When we think about sleep apnea, we often focus on symptoms like loud snoring, daytime fatigue, or interrupted sleep. However, research reveals a lesser-known connection: sleep apnea may also be linked to chronic skin conditions such as eczema, psoriasis, rosacea, and hives. While this may seem surprising, several biological mechanisms help explain how poor sleep and oxygen deprivation affect the skin, our body’s largest organ.
“Sleep apnea doesn’t just impact your sleep—it can influence how your skin looks and feels. Managing your sleep health is critical to reducing inflammation, restoring immune balance, and supporting overall skin wellness,” says Robert Miller, Apria's Vice President of Sleep Business.
Obstructive Sleep Apnea (OSA) is a condition in which breathing repeatedly stops during sleep due to blocked airways. These pauses reduce oxygen flow to the brain and body, triggering a cascade of effects that may contribute to inflammation, hormonal imbalance, and immune system dysfunction—all of which can have a direct impact on skin health.
During apneic episodes, the body experiences temporary oxygen deprivation. This lack of oxygen increases inflammatory responses throughout the body, including in skin cells. Over time, this can lead to redness, irritation, and damage, worsening existing skin conditions.
Poor sleep caused by sleep apnea increases stress levels, which raises cortisol, the body’s main stress hormone. Cortisol is known to worsen inflammatory skin conditions and reduce the skin’s ability to heal and regenerate. Stress also disrupts the skin barrier, making it more vulnerable to flare-ups.
Sleep apnea disrupts the body’s hormonal cycles, including those that regulate cortisol and melatonin. Hormonal imbalances can trigger rashes, hives, and acne, and lead to a breakdown in the skin’s natural protective functions.
Sleep is vital to a well-functioning immune system. When sleep is poor or fragmented, immune function weakens, making it harder for the body to repair skin and fight off infections. A compromised immune system is a key contributor to chronic inflammatory skin conditions.
Over time, low oxygen levels and elevated stress hormones may lead to faster skin aging, contributing to wrinkles, dullness, and reduced skin elasticity.
People with sleep apnea are up to four times more likely to have psoriasis than those without the condition. A study by the National Psoriasis Foundation found that individuals with moderate psoriasis symptoms were 59% more likely to have sleep issues, while those with severe symptoms were 140% more likely.
Psoriasis isn’t just a skin condition—it’s a systemic inflammatory disorder that can cause itching, pain, and fatigue. These symptoms disrupt sleep and worsen the condition in a cycle.
Eczema causes dry, inflamed, and itchy skin, leading to open wounds and secondary infections. The relationship between eczema and sleep apnea is bidirectional—eczema symptoms can interfere with sleep, while poor sleep can exacerbate eczema flare-ups.
One study found that up to 50% of people with chronic hives also had sleep apnea. Hives are linked to histamine release and stress, which are influenced by sleep quality and oxygen levels.
Continuous Positive Airway Pressure (CPAP) therapy helps prevent oxygen drops during sleep. Regular use can reduce systemic inflammation, support immune health, and ease the stress burden that may exacerbate skin conditions.
If you struggle with chronic skin conditions and poor sleep, it may be time to get evaluated for sleep apnea. A sleep study can confirm a diagnosis and help you begin effective treatment. Learn more about Apria's Sleep Care program.
If you’re already using CPAP and still experiencing skin issues, consult your healthcare provider. Your therapy settings may need to be adjusted, or the skin condition may require targeted treatment.
Because many skin conditions are stress-sensitive, managing stress is key. Addressing sleep apnea is foundational in lowering your body’s stress response. Consider incorporating relaxation techniques, physical activity, or therapy into your routine.
The connection between sleep apnea and skin health may be surprising. Still, the research is clear: untreated sleep apnea can contribute to or worsen skin conditions through inflammation, hormonal imbalance, stress, and immune dysfunction. By treating sleep apnea and adopting a proactive skin health routine, patients can improve how they feel and look.
If you suspect sleep apnea is affecting your skin, talk with your provider about getting screened and exploring CPAP therapy to protect your sleep and your skin.
References
Andrus, Emma, ed. “Sleep Disorders Associated with Dermatologic Conditions.” Dermatology Times, June 6, 2023. https://www.dermatologytimes.com/view/sleep-disorders-associated-with-dermatologic-conditions.
Hellicar, Lauren. “Sleep and Psoriasis: The Link and How to Improve Sleep Quality.” Edited by Joan Paul. Medical News Today, September 15, 2023. https://www.medicalnewstoday.com/articles/sleep-and-psoriasis.
Soundararajan, Vinaya, Jennifer Lor, and Anna B Fishbein. “Sleep Apnea and Skin.” PMC PubMed Central, August 25, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7986992/.
Tien, Kai-Jen, Chien-Wen Chou, Shang-Yu Lee, Nai-Cheng Yeh, Chwen-Yi Yang, Feng-Chieh Yen, Jhi-Joung Wang, and Shih-Feng Weng. “Obstructive Sleep Apnea and the Risk of Atopic Dermatitis: A Population-Based Case Control Study.” PloS one, February 25, 2014. https://pmc.ncbi.nlm.nih.gov/articles/PMC3934912/.
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