Sweet dreams…are made of this

Claire Moulds shares the recipe for a good night’s sleep. This article was published in Exchange 178, December 2020.

A good night’s sleep is soothing for mind and body, but a bad night can leave us feeling on edge, struggling to concentrate and less able to cope. When this lack of sleep builds up over weeks, months or even years, it can significantly harm our wellbeing.

People with eczema often have disturbed sleep, leaving us exhausted and at higher risk of a flare up. So, what steps can you take to increase the chances of a good night’s sleep?

Choose carefully

If you have a choice, use a bedroom that has a fairly consistent temperature over the course of the day. Try to avoid a room where the sun streams in before you wake up or that captures the heat in the late afternoon, making it hot and stuffy at bedtime.

A clean sweep

For the perfect sleeping environment, start with a deep clean. Remove soft furnishings, including curtains and cushions, and wash or dry clean them. Then, beginning with the ceiling and light fittings, work from the top of the room down, cleaning the walls, furniture, doors, skirting boards and floors.

Pull everything out, to clean behind, and give the windows (including the glass and frames) a thorough scrub – especially important as these are an entry point for irritants. Damp-dust, wherever possible, as this is more effective than dry dusting for removing dust, pollen and moulds.

A minimalist approach

When it comes to furniture, soft furnishings and knick-knacks, less is more. View every item as a potential host for triggers – and minimise clutter.

We spend over a third of our lifetime in bed – and children, teens and young adults spend even longer than adults in their bedrooms playing, studying and entertaining friends – so it’s vital to create an eczema-friendly environment.

Choose cupboards, rather than open shelving, for storing toys and keepsakes or invest in a toy box, with a lid, or a blanket box.

Take a hard line

It might seem natural to choose soft materials for a bedroom, but some people with eczema find it helps to swap carpets for hard flooring and curtains for wooden or metal blinds, as they are easier to keep clean.

Select the right bed and bedding

The Sleep Council recommends replacing one’s mattress every seven years. After that point, it will have endured 20,000 hours of wear and tear and absorbed the half pint of fluid we lose each night plus the pound of dead skin cells we shed each year – all of which make it a veritable paradise for house dust mites!

Avoid memory foam mattresses as these mould to your shape and reduce air circulation, making you warmer. If your children have bunk beds, let the child with eczema sleep on top, to avoid dust dropping down on them.

Avoid feather bedding: choose synthetic duvets and make sure pillows are non-allergenic and easy to launder with a cotton casing. Use anti-allergy protective covers on pillows, duvets and mattresses and regularly wash them on a hot cycle.

Bed linen should also be 100% cotton, as it’s soft, cool, absorbs moisture and washes well at high temperatures to remove skin debris, house dust-mite droppings and emollient residue. Some people prefer to fold a flat sheet in half and sleep ‘inside’ it, like a sleeping bag, and change this each day, to avoid re-making the entire bed.

Keep it constant

With eczema it’s often a struggle to control your body temperature. Add in a change in air temperature and it’s a recipe for scratching.

If you get cold because you roll over in bed, exposing your bare skin, consider a bigger duvet, such as a king-size duvet even if you have a double bed.

If, on the other hand, your temperature quickly spirals, choose layers of bed covers that you can easily strip off. Alternatively, put a 100% cotton cellular blanket inside a duvet cover or, if you prefer a duvet, use a summer-weight one, to prevent overheating.

If you and your partner like different temperatures, consider separate duvets. Equally, if your baby has eczema, keep the cot away from your bed to avoid your body acting like a radiator.

Aim to keep your bedroom temperature slightly cooler than your main living areas, at 16-18°C.

Day to night

During the day time, you can use emollients as often as you like. But at night, ideally you want your routine to see you through until morning. So, before bed, many people apply a more intensive emollient. Ointments can block the pores, leaving you feeling hotter and sweatier, so if you use one, apply it well before bedtime.

Wet wrapping, using tubular bandages or night-time garments, can help patients of all ages get a better night’s sleep. Not only does this provide an extra layer of protection – helpful if you scratch in your sleep – but having a wet layer over a thick layer of emollient helps keep the skin’s surface cool, reducing itching.

Play detective

If you want to understand what works for you, start a sleep diary to identify patterns. Include details of your bedtime routine, what you wore, the weather, the room temperature, which treatments you used and your stress levels. Note down anything that might offer a crucial insight.

Consider videoing yourself sleeping so you can think carefully about your sleep position, what makes you scratch and how much you move around. For example, you might spread out like a starfish, which makes you get too close to your partner, making you overheat – which in turn makes you scratch. Here, a bigger bed might be the solution.

24/7

Every day, air your room and bedding (unless a high pollen count is forecast, in which case keep the windows closed) and damp-dust surfaces and vacuum thoroughly. Every week, clean your curtains or blinds with a vacuum cleaner or damp cloth, depending on the material. Vacuum your mattress every single time you change the bed linen – including the seams.

Keep your cool

If your eczema prefers lower temperatures, try sleeping with an electric fan on. If funds permit, an air conditioning unit can be an invaluable addition – especially during a heatwave. Some people with eczema even keep a mini fridge for the bedroom, so they have cold emollient and drinks to hand throughout the night.

Behind closed doors

Just because you can’t see clutter that’s hidden away doesn’t mean it’s not contributing to your overall environment. If air cannot circulate freely, wardrobes attract moulds, mildew and sometimes pests. So, empty them regularly and give them a thorough clean.

Bed buddies

If your child refuses to sleep without their beloved cuddly toy, it’s vital to wash it regularly at 60°C to kill house dust mites. If it can’t be washed at such a high temperature, put it in the freezer in a plastic bag for at least 24 hours. Afterwards, take it outside and brush it thoroughly, to remove the dead mites and their droppings.

Dress for success

Choose natural, breathable fabrics to sleep in, such as cotton, bamboo or silk, which are soft against your skin. Many people prefer cotton – for nightwear as with bedding – as it can be laundered at high temperatures.

Avoid items with seams or zips that might rub, irritate or that you might use to scratch with. If you know you scratch in your sleep, keep your nails short and filed and consider wearing cotton gloves to bed (some people double up to ensure a snug fit). Select nightwear that covers as much of your skin as possible, for added protection. For children, look for sleepsuits with built-in feet and mittens.

And so to bed…

Having a healthy bedroom environment is key to sleep, but so is practising good sleep hygiene:

• Set a regular bedtime.
• Get fresh air and exercise during the day.
• Avoid heavy meals, caffeine and alcohol late in the evening.
• Unplug from all electronic devices at least one hour before bed.
• Follow a calming pre-bed routine – wind down with light stretching, reading or relaxation exercises and dim the lights.