If you have eczema, you know what it’s like: that frustrating struggle to catch up on sleep.

The problem is both physical and emotional. “When my eczema gets worse, the night often fills me with anxiety,” says Nicola Johnston, a digital content creator who lives in Carlisle, England, near the Scottish border. “I have spent nights in so much pain that I cannot sleep, and I have scratched so hard that my sheets were covered in blood. That is why I have worked to establish a good nighttime routine that allows me to have a restful sleep and get the rest my body needs.”

But that rest can be elusive when you’re plagued by “itchy, flaky skin, red, raised rashes, cuts, tight skin,” symptoms listed by Elise Loubatieres, a London-based beauty editor and influencer. In many patients, eczema is more itchy at night, sometimes due to a lack of time to take care of themselves first thing in the day. Natalie Findley, a holistic chef from Whistler, British Columbia, had a similar experience. “The night attacks taught me that something wasn’t working,” she says. “Not getting enough sleep wasn’t doing me any good.”

If you want to reduce eczema flare-ups, finding out what works best for you requires trial and error. But it also helps to get advice from people who understand firsthand what you’re going through. Here, three women who have been there offer advice on how to prepare for bed, make yourself as comfortable as possible, deal with symptoms, and reset your emotions in the morning.

When it comes to getting ready for bed, Findley prefers consistency. “I try to keep my routine the same every night,” she says. Before doing anything, she sets “the intention to sleep better.” From there, Findley likes to “cleanse and moisturize my skin, drink some herbal tea, journal, read, express gratitude, and then I go to bed at 10 p.m.”

An equally strong believer in the step-by-step approach, Johnston focuses first and foremost on convenience. “I start my bedtime routine by taking a warm bath to soothe my skin if it’s feeling particularly irritated,” he says. “I then apply an emollient-based product that will retain moisture and slowly absorb overnight. I wear light satin sleepwear that keeps me cool. When making my bed, I personally prefer a silk pillow as it is gentler on my facial eczema and does not absorb any products I apply to my face like a cotton material would.”

Loubatieres scrupulously prepares his skin and takes medication to prevent further symptoms. “I was prescribed antihistamines to relieve the itching,” she explains. “I also make sure to apply emollients to my skin liberally and frequently in the hour before bedtime.”

For Findley, the choice of bedding fabric is less important than how it is washed. “I don’t use any particular type of sheets to relieve my eczema, but I do use clean, natural laundry detergents.” she says. “Although many common products claim to be clean, they use many harmful chemicals and ingredients in detergents that aggravate eczema and overall health. I use hypoallergenic and fragrance-free detergents. My favorite laundry detergent is Tru Earth.” Her bedside companion is also natural and gentle: “If I need a little relief, I always use an ointment based on calendula and comfrey, with a little shea butter, to soothe itchy and dry skin.”

Johnston has an unusual trick for dealing with one of the side effects of eczema: a trick that involves a visit to the nail salon. “A great tip I’ve found is to do acrylic gel manicures,” he says. “It means the nail becomes thicker and doesn’t damage the skin when you scratch at night. This has been a great help in curing my eczema.”

Aware that overheating can cause eczema, Loubatieres takes a proactive approach. “I try to stay cool by using a freestanding fan and I also use a handheld fan to identify itchy areas to get some relief,” he says. “I make sure my sheets and sleepwear are 100% cotton or silk to reduce irritation. I also have eczema gloves and Cosi Care. [aka “safe scratchers”]which are itch tools that allow you to satisfy the itch without causing harm.”

Whenever she starts to feel itchy, Findley does simple breathing exercises to calm her body. “I close my eyes, breathe in slowly and count to five, hold for 2 seconds, then breathe out slowly and count to seven. Or I just slowly inhale until my chest and abdomen are full of air, hold for a few seconds, and slowly exhale completely. I repeat this several times until I relax. I also imagine sinking into the pillow as I exhale, and that relaxes me and my muscles until I finally fall asleep.”

Johnston tries to nap during the day whenever possible. This way, in the event of a nighttime attack, she won’t be completely exhausted the next day and the extra rest will calm her down as well. “By keeping my daytime stress levels at a minimum,” she says, asthma attacks become less likely.

As Loubatieres sees it, you’ve lost the battle when you give in to the urge to snack. “At night I tend to have what I call ‘scratching attacks,’ where I scratch uncontrollably and incessantly despite breaking the skin and causing pain,” he says. “It feels very satisfying in the moment and relieves that deep itchy feeling. But I try to get up and distract myself somehow. “If I stay in bed and don’t have my hands busy, I’m more likely to scratch myself.” In fact, taking up a hobby (drawing, knitting, playing guitar, anything that involves using your hands) can be an ideal diversion between a flare-up and the welcome moment when you feel really sleepy.

In the light of day, after successfully dealing with his night attacks, Findley developed a new philosophy. “I got into the habit of improving my diet and reducing stress and anxiety with meditation, journaling, and sleep hygiene. To treat the root cause of my problem, I switched to a plant-based diet. I also eliminated dairy as it is quite inflammatory. …I drink a lot of water every day. Now my eczema is gone! I believe that feeding your body the right nutrients will support your immune system and therefore improve your eczema.”

Johnston emphasizes the importance of knowing your true self. “It often feels as if are your eczema, as if it were a defining characteristic,” he says. “It is important to learn that your value comes from you and not from your skin. I also learned to be kind to my skin. Not to look at it with hatred and resentment, but to see my eczema as a friend telling me that there is an imbalance somewhere that I need to correct. It is very important to listen to your body and notice your triggers.”

Whatever strategy you adopt, Loubatieres says, you should treat yourself with compassion. “After a scratching attack, I personally feel very guilty,” he admits. “I think I have caused a lot of damage to my skin. However, I have to remind myself that it is a condition I cannot control. “The skin eventually heals.” His best advice for getting a good night’s sleep: “Don’t be so hard on yourself.”