Totally Exhausted? It Might Be Your Psoriasis

From glamour.com

By Alice Oglethorpe

The link between the skin condition and poor sleep isn’t fully understood, but it’s real. Here’s what researchers think is going on and a game plan for feeling more rested. 

When you first think about it, your skin and sleep seem pretty disconnected. But if you have psoriasis, they are way more closely linked than you’d think. Research has found that about 17% of people with the skin condition experience severe fatigue. And a big reason for that is sleep issues.

“We can say for certain that patients with psoriasis have a higher risk of developing sleep problems,” says Lourdes Pérez-Chada, MD, an assistant professor of dermatology at Harvard Medical School. “And it can manifest in different ways. You could have sleep apnoea or restless leg syndrome or just have disturbances in your sleep.”

You might assume that it’s just the itching that wakes people up, but that’s only, ahem, scratching the surface. Here’s a deeper look at what’s really going on.

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What we know and don’t know about the connection

People with psoriasis are four times more likely to have insomnia than those without the condition and have a 35% higher risk of developing obstructive sleep apnoea compared to the general population. So why is that?

The answer isn’t exactly straightforward.

Symptoms of psoriasis can be to blame for some poor sleep, says Tina Bhutani, MD, an associate clinical professor of dermatology at the University of California, San Francisco, and member of the National Psoriasis Foundation Medical Board. “Pain, itching, and discomfort can make you wake up in the middle of the night and have more fragmented sleep. You may not even realize it’s happening, but you could be unconsciously scratching in your sleep and not getting into the deeper sleep cycles, so you wake up feeling tired.”

But here’s the interesting thing: Take away the itching and pain, and patients with psoriasis still have worse sleep. “Even someone totally asymptomatic,” says Dr. Bhutani. And this is where the link gets a lot murkier. Researchers aren’t exactly sure what’s going on inside the body that makes getting a good night’s sleep so tough. But most experts agree that inflammation is involved.

“Psoriasis is inflammatory…and that impacts your sleep cycles,” says Dr. Bhutani. That’s because excess inflammation can impact your central nervous system, which can disturb sleep.

There’s also a mental health component. “Patients with psoriasis have a higher prevalence of mood disorders, like depression and anxiety,” says Dr. Pérez-Chada. “And those mood disorders are also associated with sleep problems.”

But the path may go the other way as well. “We don’t know which is the chicken and which is the egg. Does psoriasis lead to sleep problems, or do sleep problems lead to psoriasis?” Dr. Pérez-Chada says. “That’s what the field is trying to figure out.”

A recent study from the UK looked at almost 400,000 people without psoriasis and tracked them over 15 years. During that time span, people with sleep disorders had a much higher risk of developing psoriasis. “That’s what makes it fascinating. Previous studies looked at the association, but this looked at what preceded the other. And it showed that having a sleep disorder predated psoriasis in a large number of people,” says Ravi Ramessur, MD, PhD, a postdoctoral research fellow at the University of Pennsylvania.

But the exact reason sleep disorders can raise your risk for psoriasis isn’t known yet. “We really have very little understanding of the how, which is what we want to discover,” says Dr. Ramessur. One working theory right now involves proteins in the blood. “A study found that poorer sleep was associated with having a worse profile of proteins linked with the aging of different organs, including the skin,” says Dr. Ramessur. “And a lot of these proteins were inflammatory, so having poor sleep probably does have an effect on our systemic immunity, and one way that can manifest is with conditions like psoriasis.”

The road to being more rested

While researchers are still trying to figure out the why behind sleep issues in people with psoriasis, that doesn’t need to stop you from improving your sleep now. And this might involve seeing a few different specialists: your dermatologist, a rheumatologist, and a sleep expert.

Get your condition under control.

Though your sleep issues may not all stem from psoriasis symptoms, improving them can only help things. “Psoriasis is a chronic, ongoing condition, so if you get it under better control, at least it can be less itchy and bothersome,” says Dr. Bhutani. If your symptoms are still an issue, talk with your dermatologist about your treatment plan and whether you should try something else.

Make sure you don’t have psoriatic arthritis.

