Sleep Related Scratching: A Distinct Parasomnia?

Abstract

Pruritus (itching) during the sleep period can present as a symptom of dermatological or systemic disease, or as a parasomnia. Sleep related scratching as a primary parasomnia, exclusively confined to sleep in the absence of coexisting dermatological disorders, has not been well described. This case series describes three such patients, and discusses potentially relevant pathophysiology that can underlie itching or pain. Such cases of sleep related scratching may merit nosologic classification apart from previously defined parasomnias.

A cross-sectional survey of the nature and correlates of sleep disturbance in people with psoriasis

“…Itch and associated scratching have been reported as disrupting sleep in psoriasis and other pruritic conditions, with scratching occurring throughout the sleep period . Evidence suggests that conditioned scratching activity can occur during sleep, with nocturnal scratching reported as a distinct parasomnia in a number of cases . Moreover, itch has strong links with mood, with depression amplifying itch perception .…”

Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep

“…A recent publication of three cases suggested that nocturnal itch may occur in the absence of daytime pruritus and without the presence of a co-existent dermatologic or systemic condition [ 28 ]. Such findings suggest that nocturnal pruritus could constitute a parasomnia—abnormal behavior occurring during sleep.…”

Understanding the experience of sleep disturbance in psoriasis: a qualitative exploration using the Common‐Sense Model of Self‐Regulation

“…34,35 This may be due to biased attention towards symptoms and negative illness-related thoughts and worries, which further increase arousal and distress [36][37][38][39][40][41][42] and exacerbate sleep difficulties. Nocturnal itch and scratching were reported and may occur during sleep, 43 or during brief awakenings, thus interrupting sleep.…”