-150; PMID: 27823708.