Around 30% of people with psoriasis also have psoriatic arthritis, a related condition that impacts your joints and, as a result, your sleep (joint pain and stiffness can make you wake up throughout the night). That’s where a visit with a rheumatologist would come in, as they can screen you for psoriatic arthritis and make sure that, if you have it, you’re on the right treatment.

Study your sleep.

To find out what’s really impacting your sleep, you may need to do a sleep study. “I tell my patients: If you wake up not feeling well-rested and are groggy all day, you want to get into a sleep lab because there are treatments that can help,” says Dr. Bhutani. They will be able to see if obstructive sleep apnoea or another condition is causing your exhaustion and tailor your treatment to your actual condition. “For instance, there’s cognitive behavioural therapy for insomnia that’s been shown to be very effective,” says Dr. Pérez-Chada.

Try to improve your sleep habits.

While it’s easy to dismiss, having good sleep hygiene can have a big impact. “This won’t be the only answer if you have other disorders like chronic insomnia or obstructive sleep apnoea, but modifying your habits can help,” says Dr. Pérez-Chada. This includes having a regular sleep schedule, avoiding caffeine in the afternoon and evening, exercising regularly, and keeping your bedroom cool and dark. “Those are good tips for the general health of people with psoriasis, and they could potentially improve your psoriasis activity,” says Dr. Ramessur. “It’s a double win.”

Whatever you do, don’t think that you have to take poor sleep lying down. If you feel tired and have psoriasis, you have options—you just need to start by telling your doctor.

https://www.glamour.com/story/psoriasis-exhaustion

Why you can't sleep: a doctor explains what's really keeping you up at night

From creators.yahoo.com

By Robin Raven 

What chronic insomnia actually is, why it's linked to heart disease and dementia, and the treatment many patients never hear about

Are you sabotaging yourself? When you have insomnia, sometimes the harder you try to sleep, the more awake you feel. According to one leading sleep physician, that desperate effort to force sleep may be the very thing making your insomnia worse.

Dr. Ashkan Lee Naraghi, MD, FCCP, is a board-certified pulmonologist and sleep specialist who has spent years helping patients untangle the complicated, often misunderstood condition of chronic insomnia. In this in-depth conversation, he breaks down everything from the real definition of insomnia to the promising new treatments most patients never hear about. He also explains why the advice you've been following may be backfiring.

What insomnia actually is (and what it isn't)

Most people assume a few rough nights qualifies as insomnia. Dr. Naraghi draws a clear line. He says insomnia is defined as difficulty falling asleep, maintaining sleep, or waking up too early — despite having adequate opportunity to sleep — along with daytime consequences such as fatigue, poor concentration, mood changes, or impaired function. "Everybody experiences a few bad nights," he explains, "but to be diagnosed with chronic insomnia, symptoms are generally at least three nights per week for three months or longer."

That distinction matters, because chronic insomnia is a condition with measurable consequences for your body and brain.

                                                                                                 (antoniodiaz)

The scary link between poor sleep, heart disease, and dementia

Research connecting chronic insomnia to cardiovascular disease and cognitive decline has been making headlines, and for good reason. Dr. Naraghi confirms there is "a clear association between chronic insomnia and cardiovascular disease and cognitive decline" — though he's careful to note this reflects association, not necessarily direct causation. Still, the risks are serious enough that he wants patients paying attention.

He outlines the warning signs that turn poor sleep into a medical urgency: chest pain, severe shortness of breath, confusion, suicidal thoughts, dangerous sleepiness while driving, or symptoms that suggest sleep apnoea — "such as choking, gasping, or witnessed pauses in breathing." On the question of dementia, he offers cautious reassurance: "Chronic insomnia has been linked with higher dementia or cognitive impairment risk, but this can be ameliorated with early diagnosis and treatment."

The habits that can make insomnia worse

Here's where many well-meaning people quietly sabotage themselves. Dr. Naraghi says the biggest mistake is self-medicating with sleep aids and alcohol. Also, the list of counterproductive behaviors goes further: taking caffeine late in the day, lying awake in bed for hours, sleeping in to compensate, "catch-up" napping, and watching the clock. "A lot of these behaviours," he explains, "program the brain to think the bed is a place of frustration."

