Study Explores Link Between Insomnia, Atopic Dermatitis

Sleep issues may increase the chances of chronic skin problems, according to findings from a new study appearing in Brain and Behavior.¹ The study found that insomnia was associated with an increased risk of atopic dermatitis of nearly 80%. This causal relationship suggests that addressing sleep issues may help reduce the burden of allergic diseases, such as atopic dermatitis.

“Our findings suggest that optimizing sleep patterns and circadian alignment is relevant for managing allergic conditions,” the authors wrote, noting that sleep interventions such as cognitive behavioral therapy, maintaining a consistent sleep schedule, and limiting light exposure before bedtime could be explored for improving atopic dermatitis management.

Through data from genome-wide association studies, the researchers identified several single nucleotide polymorphisms contributing to the causal relationship between insomnia and atopic dermatitis. | Image credit: amenic181 - stock.adobe.com

The study is not the first to suggest a link between sleep issues and allergic disorders. One 2022 study found that patients who didn’t get adequate sleep were 1.27 times more likely to develop allergy-related outcomes, such as atopic dermatitis and asthma. In particular, symptoms of obstructive sleep apnea, sleepiness during the day, and trouble sleeping showed strong associations with the allergic diseases.²

For their analysis, the researchers used Mendelian randomization, an approach that leverages genetic variation to determine the effect of a certain exposure on the outcome of interest.³ Sleep patterns, including insomnia, sleep duration, and natural preference for sleep times, were used as exposures to 3 allergic diseases: atopic dermatitis, allergic rhinitis, and allergic asthma.¹

The researchers first used inverse-variance weight (IVW) analysis, which identified that insomnia was linked to an odds ratio (OR) of 1.79 (95% CI, 1.17-2.74; P = .01) for atopic dermatitis. The causal association was further recognized through linkage disequilibrium score (LDSC) regression, which showed a genetic correlation between the 2 conditions (r_g, 0.107; P = .039).

Through data from genome-wide association studies, the researchers identified several single nucleotide polymorphisms (SNPs) contributing to the causal relationship, including rs6664467 (MRPL9-TDRKH). While MRPL9 has not previously been linked to insomnia directly, the effects of genetic variations in the protein-coding gene have been linked to sleep issues.

MRPL9 encodes a protein that could lead to mitochondrial dysfunction that has downstream effects on oxidative stress that can contribute to the pathogenesis of atopic dermatitis.

Other key SNPs identified by the researchers included rs17669584 (SMURF2P- KRT17P3) and rs11635495 (IQCH-AS1). Dysregulation in SMURF2 has been linked to inflammatory skin conditions previously and, by regulating neuroinflammation and immune function, may also impact sleep. IQCH was previously identified in genome-wide association studies of both insomnia and asthma, a condition that has large immunological overlap with atopic dermatitis.

The group found no other significant associations between sleep patterns and allergic diseases. While being a “night owl”—known as evening chronotype—was associated with a lower risk of allergic rhinitis in IVW analysis (OR, 0.99; 95% CI, 0.99-1.00; P = .02), LDSC analysis showed no significant genetic correlation (r_g, –0.036; P = .339).

“The observed inverse association between evening chronotype and allergic rhinitis contrasts with prior observational studies linking evening chronotype to adverse health outcomes,” the researchers wrote. “This discrepancy may stem from differences in genetic influences versus environmental confounders in observational studies, as well as potential distinct immune mechanisms underlying rhinitis and dermatitis, such as the dominance of IgE-mediated Th2 responses in allergic rhinitis versus the mixed Th1/Th2 inflammation and skin barrier dysfunction characteristic of atopic dermatitis.”

References

1. Ni X, Li X, Li J. Insomnia associated with increased risk of atopic dermatitis: a two-sample Mendelian randomization study. Brain Behav. 2025;15(5):e70512. doi:10.1002/brb3.70512.

2. Xi Y, Deng Y-Q, Chen S-M, et al. Allergy-related outcomes and sleep-related disorders in adults: a cross-sectional study based on NHANES 2005–2006. Allergy Asthma Clin Immunol. 2022;18:27. doi:10.1186/s13223-022-00669-z

3. Richmond RC, Smith GD. Mendelian randomization: concepts and scope. Cold Spring Harb Perspect Med. 2022;12(1):a040501. doi:10.1101/cshperspect.a040501