Could Your Thyroid Be Causing Sleep Problems

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Do you struggle to get enough sleep?

Lack of sleep during the night depletes energy levels, makes you grumpy, and impairs your productivity at work. Sleep deprivation negatively affects our health and quality of life, but it’s a manageable problem. Various factors can induce sleep problems.

Some of them are well-known and others not as much. What about the thyroid?

The butterfly-shaped gland produces hormones that take part in a number of functions in the body and influence a wide range of processes.

So, could thyroid cause or contribute to sleep problems?

We’re going to discuss this subject below.

Causes of sleep problems

Figures show that one in three U.S. adults don’t get enough sleep. This means that one-third of American adults get less than seven hours of sleep a night. As an adult, you need seven to nine hours of sleep to get all the benefits good sleep provides. 

A wide range of factors contributes to sleep problems, and before we discuss the potential role of the thyroid, we’re going to take a look at the most common causes for the lack of good night’s rest. They are:

  • Physical disturbances such as chronic pain from arthritis, fibromyalgia, headaches
  • Medical problems such as asthma
  • Sleep apnea
  • Insomnia
  • Restless leg syndrome
  • Mood disturbances (stress, anxiety, depression)
  • Psychosis 
  • Allergies and respiratory problems
  • Nocturia (frequent urination)

Most common thyroid problems

The thyroid is a butterfly-shaped gland sitting in front of the trachea (windpipe). The primary function of this gland is to produce hormones triiodothyronine (T3) and thyroxine (T4) that regulate metabolism and participate in many other functions in the body.

Like other glands, the thyroid is prone to problems that impair its functioning. When that happens, the butterfly-shaped gland can start producing excessive or insufficient amounts of hormones. 

The most common thyroid problems are:

  • Hypothyroidism (underactive thyroid gland) – the condition wherein the body doesn’t produce enough thyroid hormones for proper functioning. The most common cause of hypothyroidism is an autoimmune condition, Hashimoto’s thyroiditis. Other causes include over-response to hyperthyroidism treatment, radiation therapy, thyroid surgery, some medications, damage to the pituitary gland, excessive or insufficient levels of iodine. Symptoms of this condition are numerous, ranging from hair thinning to weight gain and sensitivity to cold.
  • Hyperthyroidism (overactive thyroid gland) – occurs when the thyroid produces excessive amounts of hormones. An autoimmune condition, Graves’ disease, is the most common cause of hypothyroidism. Other causes include hyperfunctioning thyroid nodules and thyroiditis. Unintentional weight loss and fast heartbeat are some of the many symptoms of this condition. 

Do thyroid problems contribute to sleep disturbances?

Thyroid hormones imbalances manifest themselves through an array of symptoms that affect our health and quality of life. Sleep disturbances may also occur due to thyroid problems, but the relationship between the two is complex is poorly studied. Below, we’re going to focus on each of the two most common thyroid conditions and elucidate their impact on the quality of sleep.

Hypothyroidism and sleep

As mentioned above, the link between thyroid problems and sleep quality is not studied enough. Although more research is necessary current evidence shows that, indeed, thyroid conditions can impair your sleep. For example, one study found that compared to the euthyroid state (normal thyroid hormone levels), hypothyroidism is associated with an increased risk of poor sleep quality. More specifically, hypothyroidism is linked with:

  • Longer sleep latency (sleep latency is the amount of time it takes you to fall asleep)
  • Shorter sleep duration
  • Increased sleep disturbance 

The relationship between hypothyroidism and poor sleep quality is down to the inhibitory effect of sleep on TSH secretion. TSH stands for thyroid-stimulating hormone, a pituitary hormone that stimulates the thyroid gland to produce T4 and T3. Sleep loss affects the function of the hypothalamus-pituitary-thyroid axis, and it’s linked with increased TSH, and several mechanisms could explain this relationship. When you’re about to sleep, the most suspicious endocrine change is the increasing activity of the hypothalamic-pituitary-thyroid axis, which is influenced by physiological factors, generally. With the increase in TSH by the hypothalamus, the activation of the sympathetic nervous system ensues, which directly stimulates the thyroid gland. Under some pathological conditions, this can lead to sleep problems, scientists explain in the above-mentioned study. 

As you can see, the relationship between hypothyroidism and sleep problems is existent but difficult to explain. A lot more research is necessary to elucidate all the mechanisms involved. 

Moreover, since hypothyroidism is a deficiency in thyroid hormones, which are important for metabolism and bodily functions, it can slow down processes in our body. In other words, hypothyroidism can make your metabolic rate sluggish, deplete the energy levels, and cause fatigue during the day as well as poor sleep during the night. 

Besides its influence on metabolism, the underactive thyroid gland condition also contributes to other risk factors that eventually disrupt your sleep quality. One of these risk factors is obstructive sleep apnea. 

Obstructive sleep apnea is a condition wherein breathing stops involuntarily for brief periods of time during sleep. It’s not uncommon for people with hypothyroidism to have sleep apnea, which is one of the main contributors to sleep disturbances. A study from Respiratory Medicine found that sleep apnea was prevalent in people with subclinical hypothyroidism (an early, mild form of hypothyroidism). 

The underactive thyroid condition may cause changes in the upper airway that could eventually lead to difficulties breathing during sleep. Moreover, hypothyroidism has the potential to damage the nerves and muscles that take part in the breathing process. Additionally, one of the most prominent symptoms of hypothyroidism is weight gain. Carrying excess weight is a risk factor for sleep apnea too.