That psychological imprint of the brain learning to associate the bedroom with anxiety rather than rest is at the heart of why chronic insomnia becomes so self-perpetuating.

“Trying harder to sleep usually makes insomnia worse. Sleep has to be allowed, not forced." The real goal of insomnia management, he says, is "to rebuild confidence in sleep and stop the vicious cycle of fear, frustration, and compensating behaviours."

What melatonin actually does (and doesn't do)

Melatonin has become a cultural reflex for anyone with sleep trouble, but Dr. Naraghi wants to set the record straight. "Melatonin is not a sleeping pill per se but a circadian rhythm signal," he notes. "It's basically a hormone that your body naturally produces to help control your sleep-wake cycle." It has legitimate uses such as jet lag, delayed sleep phase, and shift-related timing problems. However, "results are not consistent with chronic insomnia."

He also flags risks most people overlook: next-day grogginess, vivid dreams, drug interactions, inconsistent supplement dosing, and "false reassurance that a deeper sleep problem is being treated." And on the instinct to take more when the standard dose isn't working? "Higher doses are generally not more effective than lower doses," he cautions.

The gold-standard insomnia treatment most people have never tried

If you've never heard of CBT-I, you're in good company, and that's a problem. Cognitive behavioural therapy for insomnia is, according to Dr. Naraghi, a helpful treatment for many people with chronic insomnia. "It is a structured program that retrains the sleep system," he shares. The program typically includes sleep restriction, stimulus control, work around sleep anxiety, relaxation techniques, and targeted sleep scheduling.

Why is it better than medication? Because "it treats the underlying learned insomnia pattern and has durable benefits." So why aren't more people using it? "The problem is access: there are not enough trained CBT-I clinicians, and many patients are offered medications first." The good news, he adds, is that "there are newer virtual programs that are very promising."

Why standard sleep advice doesn't work for everyone

Sleep hygiene tips like consistent bedtimes, dark rooms, and no screens get repeated so often they've almost become background noise. Dr. Naraghi insists they’re not a catch-all solution, and certain groups need a fundamentally different approach. Menopause, pregnancy, having a newborn, shift work, anxiety, depression, chronic pain, and sleep apnoea all "warrant a different approach," he states.

The specifics matter enormously. "A shift worker may need circadian scheduling and light management, whereas someone going through menopause may need treatment of hot flashes or hormonal contributors." One-size-fits-all advice, he suggests, can do more harm than good when the underlying cause is being ignored.

When it's time to stop self-treating and see a specialist

Dr. Naraghi is specific about the red flags that mean it's time to seek professional help. Insomnia lasting more than a few weeks, affecting daytime functioning, or requiring regular medication or alcohol is a clear signal. So is insomnia occurring alongside snoring, gasping, restless legs, abnormal behaviours during sleep, depression, anxiety, or excessive daytime sleepiness. If poor sleep is affecting your driving, work, relationships, or existing medical conditions, he's unequivocal: get help.

What the future of insomnia treatment looks like

For patients who feel like they've tried everything, Dr. Naraghi offers genuine optimism. He thinks the future is moving toward more personalized care: better access to virtual cognitive behavioural therapy programs and behavioural sleep medicine. Also there should be better access to newer medications — specifically "dual orexin receptor antagonists, which target wakefulness rather than simply sedating the brain." He's measured but hopeful: "These are not magic fixes, but they give us more nuanced tools for patients who have not responded to older approaches."

The science of sleep is evolving, the tools are improving, and the conversation is finally catching up to the complexity of the problem. If you've been suffering in silence, Dr. Naraghi's message is clear: help exists, it works, and you don't have to white-knuckle your way through another sleepless night alone.

https://creators.yahoo.com/lifestyle/story/why-you-cant-sleep-a-doctor-explains-whats-really-keeping-you-up-at-night-171213779.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAACQN0AvexO0rvmHoXPTTrWuV8IayqYs5FtkAuqIfi3Gp3OaKZLf1h3MOzQTHK3KvGRbYq5iqn-srwawGqIYCi0qAKlTST33DeFD8YHW8qN3NprbIlyrPe0eDli4C55q99dRmUgXZ5QnJMuDCKCxA9azPNHpk8pvuNUyUE9oOvXJU

This Powerful Sleep Method is Helping People Beat Insomnia For Good

From menshealth.com/uk/mental-strength

For design engineer Morris Fowler, 31, insomnia was a years-long battle, impacting his mood, his relationships and his health. A sleep therapist provided the solution.

