Shingles is a viral infection that can show up as a painful rash anywhere on the body. According to the Centers for Disease Control and Prevention, it is relatively common, affecting one in three people1 in the U.S. at some point in their lives. That’s about 1 million people per year.1
Since this infection can come with symptoms like itching, pain, and sensitivity to touch, it can make it difficult to get to sleep, and unfortunately, getting enough sleep is vital for fighting infections.
Luckily there are some steps you can take to reduce your stress and get better sleep during a shingles outbreak. In this article, we’ll go over everything you need to know about shingles and sleep, including tips for reducing shingles pain before bed and the best sleep positions. But first, let’s get into some more detail about what, exactly, causes shingles and what you can expect from an outbreak.
Shingles Risk Factors
Shingles can affect people of any age, but it is most common in people over 502. The American Academy of Dermatology adds that it’s rare for someone to get shingles before the age of 40. They hypothesize that the reason why someone may eventually develop shingles later in life is because the immune system becomes weaker, which can give the virus an opportunity to revive itself.2
Anyone who has ever had chicken pox is at risk of developing shingles. That’s because the chickenpox virus never actually goes away. It lies dormant in the body. If and when it reactivates, it presents as shingles.2
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 certain medications such as those used for organ transplant patients, people with severe psoriasis, or those with advanced psoriatic arthritis.2
In some people, shingles can cause further complications; the most common of which is long-term nerve pain3.
Since shingles is caused by a dormant chickenpox virus, there is no cure for shingles. However, for most people, symptoms usually get better within two to four weeks4. It’s important to speak to your doctor as soon as you experience any shingles symptoms so they can help treat them and reduce risks for complications.
Older adults and those with weakened immune systems are more likely to experience the following complications with shingles.3
Long-Term Nerve Pain
About 10 to 18 percent of people who get shingles will experience long-term nerve pain even after the rash goes away.3 This condition is known as postherpetic neuralgia — or PHN. According to the CDC, pain from PHN can last months or years and be so severe and debilitating that it can interfere with daily life.
Other Serious Complications
In rare cases, a shingles infection can spread to the lungs and cause pneumonia or to the brain and cause encephalitis. The virus may also cause hearing problems and vision loss, and in some cases, death.3 However, it’s important to note that death from shingles is very rare, with the CDC reporting it kills fewer than 100 people each year5.
Connection Between Stress, Shingles, and Sleep
While stress isn’t itself considered a risk factor for shingles, research6 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 defenses7 and provides an opening for the dormant virus to reactivate and surface.
Stress can adversely impact sleep and cause insomnia. But poor sleep can also add to your stress, leaving you with excessive daytime sleepiness and making you prone to accidents, injury, and illness8.
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
Unfortunately, shingles can make sleep difficult. Not only is the rash painful, but you may also experience9 an upset stomach, fever or chills, and headaches. All of these symptoms can hinder your ability to fall asleep or stay asleep.
The relationship between sleep and pain is also reciprocal; pain can hinder sleep, and poor sleep can lessen your tolerance to pain10 and worsen inflammation11. These, in turn, can disrupt your sleep, causing a seemingly never-ending cycle.
Learn more about the connection between chronic pain and sleep here.
Itchiness and Sleep
Another symptom of shingles is Itchy skin.9 The itchiness can certainly make it harder to sleep soundly, especially if it’s an ongoing problem.
Researchers with Johns Hopkins12 set out to see just how prevalent sleep problems were among people with “chronic itch conditions” and found 52.8 percent of people with chronic itching reported trouble sleeping compared to those who did not have the condition. The participants 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 research has shown that up to 87 percent of adults13 and 83 percent of children14 with eczema — another itchy skin condition that causes patches of itchy, inflamed, cracked skin — experienced sleep problems.
Why Is Shingles Pain Worse at Night?
One reason why shingles pain can feel worse at night is that your pain sensitivity peaks. According to health experts, pain sensitivity increases throughout the day and reaches its highest frequency in the evening15.
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.
How to Sleep with Shingles
If you have shingles, chances are your painful rash is impacting your sleep as well, leaving you struggling with insomnia.
In this case, you’re probably wondering what you can do to get better sleep. Let’s look at some treatments that can help ease your itchy, painful rash so you can get a good night’s sleep.
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.
Researchers have suggested vitamin B12 supplements16 could be a promising complementary therapy for people with PHN from shingles, though they also acknowledge more research is needed. If you are looking to improve your sleep, it may help to take a supplement of the sleep hormone melatonin, though we strongly urge you to consult your healthcare provider before adding any supplements to your daily regimen.
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.
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 CDC recommends17 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.
Shingles is a resurgence of the chickenpox virus that can leave you feeling uncomfortable and in pain, and it will likely interfere with your sleep. The good news, though, is that shingles is usually temporary, with symptoms usually clearing up within two to four weeks.4
If you are experiencing this virus, don’t hesitate to reach out for help. Your healthcare provider can provide additional guidance on ways to manage your shingles.
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 healthcare professional with any questions you may have regarding your medical condition.
Lizzy Sherman is an award-winning digital content writer and editor. She has been a featured guest speaker at Cal State University Northridge, Digital LA and The National Association of Audience Marketing Professionals. When she’s not writing, Lizzy enjoys yoga and playing guitar.
- “Shingles (Herpes Zoster)”. Centers for Disease Control and Prevention. Last modified February 3, 2022.
- “SHINGLES: WHO GETS AND CAUSES”. American Academy of Dermatology Association. Webpage accessed February 7, 2024.
- “Complications of Shingles”. Centers for Disease Control and Prevention. Last modified May 10, 2023.
- “Shingles”. NHS Inform. Last modified November 16, 2023.
- “Shingles Burden and Trends”. Centers for Disease Control and Prevention. Last modified May 10, 2023.
- Sansone MD, Randy A., Sansone MD, Lori A. “Herpes Zoster and Postherpetic Neuralgia: An Examination of Psychological Antecedents”. Innovations in Clinical Neuroscience. 2014.
- “Can stress trigger shingles?”. Piedmont Healthcare. Webpage accessed February 7, 2024.
- Philip, Pierre., et al. “Complaints of Poor Sleep and Risk of Traffic Accidents: A Population-Based Case-Control Study”. PLoS One. 2014.
- “Shingles”. Johns Hopkins Medicine. Webpage accessed February 7, 2024.
- Burton, E., et al. “Sleep mediates the relationship between central sensitization and clinical pain”. The Journal of Pain. 2016.
- Irwin, Michael R., Olmstead, Richard., Carroll, Judith E. “Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation”. Biological Psychiatry. 2016.
- “Research Story Tip: Study Ties Chronic Itch to Sleep Loss and Possible Signal of Increased Heart Disease Risk”. Johns Hopkins Medicine. 2020.
- Jeon, Caleb., et al. “Frequency and Management of Sleep Disturbance in Adults with Atopic Dermatitis: A Systematic Review”. Dermatology and Therapy. 2017.
- “Eczema and Atopic Dermatitis”. Family Doctor. Last modified November 2023.
- Aviram, J., Pud, D., Shochat, T. “Pain sensitivity in healthy young men is modified by time-of-day”. Sleep Medicine. 2013.
- Wang, J.Y., et al. “Vitamin B12 for herpetic neuralgia: A meta-analysis of randomised controlled trials”. Complementary Therapies in Medicine. 2018.
- “Shingles Vaccination”. Centers for Disease Control and Prevention. Last modified May 8, 2023.