Nocturnal pruritus is a common condition that is caused by natural bodily processes, conditions that irritate the skin, or medications. According to a study published in the journal, Ingenta, about one-quarter of adults in the U.S. will experience long-term skin itchiness called chronic pruritus during their lifetime, and 90% of people with chronic pruritus complain of noctural pruritus or increased skin itchiness at night.

Causes

The natural cycling of hormones, molecules, and chemicals that occur in the body at night can cause itchiness. There are some cases where in the skin only feels itchier during the night due to lack of outside distractions. However, nighttime itchiness may also be a sign of a more serious condition. Some of the natural causes of night itchiness include:

Circadian Rhythm

The body regulates hormones and chemicals in part by using the body’s natural 24-hour cycle called the circadian rhythm. The circadian rhythm causes few different fluctuations that increase nighttime skin itchiness which include:

increased blood flow to the skin
increased skin temperature
increased cytokine molecules that coordinate cells communication during immune responses which may increase inflammation
decreased corticosteroid (which helps reduce inflammation)
disrupted prostaglandin (hormones that cause blood vessels to widen)
increased water loss from the skin (sweat)

Menopause and Pregnancy

Pregnant women may experience itching due to the changes in the level of estrogen. This may cause dryness, itchy skin, or flushed skin. Some menopausal women also feel like something is crawling on their skin.

Other Causes:

insect bites (bed bugs, lice, flies, fleas)
allergic reactions to chemicals, dyes, or scents
dry skin
sunburn
chicken pox
stress
sweating
medications

bed bug bites

Nighttime itchiness may also be a sign of serious conditions which include:

eczema (a condition that causes long-term itchiness and rashes)
psoriasis
fungal skin infections (athlete’s foot, pinworm infections)
thyroid conditions
skin cancer
lyphoma and leukemia
conditions that affect the nervous system (diabetes, shingles, multiple sclerosis)
HIV
anemia
kidney or liver failure
severe depression or anxiety

Home Treatment

Bathe in cool or lukewarm water before bed and use moisturizing, scent-free soaps
Apply glyrcerine-based oil- and alcohol-free moisturizers before bedtime
Use natural ointments and creams with vitamin E and aloe vera
Use humidifiers to moisten the air
Apply cool compresses
Wear gloves and mittens to avoid scratching
Trim your fingernails to reduce chances of irritating the skin further
Wear loose fitting clothing
Do a routine check of beds for signs of bedbugs or other infestations

Prevention

Stay hydrated to reduce dry skin
Avoid long warm baths and showers before bedtime
Wear organic cotton clothing to let your skin breathe
Avoid scented cosmetics and cleansers
Keep your bedroom cool
Change bedding regularly

Medications

Doctors would recommend over-the-counter medications to treat and prevent nighttime itchiness which include corticosteroid creams, allergy medications such as diphenhydramine, fexfenadine, and cetirizine, and supplements that increase drowsiness such as melatonin. Other doctors may also recommend phototherapy which uses UVB wavelengths to help reduce the skin’s immune response and decrease inflammation, as well as hormone replacement therapy, which is usually estrogen-based medications that help reduce dry skin.