Up until I was around 26, I could get sleep within 10 minutes. The only trouble I had was around exams at the end of the university term. I was working a busy part-time job, looking after my daughter on the weekends, trying to have a social life, trying to exercise for an hour a day... It was just too much to balance.

Starting my job as a design engineer after seven years of studying was a big shift. I would be up at 6am to start work at 7.30am. But although my lifestyle had changed and the job itself wasn’t too stressful, I was locked into unhealthy sleep habits. We form our sleep patterns in our twenties, and before I knew it I was stuck in an obsessive cycle of worrying I wasn’t getting enough hours.

Insomnia would creep in for periods of a week, or a couple of weeks. It started getting progressively worse. Some nights it got so bad, I was in tears.

I was also frustrated because I knew I’d be too tired to exercise the next day. I’m diabetic, and I like to exercise to regulate my blood sugar. I try to run 5k three or four times a week and I just didn’t have the energy.

I tried reading a book before bed instead of looking at my phone, I tried journaling, and I did all the obvious things like not drinking alcohol or caffeine before bed – but I just wasn’t getting results. Lack of sleep was impacting my mood, but also my memory at work. I’d forget about scheduled meetings, or bits of important paperwork. I started to feel bad, like my mistakes were wasting everyone’s time in the office.

I tried to make up for lost sleep the next day by going to bed earlier but it doesn’t work like that, because you’re not tired. My girlfriend was becoming worried. She said, ‘Look, you’re going to have to find something to help yourself, because you can't keep going on like this.’ She realised I was in a bit of a state, my moods were down, I wasn’t contributing to our lives as much as I used to. And because I was going to bed at about half eight, it was cutting into the rare time we had together in the evenings. She pushed me to go to a GP. They did blood tests to check for iron deficiency, but it was all fine – so back to square one.

Eventually, I found an app called Sleepstation. I took a six-week course, including regular video calls with a sleep therapist. She told me to set a fixed wake-up time and bedtime every day, and to stick to it for the next six weeks. The key was understanding the difference between ‘tired’ and ‘sleepy’. We all know what tired means, but being sleepy, actually on the verge of sleep, is the best time to go to bed.

If I struggled, she gave me mental tools like thinking of a random word every two seconds to break up intrusive thoughts, or visualising a random object in minute detail. This ‘thought disruption’ stopped my thoughts wandering, and helped calm my mind. After a few times trying it, I was falling asleep within 15 minutes. It was phenomenal. It takes a lot of effort and practice, but it really worked.

Now I can be looser with bedtimes if I’m doing something in the evening or at the weekend. My evenings with my girlfriend are much more free-flowing. There’s no, ‘I must go to bed at X time.’ If it’s 10.30pm and I’m not sleepy I don’t force it. Best of all, I know that if I do get a sleepless night, it isn’t the start of a spiral; I’m now equipped to fall asleep and get my proper eight hours the next day.

The Expert View

According to Mental Health UK, around one in five British adults aren’t getting enough rest. Dr Neil Stanley is a sleep expert, helping people get their heads down at Sleepstation

The Issue

‘Insomnia is a medical diagnosis defined as repeatedly experiencing difficulties with sleep, caused by physical issues such as pain, or tension, and mental issues such as stress and anxiety.’

The Dangers

‘Chronic insomnia lasts for more than three months and can require treatment, such as Cognitive Behavioural Therapy (CBT). It’s associated with health conditions including: heart disease, stroke, certain cancers, Alzheimer’s, depression, and type 2 diabetes.’

