Getting Better Sleep

Getting enough sleep is important for your child’s growth, daytime mood, and ability to concentrate and learn. Unfortunately, for many children with eczema, itch makes it harder to fall asleep and stay asleep. If your child isn’t sleeping well, you are most likely exhausted as well.

If you find your child’s itch is worse at night, you’re not alone. 

Why does my child itch more at night?

Everyone has an internal clock (circadian rhythm) that helps control daily cycles, such as our sleep and wake time, and even changes in the skin barrier.

  • Heat escapes the body through the skin in the hour or two before bed. This is a normal part of cooling our body to prepare for sleep, but it may also increase itch. This is one reason why keeping the bedroom cool is important for children with eczema. 

  • The skin also loses more water at night, which could also lead to dry, itchy skin. Good nighttime skincare is important to keep the skin hydrated and help the skin heal at night. This episode of the Eczema Breakthroughs podcast breaks down the best tips for applying moisturizer — plus read this blog for some sleep tips as well.

  • We all have very brief awakenings at night at the end of each sleep cycle, which for children is every 1-2 hours. Most of us fall right back to sleep, but children with eczema may experience itch at these times. This could lead to “scratching in their sleep” and sometimes full awakenings. 

    Understanding factors that contribute to itch at night is an important first step to improving your child’s sleep - and your own! To learn more about eczema, itch, and triggers, here are our tips for getting started.

    If your child hasn’t found a treatment that works for them, our eczema treatment navigator highlights all of the available options — from natural remedies to injectables to topical steroids.

Click below for further information

Eczema Treatments and Sleep
Positive Sleep Routines and Environments
Mind-Body Relaxation Strategies to Prepare for Sleep
Behavioral Strategies to Manage Sleep Problems
Other Trusted Resources
childhood eczema and sleep

How can I help my child with eczema get more sleep?

Children usually start sleeping better when their eczema is under better control.  In turn, sleep helps the skin to heal, starting a positive cycle.

Nighttime skin care to reduce itch:

  • The skin loses the most moisture at night. Bathing and moisturizing before bed may be particularly helpful for sealing in water and keeping the skin hydrated.  

  • Medications applied to the skin help the skin heal at night.

  • Sleeping with wet wraps (if recommended by your child’s healthcare provider) can keep the skin moist and protect the skin from scratching.  

Many families find that keeping the skin covered with cotton pajamas, or covering the hands with cotton gloves or mitts can also reduce damage to the skin due to scratching.  

If your child wakes up itchy in the middle of the night, it can help to reapply moisturizer or soothe the skin with a cool washcloth or cool pack.  For an older child, consider keeping moisturizer on the bedside table.  

How to reduce allergens for better sleep:

  • For children with dust mite allergy, ask your child’s healthcare about dust mite control in the bedroom. Try to limit stuffed animals and wash favorite stuffed toys at least weekly in very hot water. Place them in a dryer to kill dust mites and other allergens.    

  • For children with allergies to animals, keep pets out of the bedroom. In addition to triggering eczema, pets can also disturb your child’s sleep when they move or make noise at night.

  • For children with pollen allergies, keep bedroom windows shut during pollen season.

Your child’s health care provider may recommend an oral (by mouth) antihistamine at night. Antihistamines may help your child feel drowsy, but they have not been proven to help itching and scratching.

Pro-tip: Talk to your child’s healthcare provider if your child is having difficulty sleeping due to itch, so they can recommend the treatment plan that is best for your child.  

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How to set up a child’s bedroom and nighttime routine for better sleep

A first step to improving your child’s sleep involves good “sleep hygiene.” This includes thinking about the bedroom environment, bedtime routines and daytime habits that can promote better sleep.

Baby eczema and sleep
Eczema sleep routine
Childhood eczema sleep

  • Having a set schedule helps to set your child’s biological clock, so it’s easier to fall asleep at night and wake up in the morning. Wake-up times are easier to control and help determine when your child can fall asleep. Try to avoid having your child sleep in for more than 1-2 hours on weekends. Otherwise, it will be hard to switch back to the school day schedule.

  • Naps are tempting when children have been up at night itching and scratching. However, they can make it harder for your child to fall asleep at night. If your child needs a nap, keep them short (about 30 minutes). If your child is younger and is still napping as part of their normal sleep routine, avoid naps past 4pm.

