Nocturnal itch: why do we itch at night?
Pruritus is exacerbated at night in many systemic and dermatological diseases, resulting in reports of significantly diminished quality of life and sleep disturbances. At present, the underlying mechanisms responsible for night-time itching are not well understood. Nocturnal pruritus may be related to the circadian rhythm of itch mediators and possibly the disruption of such patterns. Diurnal changes in skin physiology, such as temperature and barrier function, may also play a role. Currently, the paucity of specific treatment options for nocturnal pruritus is alarming and needs to be addressed by future research. This review describes the scale of the problem associated with nocturnal pruritus, the impact it has on patients, possible underlying mechanisms and, lastly, treatment options.
Patel
Tejesh
T
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Ishiuji
Yozo
Y
Yosipovitch
Gil
G
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D016207:Cytokines / Q000378:metabolism; D004643:Emollients / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D008550:Melatonin / Q000627:therapeutic use; D010789:Phototherapy; D010913:Pituitary-Adrenal System / Q000502:physiology; D011453:Prostaglandins / Q000378:metabolism; D011537:Pruritus / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D011957:Receptors, Opioid / Q000378:metabolism; D012881:Skin Temperature / Q000502:physiology; D012893:Sleep Wake Disorders / Q000503:physiopathology; D014870:Water Loss, Insensible / Q000502:physiology
D000276:Adjuvants, Immunologic; D016207:Cytokines; D004643:Emollients; D006634:Histamine H1 Antagonists; D011453:Prostaglandins; D011957:Receptors, Opioid; D008550:Melatonin