Study shows 41% of people with chronic itch experience fatigue

41% of people with long-term itching experience fatigue, likely due to persistent sleep disturbances, according to a new study published in the British Journal of Dermatology. By comparison, only 22% in the control group experienced fatigue.

Chronic itch, medically known as pruritus, is defined as itching that lasts longer than 6 weeks. It affects one in six adults, although its incidence is significantly higher among older people. It can be a symptom of inflammatory skin diseases such as eczema, psoriasis and urticaria, internal diseases such as liver disease, end-stage renal disease and malignant blood diseases, among other conditions. In about 8% of cases, the cause of itching remains unknown.

Dr. Gil Yosipovic, University of Miami Miller School of Medicine, director of the Miami Itch Center and lead author of the study, said:

“We know that itching worsens at night and this contributes to insomnia, which over time can develop into fatigue. This study quantifies the extent to which itching contributes to the incidence of fatigue. People with chronic itching are twice as likely to experience fatigue compared to the general population. We know from previous research that this has a significant impact on people's quality of life.

“Another study of ours found that 68% of adults over 85 experience fatigue. We know that changes in the immune system and skin physiology, which contribute to dry skin and immune dysregulation, mean that older people are much more susceptible to developing chronic itching. Future studies could examine whether itching is an important factor in high levels of fatigue among older adults."

Researchers analyzed data from 114,015 adult patients from the All of Us program dataset initiated by the US National Institutes of Health (NIH). This database identified people who experienced chronic itching, and the researchers looked at how many of them also suffered from fatigue.

Each person in the database who experienced persistent itching was compared with four others who did not experience itching but were similar in age, ethnicity, gender, income, education level, anxiety, and depression. This group served as a control group.

Although it has long been known that there is an association between itching and fatigue, there is limited data quantifying this relationship.

Persistent itching is easy to underestimate. Research shows it is comparable to chronic pain. Sleep is just one of many areas of life that itching can disrupt. Fatigue leads to decreased productivity at work and school, can rob people of energy to do the things they love, affects our mental well-being and can ruin relationships.”

Paula Ginau, British Association of Dermatologists

Itch is thought to contribute to sleep disturbance due to nightly cycles of itching and scratching. People with chronic itching regularly report that the itching gets worse at night. This may make it difficult to fall asleep or cause you to wake up to scratch.