  • When your child follows the same routine each night, this will cue their body and mind that it’s time for sleep. For most children with eczema, skincare is the first part of the bedtime routine.

    -For young children, the routine could include brushing teeth, a book and a couple of songs.

    -For older children and teens, the routine could include reading, listening to relaxing music or an audiobook or using relaxation techniques.

  • Younger children and children who have difficulties with transitions may benefit from a bedtime chart, to learn what to expect at bedtime and make transitions easier. This can include pictures of each step of the bedtime routine (such as a bath, moisturizer, brushing teeth, a book, a song, and bed). You can use pictures from the internet, photos from your home, or draw pictures with your child. When each step is completed, your child gets to put a star or sticker next to the picture.

    Example of a bedtime chart

  • We all sleep better when it is cool, and for children with eczema, feeling hot often triggers itch.

  • Darkness signals the body to produce melatonin, a hormone that gets the body ready for sleep. A dim nightlight is okay!

  • For many children and teens, technology can make it difficult to fall asleep due to the light from TVs, phones, tablets and computers, but even more so from the challenges with disconnecting from engaging screen activities. Be sure to put all devices in night mode to limit blue light exposure. Ideally place all technology (including parent devices) in a central charging station in a location away from the bedrooms at least 30 minutes before bed. If that is not possible, use the 'Do Not Disturb' mode on phones and if you or your child needs help relaxing, refocusing attention away from itch, or winding down, you can use audiobooks, meditation sessions, or podcasts. Check here for mindfulness resources and our Caregiver app.

    Caregiver app access code: GPER24*

  • If your child plays games on their phone, watches TV, or does homework in bed, their brain will learn that the bed is a place for activity, instead of for relaxation and sleep.

  • Have your child get exposure to sunlight in the morning. This tells their body that it’s time to be awake, just like the dark signals it’s time to be asleep.

    Avoid drinks with caffeine like coffee, tea, soda, iced tea and energy drinks. If your child does drink something with caffeine, try to limit this to before lunch.

    Encourage daily exercise. This helps manage stress and makes it easier to sleep. Your child should finish exercising at least 3 hours before bed.

    Avoid heavy meals in the hour before bedtime as this can mean your body is digesting when it’s supposed to be slowing down. Keep snacks before bed on the lighter side.

Just like brushing and flossing your teeth, sleep hygiene is essential for good sleep health. Keep in mind that consistency is important to see the impact of good sleep hygiene on your child’s sleep. Good sleep hygiene is an important part of treating sleep problems, but some children may need additional support. Talk to your child’s healthcare provider if your child is having ongoing sleep problems.

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Relaxation techniques and meditations for better sleep with eczema

mind-body relaxation for sleep

Relaxation strategies at bedtime can be particularly helpful for children with eczema because they:

  • Refocus attention away from itch.

  • Turn down stress and anxiety, which are triggers of itch.

  • Help the body prepare for sleep.

There are different types of relaxation strategies that can be added to your child’s bedtime routine, such as:

  • Belly Breathing

    Using your breath to trigger the relaxation response and increase comfort.

    Breathe

  • Imagery

    Using the imagination to create relaxing or healing images, using all of your senses. The body responds as if you are actually in the scene you are imagining, so you can feel more calm and comfortable.

    Imagine

  • Mindfulness

    Using your senses to focus on what is happening around you, what your body is doing and how you are feeling in the present moment, without judgement.

    Be Present

Relaxation Strategies

Relaxation Strategies

Imagery can be particularly helpful at bedtime, because it is engaging for children, which helps refocus attention away from itch. You can guide your child in using all of their senses to create a relaxing or pleasant scene in their mind. You can also incorporate healing imagery (like cool water or a magic cream that soothes itch). Your child’s body will respond as if they are the scene they are imagining. 

Practicing relaxation is like learning to play a sport or an instrument. It takes practice. At first, have your child practice these skills when they are not very stressed or itchy. Once your child is used to the feel of relaxation they can use these tools at bedtime or whenever they need them. 

