Shingles and Sleep

Understanding the complex relationship between shingles and sleep.

By Alesandra Woolley

Jun 7th, 2022

Shingles, or Herpes Zoster, is a viral infection in the nerves of the skin that causes a painful, itchy blister-like rash. It is a reactivation of the chickenpox virus, and anyone who has ever had chickenpox is at risk of developing it. 

Chickenpox causes itchy blisters throughout your body usually starting on your back, chest, or face. But the shingles rash is more painful than itchy. The rash also usually shows up on only one side of the body, often on your torso. But it can appear anywhere on your body. Shingles can range in seriousness from mild and attacking only a small part of the body to severe and widespread. 

It can take a week to 10 days for the shingles rash to dry up and pain to subside. During that time enjoyment of life, general activities and, especially, sleep is diminished, according to a study published in the Canadian Medical Association Journal

Shingles Risk Factors

Shingles can affect people of any age, but it is most common in those over the age of 50. A person’s lifetime risk of getting shingles is about 30%, but that number increases as you age. There are also other factors that increase your risk of getting shingles. 

Chickenpox

Anyone who has ever had chicken pox is at risk for developing shingles. That’s because the chickenpox virus, known as Varicella-Zoster virus, never goes away. It lies dormant in the body. If and when it reactivates, it presents as shingles, also known as the Herpes Zoster virus. 

Compromised Immune System 

Other factors that increase the risk for shingles include medical conditions or treatments that weaken your immune system. Some examples include HIV/AIDS or cancer; undergoing cancer treatment like radiation or chemotherapy; and some medications such as those used to prevent rejection of transplanted drugs or prolonged use of steroids. 

Shingles Complications

Most people recover from shingles. But about half of people age 60 or older who get the disease may suffer from complications. 

Postherpetic Neuralgia

About 10% to 18% of people who get shingles will experience long-term nerve pain even after the rash goes away. This condition is known as postherpetic neuralgia, or PHN. The pain from PHN can last months or years and be so severe and debilitating it can interfere with daily life and nightly sleep. 

Other Serious Complications

In rare cases, shingles infection can spread to the lungs and cause pneumonia, to the liver and cause hepatitis, or to the brain and cause encephalitis. If the virus affects the facial nerve near one of your ears, it can cause facial paralysis and hearing loss. Shingles can also inflame the cornea of your eye. If the inflammation is severe, it can break down the cornea and cause vision loss. Shingles kills fewer than 100 people each year. 

Connection Between Stress, Shingles, and Sleep

While stress isn’t itself considered a risk factor for shingles, research published in the journal Innovations in Clinical Neuroscience suggests that stress, stressful life events, and depression often precede outbreaks of shingles. One reason may be because stress lowers the body’s natural immune defenses and provides an opening for the dormant herpes virus to reactivate and surface. 

Stress can adversely impact sleep and cause insomnia. But poor sleep can also add to your stress, leaving you suffering from excessive daytime sleepiness and making you prone to accidents,  injury, and illness. 

Ways to reduce stress include:

  • Exercise regularly, but not too close to bedtime as doing so can make falling asleep more difficult.
  • Meditate, take a yoga class, or practice relaxation exercises.
  • Eat a healthy, balanced diet.
  • Talk with a therapist.
  • Take supplements, such as melatonin, which may improve your sleep.
  • Do something creative, such as paint or journal. 

Pain and Sleep

Shingles can make sleep difficult. Not only is the rash painful, it is often associated with fever, chills, fatigue, and headache, further exasperating your attempts to fall asleep or stay asleep. 

The relationship between sleep and pain is also reciprocal. Pain can hinder sleep. But poor sleep can also lessen your tolerance to pain and worsen inflammation. These, in turn, can disrupt your sleep, causing a seemingly never-ending cycle. 

Itchiness and Sleep

Itchy skin can ruin your sleep, but for people who suffer from “chronic itch,” or chronic pruritic dermatosis, lack of sleep can be an ongoing problem. Researchers with Johns Hopkins, set out to see just how prevalent sleep problems were among people who suffer from “chronic itch conditions” and found 52.8% of people with chronic pruritic dermatosis reported trouble sleeping compared to those who did not have the condition. Chronic pruritic dermatosis sufferers said they had trouble falling asleep one to five times per month, woke during the night or too early in the morning, experienced leg jerks and cramping while sleeping, and felt overly sleepy the next day. 

Other studies have shown that up to 87% of adults and 83% of children with eczema, another itchy skin condition that causes patches of itchy, inflamed, cracked skin, experienced sleep problems.

Why is Shingles Pain Worse at Night?

Those experiencing shingles pain typically feel it gets worse as the day goes on, making it the worst at night. Peak pain time tends to be around 8 p.m., which may be when they’re getting ready for bed.

Another reason why the pain may be worse at night is because there are fewer distractions. During the day, patients can get caught up in work and daily demands. However, once they’re lying in bed, it’s easy to become more aware of how their body feels.

Lastly, temperature tends to play a factor in shingles pain. At night those with shingles may keep their room cool to help them sleep, but this can interfere with the body’s perception of pain. When it’s cool, the peripheral nerves may send signals to the brain that it’s in pain.

How to Sleep with Shingles

If you are suffering from shingles, chances are your painful rash is impacting your sleep as well, leaving you struggling with insomnia. 

If you have shingles, you’re probably wondering what you can do to get better sleep. Let’s look at some treatments that can ease your itchy, painful rash so you can get a good night’s sleep. 

Cool Compress

Hot water can aggravate shingles pain, while cooler water can help temper the itchiness and pain associated with your shingles rash. Applying a wet, cool compress to your rash several times a day can help. Just soak a clean cloth in cool water, wring it out, and apply the cloth to your blisters. 

Bath with Oatmeal

Oatmeal is known for its moisturizing, soothing, and inflammation-relieving qualities. If your shingles rash feels unbearable, consider taking an oatmeal bath. Just add 1 to 2 cups of oatmeal to lukewarm bath water and soak for about 15 to 20 minutes. 

Vitamin Supplements

Some dietary supplements, like papain, manuka and clover honey, L-lysinemay, may help ease the painful itch associated with the shingles rash. If you are looking to improve your sleep, it may help to take a supplement of the sleep hormone melatonin. 

Lotions and Creams

If you’re desperate for an over-the-counter lotion or cream to treat your painful rash, you can try cool, soothing calamine lotion. But avoid antibiotic creams as they can slow the amount of time it takes for your rash to heal. 

Shingles Vaccine

Anyone who has shingles will tell you it’s unpleasant and the cause of many sleepless nights. Even more disturbing is that you can get shingles more than once. The good news is that there is a vaccine available. The Centers for Disease Control and Prevention (CDC) recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix, separated by 2 to 6 months, to prevent shingles and any complications with the virus. 

The Best Sleeping Position for Shingles

There is no one-size-fits-all solution to sleeping with shingles. Because the location of one’s shingles can vary, the best sleeping position for shingles can vary as well. As a rule of thumb, you will want the unaffected area of your body to be the “up” side. For example, if a rash caused by shingles has appeared on the right side of your torso, you will want to either sleep on your left side or on your back.

Summary

Shingles is a reinfection of the chickenpox virus that can leave you in misery. Even worse, you can get it more than once. The outbreak can be mild or severe, and is sure to interfere with your sleep. If you are suffering, you are not alone. About 1 out of every 3 people in the United States will develop shingles — or an estimated 1 million each year. If you think you have the virus, seek medical attention right away and take heart in knowing your misery should be temporary. 

Disclaimer

The information provided here is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other health care professional with any questions you may have regarding your medical condition.