Itching at Night

Itchiness is a normal sensation that a lot of people experience at any time during the day or night but it can happen that it represents a symptom of a skin/systemic condition. It is important to make the difference between what can be described as a normal sensation and a symptom of a medical problem. When itchiness signifies an underlying health problem, it may persist throughout the night, disturbing your sleep. In some situations, the itchiness might be present throughout the day as well, becoming however worse at night. Finding the underlying cause is the first step towards getting the right treatment for the problem.

Why does Itchiness worsens at night?

According to the specialists in the field, there are certain medical conditions, in which the itching becomes worse at night. It should be mentioned that the nocturnal pruritus does not appear in each and every person but in the overall majority.

Among the conditions that are characterized by itching that worsens at night, there are:

• Atopic dermatitis
• Psoriasis
• Systemic conditions
  • Chronic renal conditions
  • Renal failure.

Factors influencing the Night Itchiness

Circadian rhythm

The itching at night worsens as the body goes through the normal physiological phases of the circadian rhythm. This is actually the internal clock of the body, being responsible for the regulation of different processes.

These are the changes that occur with the circadian rhythm (contributing to the itching at night):

• Increased temperature – this factor can contribute to the worsening of the itchiness, as the levels of mediators that are involved in the itchiness process increases throughout the night
• Dehydration – this is a physiological water loss process, which increases during the night; as the skin becomes more dry, it also presents an increased risk for irritation and associated itchiness
• Natural agents with pain relieving properties – these appear during the night at the level of the skin; as the pain level is reduced, the itchiness might appear as if it were more intense
• Corticosteroid levels – these decrease as well during the night, with the itchiness worsening, as the anti-inflammatory effect wears down; this change is often seen in those who suffer from inflammatory skin conditions
• Parasympathetic activity – as a physiological change, the parasympathetic activity decreases during the night (this is a normal response, as is the one related to the sympathetic activity being increased in the morning); it is believed that the changes related to the autonomic nervous system can worsen the itchiness
• Disturbed circadian rhythm – the levels of substances such as cytokine, prostaglandin and interleukin are modified, which can lead to the worsening of the itchiness.

Often times, the itching appears to be more intense at night, due to the fact that the person is unable to sleep. The sleeping patterns are disturbed when a person suffers from an inflammatory condition. So, the person practically enters into a vicious cycle, with the inflammatory disease leading to both insomnia and causing the itching to appear more intense during the night. Because of these changes, one might also suffer from mood swings and irritability throughout the day.

Among the other factors that may influence the itching at night, there are:

• Bed sheets (irritating factor – laundry detergent)
• Bed linen infestation (bed bugs – feeding time is at night)
• Infestation with scabies or body lice
• Dust mites (allergies – itchiness more intense at night)
• Blanket fabric (wool – may irritate the skin, especially if you already suffer from an allergic condition).

Symptoms of Nighttime Itching

These are the most common symptoms that can be associated with itching at night:

• Rash on the skin
• Redness in the area where the itchiness is present
• The skin may feel warm to the touch
• In the situation that the itchiness is caused by an allergy, bumps might be present at the level of the skin
• Burning or tingling sensation
• Pins and needles sensation
• Sensation of insects crawling under the skin.

What Causes Itchy Skin at Night?

These are the most common causes that can lead to the appearance of the nocturnal pruritus:

• Atopic dermatitis
• Urticaria (this is also known as hives)
• Lichen simplex
• Psoriasis
• Chronic renal problems
• Renal failure (low levels of calcium, high levels of phosphorus – skin)
• Liver disease (excessive bile at the level of the skin)
• Blood disorders
• Xeroderma (excessively dry skin)
• Psychogenic itching
• Insomnia
• Hot showers (causes the skin to become dry and itchy)
• Thyroid disease (hyperthyroidism – Graves’ disease)
• Menopause (hormonal changes – lower levels of estrogen – moisture of the skin is no longer regulated)
• Fungal infection
  • Jock itch
  • Athlete’s foot
  • Infestation with pinworm
  • Swimmer’s itch
• Cancer
  • Lymphoma
  • Leukemia
• Anemia
• Sexually transmitted diseases
• Hemorrhoids
• Anxiety
• Stress
• Diabetes
• Shingles
• Pregnancy.

How to Relieve Itching at Night?

There are certain measures that you can take, in order to improve the itching at night. For example, it is recommended that you avoid using lotions or soaps that might irritate the skin before going to bed. Keep in mind that the antibacterial or scented soaps can cause similar problems, so that they should be avoided as well. If you are suffering from dry skin, you should consider using a thick moisturizer before going to bed. In this way, you will keep your skin hydrated and prevent the intense itching at night.

Before going to bed, it is advisable that you take a warm shower, so that you eliminate any sweat or bacteria from the skin. Make sure that you open the windows and let the fresh air get in the room you are about to sleep in. If you ventilate the air and cool down the temperature a little bit, you stand a very good chance of reducing the sensation of itchiness. As for the bed linen, this should be changed on a regular basis, so as to reduce the risk of allergies. In the situation that your bed linen is infested with bed bugs, you should throw away the sheets and also change the mattress. You may also want to contact a team of experts and arrange for special treatments, in order to get rid of bed bugs. When going to bed, make sure that you wear pajamas that are made from light fabrics. Wearing pajamas that are made from heavier fabrics, such as cotton, you run a higher risk of suffering from itching at night.

Cider vinegar is recommended as one of the most efficient natural remedies against itching at night. This remedy is indicated for such problems, as it has both antiseptic and antifungal properties. You just take a cotton ball, dip it in the cider vinegar and apply it directly on the skin. You can always dilute the cider vinegar with water before applying it on the skin. Cold compresses are just as recommended, as they can calm the intense itchiness and bring the much-desired relief to the skin.

Treatment for Nocturnal Itching

These are the most common measures of treatment that you can take, in order to relieve the itching at night:

• Antihistamines
  • Topical/oral administration
  • Topical – cream, ointment, gels
  • Oral administration recommended for more severe cases
  • Anti-inflammatory effect, also relieves the itching
• Corticosteroids
  • Topical/oral administration
  • Recommended for those who suffer from inflammatory skin conditions
  • Cannot be administered for prolonged periods of time, due to the side-effects over a person’s health
  • Topical administration as cream or ointment
  • Oral administration recommended in more severe cases
• Calcineurin inhibitors
  • Similar mechanism with the corticosteroids
  • Main action – suppression of the overactive immune system
• Antidepressants
  • Recommended for patients diagnosed with psychogenic itching
  • May help not only with the itchiness but also with the mood swings or irritability caused by the insomnia.