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How Parents of Kids with Eczema Can Get More Sleep

When your child’s skin is flared, they may need more help falling asleep. It’s common for parents of children with eczema to stay with their child until they fall asleep or to co-sleep to help comfort their child and limit scratching at night. It’s understandable that parents will do whatever they can to help their child get a good night’s sleep! 

Sometimes even after their eczema has improved, children still have problems falling asleep on their own, or they wake up in the middle of the night.    

Older children and teens may have worried thoughts about whether they will feel itchy or have trouble sleeping. This can increase stress and anxiety, which makes it even harder to fall asleep and can trigger more itch.

In addition to good skincare and sleep hygiene, there are psychological strategies to help improve sleep.  

  • One reason for nighttime awakenings after eczema is improved has to do with what we call “sleep associations,” or the ways that we fall asleep. If your child depends on you to fall asleep at the beginning of the night, they will probably also need you to fall back to sleep when they wake in the middle of the night, as well.

    When you’re teaching your child to fall asleep on their own, you can still be a part of their relaxing bedtime routine. The difference is that you are working towards leaving the room while they are still awake, so they can learn to fall asleep without you there.

    Some children make this transition easily. Others may benefit from a gradual approach.

    • For example, if your child protests when you leave the room, you can wait gradually longer periods of time before checking on them over the course of the night (1 minute, then 3 minutes, then 5 minutes) or over several nights (3 minutes the first night, then 5 minutes the second night). When you go back into the room, keep interactions brief and matter of fact. “I love you, it’s time for sleep.”

    • For other children, you can try gradually moving a little further away from the child each night, such as sitting on a chair next to the child’s bed for a couple of nights as they fall asleep, then across the room, and eventually outside of the room.

    • For many children, the least stressful approach is having a parent take a short break for several minutes (“Mommy has to go brush her teeth”) and then come back and lay with the child until they fall asleep. Once the child is comfortable and stays relaxed knowing you will return, begin to increase the length of the break each night. The goal is that the child feels comfortable without you there ands falls asleep on their own. But be sure to always go back! Set a timer on your phone and if your child is asleep, leave a token or sticker so they know you returned even though they were asleep.

  • If bedtime is when your child’s mind tends to drift to worried thoughts, or they get stressed about things they have to do the next day, you can try:

    • Setting a “worry time” a few hours before bed, for your child to talk with you about anything that’s on their mind.

    • Keeping a pad and pencil next to their bed, so they can write down thoughts or to-do’s that might keep them up at night.

  • If your child lies in bed stressed about sleeping or itching, they will become more and more anxious, which means it will be even harder to fall asleep. The bed will also start to be associated with anxiety, instead of sleep.

    For older children and teens: If your child can’t fall asleep within about 30 minutes, they should get out of bed and do something calming, in dim light. This could include reading a book (but probably not a mystery they can’t put down!), listening to music, a podcast with headphones, or coloring. If your child is itchy, this could also be a good time to reapply moisturizer or get a cold, wet washcloth to soothe the skin. Then, they can try to go back to bed again after about 20 minutes. They can repeat this process as needed. It can help to have calming activities ready.

  • Tell your child’s healthcare provider if your child is having ongoing problems falling or staying asleep, especially if sleep problems keep happening after the skin gets better.

    It may be helpful to meet with a sleep specialist or psychologist with expertise in treating insomnia and other childhood sleep problems.

    Your child’s healthcare provider can also make sure there are no other health problems affecting your child’s sleep.

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Online Resources:

Pediatric Sleep Council www.Babysleep.com

* This website was developed to provide free, evidence-based information on sleep in young children (0-3 years).  Content is developed by physicians, psychologists and researchers with expertise in pediatric sleep. 

National Sleep Foundation www.thensf.org

Books for Parents and Other Caregivers:

Sleeping Through the Night, Revised Edition: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep by Jodi Mindell

Take Charge of Your Child’s Sleep: The All-in-One Resource for Solving Sleep Problems in Kids and Teens by Judith Owens and Jodi Mindell

Books for Children:

What to Do When You Dread Your Bed: A Kid’s Guide to Overcoming Problems with Sleep by Dawn Huebner (workbook that guides children ages 6-12 and parents through cognitive-behavioral techniques to decrease bedtime problems)

Other Trusted Resources