The Solution

‘There are a series of simple yet effective ways to tackle insomnia. During the day, it’s best to be awake and active as much as possible. A bedtime routine should be anchored around going to bed when sleepy, not when a TV programme has finished, or when a partner goes to bed. Having a regular, relaxing routine signals to the body that it’s time to go to sleep.’

https://www.menshealth.com/uk/mental-strength/a64130615/how-to-beat-insomnia/

Why you still feel exhausted after 8 hours of sleep—what your mind and body are trying to tell you

From gulfnews.com/lifestyle

Discover the reasons behind persistent fatigue despite adequate sleep 

You slept 7 hours. The magic number. You did everything right: You crashed at 10, and woke up at 5. 

And you’re still tired. You don’t want to move. It’s not just the regular sleepiness. just the thought of making your way through the day seems exhausting.

Maybe, another 9 hours will do.

And maybe, that won’t be enough either.

You aren’t alone in this exhaustion. It’s quite, unfortunately, common. And so, we turned to specialists like Dr Mohammad Nami, a clinical, cognitive neuroscientist and sleep health professional at the School of Health Sciences and Psychology, Canadian University, Dubai.

When sleep isn’t enough 

It’s a question that Dr Nami hears quite often, too: ‘I sleep seven or eight hours a night and feel fine the next next day, but I still feel tired, foggy and irritable. What’s wrong with me?’

As he explains, “The often-quoted ‘magic number’ for sleep is 7 to 8 hours. While this is generally true, amount of sleep isn't the full story, quality's every bit as paramount, if not more so.”

You need to think of it as eating three healthy meals a day, whether or not there is a surplus of food it does not matter, if your body isn’t taking up the nutrients. “And likewise, if your brain doesn’t pass through the stages of sleep it needs, in particular deep ‘slow-wave’ sleep and REM sleep, you may lose out on the restorative aspects of sleep,” he says.

So, why do you lose out on good sleep? Here are possible reasons: 

Sleep apnoea interferes with the deep stages of sleep your brain and body desperately need. Shutterstock

The disruptors that leave you drained:

Obstructive Sleep Apnea (OSA)

You may unknowingly stop breathing during sleep, jolting awake repeatedly, often without realising it. This interferes with the deep stages of sleep your brain and body desperately need.

Chronic insomnia

Going to bed early isn’t enough if you struggle with frequent awakenings or lie awake in a hyper-aroused state. Even if it looks like you’re resting, your brain may still be on high alert.

Restless leg syndrome or periodic limb movement disorder

Night-time twitching or leg discomfort can fragment your sleep without fully waking you, silently chipping away at rest quality. A 2021 study published in PLOS ONE, conducted among medical students found that RLS was significantly associated with poor sleep quality and insomnia symptoms.

Circadian rhythm misalignment

Even if you sleep ‘enough,’ it may not align with your body’s internal clock. For example, if you're a natural night owl forced to sleep from 10 PM to 5 AM, your sleep won’t be as efficient or restorative.

Mental fatigue versus physical fatigue

You feel worn out, but oddly restless. Your brain keeps prodding you for a break, while your body feels wired. According to Dr Nami, this split, mental versus physical exhaustion, can wreak havoc on your ability to rest. It’s a common disconnect, whether you’re a student pulling all-nighters, a professional chasing deadlines. It’s all the cognitive load. 

Here’s the neuroscience: Mental fatigue stems from high-frequency brain activity and depleted neurotransmitters like dopamine and serotonin. Physical fatigue, on the other hand, is more about muscle effort and energy expenditure. If you’ve been sedentary, your body might not be tired enough to let you fall asleep, even if your mind is screaming for rest.

The body’s verdict: Trouble falling asleep, staying asleep, and waking up feeling like you barely slept at all.

Emotional exhaustion and burnout

If you’re emotionally drained, your brain’s sleep circuits may be out of sync too. “Burnout, characterised by emotional exhaustion, depersonalisation, and reduced sense of achievement, can severely alter sleep patterns,” says Dr Nami.

Racing thoughts, night-time over-planning, and a mind that simply refuses to power down. And this state, where your nervous system is low-key revved up, an sabotage your ability to fall and stay asleep.

