Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep
Abstract
:1. Introduction
2. The Importance of Sleep
3. Stages of Sleep
4. Physiological Mechanisms for Nocturnal Pruritus
5. Conditions that Cause Nocturnal Itch
6. Sleep Monitoring
7. Treatments for Nocturnal Pruritus
7.1. Antihistamines
7.2. Antidepressants
7.3. Gabaergics
7.4. κ-Opioid Agonists
7.5. Benzodiazepines
7.6. Hormones
7.7. Psychological Interventions
8. Conclusions
Conflicts of Interest
References
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Stage of Sleep | Electroencephalogram (EEG) Characteristics and Associated Sleep Stage Features |
---|---|
Wakefulness | Mainly alpha (8–13 Hz) and beta activity (>13 Hz) on EEG |
NREM Sleep | |
N1 (formerly Stage 1) (10% of sleep time) | Slow theta waves (4–7 Hz) emerge on EEG |
Rolling eye movements | |
Lightest stage of sleep | |
N2 (formerly Stage 2) (50% of sleep time) | Background theta wave, less than 20% delta waves. Sleep spindles (central 14–16 Hz rhythms) and K complexes (0.5–1 s high amplitude central sharp waves) on EEG. |
Eye movements usually cease | |
N3 (formerly Stages 3 + 4) (20% of sleep time) | High amplitude delta waves (<4 Hz) on EEG Also termed slow wave sleep |
Eye movements are slow or absent | |
Deepest stage of sleep | |
REM Sleep (20% of sleep time) | Low voltage, mixed frequency background on EEG |
Saccadic eye movements | |
80% of dreams occur in this stage. They may be recalled easily especially if immediate awakening after dream onset |
Category | Disease |
---|---|
Dermatological | Atopic dermatitis |
Psoriasis | |
Chronic idiopathic urticaria | |
Infestations (scabies, bed bugs, pediculosis, pinworms) | |
Lichen planus | |
Lichen simplex chronicus | |
Prurigo nodularis | |
Non-Dermatological | Liver disease |
Chronic kidney disease | |
Hematopoietic disorders | |
Neurological (e.g., brachioradial pruritus) | |
Psychological (delusional ideations, depression, schizophrenia, stress) | |
Substance abuse | |
Advanced age (senile) pruritus | |
Restless legs syndrome |
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Lavery, M.J.; Stull, C.; Kinney, M.O.; Yosipovitch, G. Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep. Int. J. Mol. Sci. 2016, 17, 425. https://doi.org/10.3390/ijms17030425
Lavery MJ, Stull C, Kinney MO, Yosipovitch G. Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep. International Journal of Molecular Sciences. 2016; 17(3):425. https://doi.org/10.3390/ijms17030425
Chicago/Turabian StyleLavery, Michael Joseph, Carolyn Stull, Michael Owen Kinney, and Gil Yosipovitch. 2016. "Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep" International Journal of Molecular Sciences 17, no. 3: 425. https://doi.org/10.3390/ijms17030425