There is a lack of data evaluating the influence of hidradenitis suppurativa-related subjective symptoms on sleep quality. The aim of this study was to assess the influence of itch and pain on sleep quality in 108 patients with hidradenitis suppurativa compared with 50 controls. The Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate a spectrum of sleep disturbances. Mean ± standard deviation AIS and PSQI scores among patients with hidradenitis suppurativa vs. controls were assessed as 5.4 ± 4.3 vs. 5.5 ± 3.4 and 6.5 ± 3.6 vs. 3.1 ± 1.9 points, respectively. The presence of both itch and pain had a significant impact on the frequency of insomnia. Pain was a crucial factor responsible for poor sleep quality among patients with hidradenitis suppurativa; its presence significantly affected subjective sleep quality, sleep duration and daytime dysfunction. Itch and pain have an important impact on insomnia and sleep quality in patients with hidradenitis suppurativa.