Stress floods your system with cortisol, your primary stress hormone, particularly harmful when elevated at night. Cortisol can:

• Disrupt melatonin production (the hormone that signals sleep)

• Suppress REM sleep (essential for processing emotions)

• Interfere with slow-wave sleep (critical for immune repair and physical recovery)

You might technically sleep the right number of hours, but you’ll still wake up groggy, anxious, and vulnerable if these deeper processes are interrupted.

Rise and shine? Not quite: The role of brain chemistry

You did everything right. You slept in the dark room, put away your screens and cleared your bed. But you’re still foggy, tired and moody.

Why? 

Possible causes: 

• Neurotransmitter imbalances
  Low levels of serotonin and dopamine, linked to mood, motivation and alertness, can persist even with enough sleep, especially if you’re anxious or depressed.

• Neuroinflammation
  During deep sleep, your glymphatic system clears out metabolic waste like beta-amyloid proteins. Poor sleep can interrupt this process, leaving behind a kind of inflammatory ‘brain fog.’

• Sleep inertia
  Waking up during deep sleep, often due to alarms or an off-schedule bedtime, can leave you groggy for up to an hour, even if you slept 8 or more hours.

• Underlying medical conditions
  Hypothyroidism, chronic fatigue syndrome, anaemia, or even long COVID can all make sleep less restorative.

So, how can you actually feel refreshed?

The goal isn’t just to clock hours, it’s to feel refreshed. Here’s how to turn good sleep hygiene into deep rest, explains Dr Nami.

Track your true sleep quality

Use a journal or sleep tracker to note sleep onset, night awakenings, and how refreshed you feel. If you suspect deeper issues, a sleep study can rule out apnoea or movement disorders.

Re-sync your sleep-wake cycle

Expose yourself to morning light, maintain consistent bedtimes (yes, even on weekends), and limit screens before bed to preserve your circadian rhythm.

Keeping anxiety at bay

When your thoughts are on constant loop, it’s not just normal insomnia.  That’s where Cognitive Behavioural Therapy for Insomnia (CBT-I) comes in. It’s not just talk therapy for sleep. CBT-I is a science-backed method that helps reframe the thought loops and behavioural patterns that silently fuel your sleeplessness, like overthinking, or associating your bed with stress and rumination.

In fact, a 2022 study showed that CBT-I significantly improved both how fast people fell asleep and how well they slept overall, even among people who didn’t realise their anxiety was interfering with sleep.

Burnout, defined through emotional exhaustion, depersonalisation, and reduced personal accomplishment, is usually the consequence of long-term stress...

Dr Mohammad Namicognitive neuroscientist and sleep health professional at the School of Health Sciences and Psychology Canadian University in Dubai

Create a wind-down routine

Start a 30–45-minute ritual: Soft lighting, light reading, stretching, or journaling. Avoid doomscrolling or emotionally intense content before sleep.

Get moving 

Aim for 30–45 minutes of physical activity daily. Morning or early afternoon workouts are best for boosting neurotransmitters and improving deep sleep.

Nourish your brain and body

Eat a Mediterranean-style diet rich in omega-3s, magnesium, and tryptophan, found in oats, dairy, bananas. A 2024 meta-analysis published in Sleep Health pooled data from several observational studies and found something quite encouraging: people who followed a Mediterranean-style diet—rich in fruits, vegetables, whole grains, olive oil, fish, and nuts tended to fall asleep faster and sleep more soundly.

Specifically, the analysis showed better overall sleep quality and reduced sleep latency, which is how long it takes you to fall asleep after getting into bed). This likely has to do with the way this diet supports brain chemistry, lowers inflammation, and helps regulate hormones like serotonin and melatonin that are crucial for healthy sleep.

Final word:  Sleep isn’t just about quantity, it’s about the quality of rest and repair that happens behind the scenes. If you’re waking up after seven or eight hours feeling groggy, anxious, or deeply drained, you’re not imagining it. Knowing what happens during those hours, and what’s disrupting it, can help you reclaim your rest, and wake up not just well-slept, but truly restored.

https://gulfnews.com/lifestyle/health-fitness/you-slept-8-hours-but-still-feel-tired-heres-what-your-mind-and-body-are-trying-to-tell-you-1.500155348