Let’s not forget that people with hypothyroidism have increased sensitivity to cold. The feeling of chills can inhibit your sleepiness. As a result, it can take you a while to fall asleep, and you may wake up frequently during the night.

Hyperthyroidism and sleep

The impact of hyperthyroidism on sleep is poorly studied, just like it’s the case with hypothyroidism. However, people with overactive thyroid glands do experience sleep disturbances. In fact, it’s one of the most common symptoms of this condition, and even current evidence confirms the relationship between the two. Despite all this, the exact reason why people with hyperthyroidism don’t sleep well is unknown. 

One study found that the hyperthyroid state is strongly associated with difficulty falling asleep and difficulty maintaining sleep. However, the problem doesn’t stop there. Sleep disturbances can aggravate the health of people with hyperthyroidism, especially behavioral and cardiovascular performance.

A lot more studies are necessary to elucidate all the mechanisms involved in this relationship. Hyperthyroidism can cause arousals due to nervousness and irritability, thus makes it difficult for you to fall asleep. Another potential mechanism is that the overactive thyroid gland causes night sweats and frequent urges to urinate, both of which affect your sleep and make you wake up several times during the night.  

Other symptoms of hyperthyroidism can also cause sleep problems. Heat intolerance is one of them. You may feel uncomfortable and even too hot in your room, and it can be difficult to fall asleep. Hyperactivity and restlessness are also common symptoms of hyperthyroidism, and both can impair your sleep cycle. These symptoms stimulate your nervous system.

Many hyperthyroid men and women have abnormal heart rhythm and notice they have palpitations. When the heart’s beating fast, it’s not easy to fall asleep.

All these symptoms occur because excessive amounts of thyroid hormones in the blood accelerate metabolism. Contrary to hypothyroidism, which slows down metabolic rate and functions linked to it, hyperthyroidism speeds things up. Evidence shows that a fast metabolic rate can contribute to insomnia. In fact, in people with insomnia, the metabolic rate is increased during both night and day. Since the body is a unique system where everything is connected, it comes as no wonder why hyperthyroidism and its symptoms don’t allow you to get a good night’s rest. 

It’s also useful to mention that Graves’ disease, which leads to hyperthyroidism, is also associated with sleep problems, including difficulty falling asleep and insomnia.

How to sleep better

Thyroid problems tend to contribute to sleep disturbances. Sure, it’s frustrating to deal with these problems, but you’ll be glad to know they’re manageable. You can sleep better, despite thyroid conditions. The first and most important step for better sleep is to be proactive about a thyroid problem.

Adhere to doctor-recommended treatment religiously and modify your lifestyle. A healthy, well-balanced diet and regular exercise can not only improve the quality of sleep but also support thyroid condition management. 

These tips can help you out:

  • Keep the bedroom cool – comfortable bedroom temperature is important, but if you’re hypothyroid, then find a good balance between cool and cold. Since you’re prone to more intense feelings of cold, you don’t want to feel as if you’re about to freeze in bed. On the other hand, keeping the bedroom cool induces calmness and helps you relax more effectively. 
  • Keep bedroom dark – probably the most common mistake we repeat is spending a lot of time watching TV, streaming services, or staring at the phone in bed. Blue light keeps you awake. To get more sleep, you need to keep the bedroom dark, turn off your devices, and avoid watching TV. Darkness will stimulate the production of melatonin for better sleep.
  • Have a relaxing bedtime routine – a great way to facilitate good sleep is to establish a relaxing bedtime routine, and options are endless here. There are no rules to what you can or can’t do; just make sure it’s a relaxing and calming routine you can easily repeat every night.
  • Make sure your bed is comfortable – sometimes an uncomfortable bed can contribute to sleep problems. Therefore, make sure your mattress is comfortable yet supportive enough to help you sleep better.
  • Manage stress – when left unmanaged, stress can negatively affect your quality of life, impair sleep, and even aggravate thyroid problems. Be proactive about stress and strive to manage it, so you don’t go to bed with all negative emotions building up.
  • Avoid drinking coffee – caffeine is a stimulant, meaning if you are drinking it at night, you’re highly likely to stay awake. You don’t need to ditch coffee entirely but strive not to drink it at night. 

Conclusion

Sleep problems occur due to a number of factors. In most cases, a combination of different factors is involved in sleep disturbances.

Conditions affecting the thyroid gland also tend to impair sleep quality. Both hypo- and hyperthyroidism affect your sleep, but with a proactive approach, you can get a good night’s rest more easily. A healthy lifestyle is crucial for both good sleep and management of your thyroid condition.

If you’re not diagnosed with a thyroid problem, you may want to schedule an appointment to see your doctor, who will determine whether your butterfly-shaped gland functions properly or not.

References

https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html 

https://www.ncbi.nlm.nih.gov/books/NBK547676/#:~:text=Common%20contributing%20causes%20of%20sleep,of%20these%20underlying%20factors%20directly.

https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

https://www.mayoclinic.org/diseases-conditions/hyperthyroidism/symptoms-causes/syc-20373659#:~:text=Overview,a%20rapid%20or%20irregular%20heartbeat.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927586/

https://www.sciencedirect.com/science/article/pii/S0954611111002411

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079865/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054926/

https://www.health.harvard.edu/a_to_z/graves-disease-a-to-z

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