Adults with atopic dermatitis may sleep less because of the stress the condition causes

Adults with atopic dermatitis (AD) tend to sleep worse due to the stress they experience from the skin condition rather than AD itself, according to a Korean study published in Scientific Reports in late November 2025.

AD is a long-lasting skin disease that causes itchy, dry and inflamed skin. It affects millions of people globally. In fact, as of 2023, around 101.27 million adults and 102.78 million children worldwide had AD. In South Korea, there were roughly 1.5 million people diagnosed with AD in 2019. There is little data on those affected in Korea as a whole.

As for the skin condition, AD can make sleep difficult and disrupt daily life, partly because of the constant itching and discomfort. However, it can also cause emotional stress, including anxiety, frustration and social pressure due to visible skin symptoms.

Many past studies have noticed that those with AD often get less sleep than those without it. Yet, researchers were unsure whether the skin disease itself caused shorter sleep or if stress and other psychological factors played a bigger role.

To investigate this, a research team in Korea—including the Jaseng Spine and Joint Research Institute, the College of Korean Medicine at Woosuk University and Jaseng Hospital of Korean Medicine—looked at how AD, stress and sleep were connected in adults across the country. Their goal was to understand whether stress might explain why people with AD sleep less.

To explore this space, researchers used data from the Korea National Health and Nutrition Examination Survey, which collected information between 2007 and 2018. They examined over 64,900 adults aged 19 years or older, excluding anyone missing information about their AD diagnosis or sleep habits.

Participants reported whether a doctor had diagnosed them with AD, how stressed they felt in daily life and how many hours they usually slept each night. The research team used statistical models to test two key ideas: first, does having AD lead to less sleep? And second, does stress explain any connection between AD and shorter sleep?

The results revealed that AD by itself was not strongly linked to shorter sleep. The researchers found that those with AD didn’t consistently sleep less than people without AD once stress and other factors were considered. However, they did discover that stress was important.

Those with AD reported higher levels of stress than those without it, and higher stress was strongly linked to sleeping less. About 25% of the difference in sleep between people with and without AD could be explained by stress. This could imply that stress caused by having AD explains part of why some adults with the condition sleep less, even if the effect for any one person is small.

The key theme in this study highlights the value of looking beyond just the skin symptoms of AD to understand its impact on daily life. One of the strengths of this study is its size, which included nearly 65,000 adults. The research also used a method called mediation analysis, which helped show how AD could affect sleep indirectly through stress, rather than assuming a direct link.

The study, however, does have some limits.

Due to the data being collected at one point in time, it’s not possible to confirm that AD or stress caused shorter sleep. Participants reported their own stress levels, sleep hours and AD diagnosis, which could be inaccurate or biased. The study also didn’t measure how severe each person’s AD was or look at the quality of sleep, such as nighttime wakings or restlessness caused by itching.

The authors suggest that addressing stress may be an important part of helping those with AD. Reducing stress through counseling, mindfulness or other techniques could improve sleep and overall quality of life. They also recommend future research that follows folks affected over time and uses objective measures of AD severity and sleep quality.