In atopic dermatitis, itching worsens at night. This is because ①body temperature rises at night, increasing skin blood flow, ②cortisol secretion decreases, reducing anti-inflammatory effects, ③the urge to scratch that was suppressed during the day becomes active at bedtime. Chronic sleep deprivation leads to the vicious cycle of excessive stress hormone (cortisol) secretion → Th2 immune overactivation → atopy worsening.

Sleep improvement strategies: ①Pre-sleep moisturizing — apply generous moisturizer before bed, ②Bedroom environment — temperature 18-22°C, humidity 40-50%, mite-barrier bedding, ③Antihistamine — drowsiness-inducing 1st-generation antihistamines (prescribed by doctor) can help with short-term sleep assistance, ④Nail care — keep short and wear gloves, ⑤Stress management — meditation, breathing exercises, regular bedtime.

Korean Medicine Perspective

In Korean medicine, the pattern of concurrent sleep disturbance and itching is viewed as heart-blood deficiency (心血不足) and heart-spirit instability (心神不安). Adding an Anshin (安神) prescription containing Sanjoinjin (Zizyphus seeds), Yunji (Polygala), and Baekjain (Thuja seeds) to the existing atopy prescription can simultaneously improve sleep quality and relieve itching. For severe nighttime itching, wiping the affected area with decocted herbal water and applying a thin layer of Mapunggo before bed is effective for immediate itch relief.