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Sleep and Hidradenitis Suppurativa: 6 Ways To Manage Nighttime Pain and Get Better Rest

Posted on September 29, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sarah Winfrey

Pain from hidradenitis suppurativa (HS) can make getting a good night’s sleep difficult. Also known as acne inversa, HS is a chronic, inflammatory skin condition that causes acnelike lesions or abscesses to form under the skin. The discomfort associated with these lesions can range from mild to debilitating.

Lack of sleep can keep you from functioning at your best and negatively affect your mental health and quality of life, so it’s important to find ways to rest well so that you can live well during the day.

How Does HS Affect Sleep?

Many myHSteam members have shared that symptoms of HS negatively affect their sleep. Painful lumps or nodules, in particular, may keep a person up at night. “My armpits are on fire right now,” wrote one member. “I’m in pain and can’t sleep.”

The pain from HS can be severe. As one member explained, “I woke up at 1:39 a.m. with my right armpit inflamed once again. I can’t sleep. I’m in so much pain that I just wanna take a box cutter to my armpit, but can’t do that.”

Some people with severe HS pain find that sleep medications help them rest better: “I had some sharp pains a couple of hours ago, so I have to take sleep meds and pain meds to sleep!”

Other members try to deal with the lack of sleep but find that it becomes chronic. “I don’t remember my last full night's sleep where pain or itching didn’t interfere,” one said.

Sometimes, HS causes other problems that make sleep difficult. “I’m with you! I can’t sleep! The itching …”, one member wrote. Another added, “Does anyone find themselves itching in their sleep? I keep waking up in pain because I am opening up wounds that are healing and itching!”

HS can cause a number of problems that negatively affect sleep. If that’s the case for you, contact your dermatologist or another health care professional. They can discuss pain relief and suggest more ways to help you sleep better.

How To Sleep Better With HS

You can take several steps to help yourself sleep better, even when you’re dealing with a chronic skin condition like HS.

1. Sleep With Your Arms Overhead

If you struggle with HS pain in your armpits or around your breasts, some members recommend sleeping with your arms overhead to help prevent pain and irritation. The Sleep Foundation refers to this as the starfish sleeping position.

“I had to sleep with my arms raised above my head. Otherwise, I could not sleep the way it was aching,” one member wrote. Another echoed this, adding, “I have to sleep with my arms up at night, as it’s too painful.”

Although this position might feel uncomfortable or unnatural, it could be worth a try to see if it allows you to get the rest you need.

2. Protect Your Skin

Members of myHSteam recommend ways to protect your skin and reduce pain. “I fold a soft paper towel the length of the wounded area and put wound tape to hold in place,” one member shared. “I have learned there has to be a layer between the wound and clothes.”

“I’ve started using HidraWear for the dressings, and I can say it’s much more comfortable!” another member reported.

Menstrual and nursing pads can also be used as bandages.

3. Practice Good Sleep Hygiene

Although it doesn’t address pain directly, practicing good sleep hygiene might give your body the structure it needs to fall asleep, even when you are hurting or itching. Practicing good sleep hygiene includes these strategies:

  • Choose a single bedtime and wake-up time, and stick to that schedule.
  • Develop a nightly routine. Set an alarm that reminds you to start getting ready for bed, and take any pain medication early enough to begin working by the time you want to sleep.
  • Turn down your thermostat to around 65 degrees Fahrenheit at night. A cooler bedroom not only promotes better sleep for most people but also helps reduce inflammation.
  • Lower the lights in your bedroom while preparing to turn in. As bedtime approaches, you may also want to wear glasses that block blue light.
  • Exercise regularly, even if it’s just light activity, but not within two to three hours of bedtime.

If you do awaken and can’t get back to sleep, get up and do something quiet for a while. Don’t return to bed until you’re sleepy. You could also try a relaxation technique such as meditation to calm your nervous system before you try to go back to sleep.

4. Treat Your Hidradenitis Suppurativa

Although there is no cure for HS, available treatment options include antibiotics and biologic medications. Treatments for HS can help reduce symptoms like pain and itching and, as a result, improve your ability to sleep. Your dermatologist will help create a treatment plan based on the type of lesions, the areas of skin affected, and the severity of your HS.

5. Quit Smoking

Smoking cigarettes is associated with HS. Researchers have found that 70 percent to 90 percent of people who develop HS also smoke. Quitting smoking may help prevent worsening HS symptoms and reduce your risk of flare-ups.

6. Adjust Your Diet

What you eat may affect your HS. Some foods may trigger HS flares, whereas others can help prevent them. A few small studies have found that avoiding the following foods may lessen flare-ups and sometimes clear HS:

  • Dairy products — Cheese, butter, and cow’s milk
  • Sugary foods and beverages — Soda and candy, for example
  • Brewer’s yeast — Found in soy sauce, beer, and wine

Changing your diet to include more foods that are high in fiber (fruits, vegetables, and whole-grain oats) and contain omega-3 fatty acids (salmon, sardines, and walnuts) may help reduce inflammation, balance hormones and blood sugar levels, and relieve your HS symptoms.

Some dermatologists have reported seeing improvements in people with HS who followed a Mediterranean diet or a plant-based diet. It’s important to first speak with your dermatologist or primary care provider before changing your diet.

Find Your HS Team Today

On myHSteam — the social network for people with hidradenitis suppurativa and their loved ones — more than 28,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.

Do you struggle to sleep well because you’re dealing with HS pain? Do you want to find people to talk to who understand what you’re going through, especially when you’re awake in the middle of the night? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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