Top tips for coping with thyroid-related insomnia

A thyroid imbalance is known for making you feel tired. But did you know thyroid conditions, particularly hyperthyroidism, and insomnia often go hand in hand? We explain the link between underactive and overactive thyroid conditions and sleep disorders, and exactly what you can do to get the rest you need.

• What is insomnia?
• Why can thyroid conditions cause insomnia?
• Why does an overactive thyroid cause insomnia?
• Can an underactive thyroid cause insomnia?
• Top tips for sleeping better with a thyroid condition

What is insomnia?
 

Before we get into how your thyroid affects sleep, let’s explain what insomnia actually is.

Insomnia is a sleep disorder that presents in a few ways:

• Extreme difficulty in falling asleep
• Problems staying asleep
• Waking up too early and not being able to get back to sleep

Insomnia affects around one in three people in the UK in its acute form, and 10-15  in every 100 have chronic insomnia (where it lasts longer than three weeks) [1].

Why can thyroid conditions cause insomnia?
 

Your thyroid gland produces the hormones that regulate how your body uses energy.

These hormones (thyroxine and triiodothyronine) affect most organs and are vital to:

• Breathing
• Digestion
• Regulating heart rate and body temperature

Too little or too much of these hormones can throw your body out of whack. So, it’s no surprise that thyroid conditions are linked to sleep problems. 

For example, your thyroid produces hormones that influence how much the blood vessels dilate, which affects how much heat can escape your body. As a result, when you make too much thyroid hormone, your body temperature rises. With hypothyroidism, the opposite tends to be true. You can find your body temperature decreases (making you more susceptible to the cold).  

One study of 137 patients with Graves’ disease (the most common cause of hyperthyroidism) found that 66.4% of study participants had difficulty falling asleep [2,3].

And while hyperthyroidism is much more likely to cause insomnia, hypothyroidism isn’t totally out of the hot water, either. Although hypothyroidism often causes more fatigue and lethargy, hypothyroidism and insomnia may co-occur. This is because the symptoms associated with a thyroid hormone deficiency may contribute to insomnia, like joint and muscle pain, cold intolerance, and increased anxiety.

An overactive thyroid and insomnia
 

Hyperthyroidism (an overactive thyroid) is where your thyroid produces too many thyroid-related hormones. Increased thyroid activity and thyroid hormone production are well-known causes of sleep dysfunction.  

Often, the hyperkinetic (motion beyond the usual) features of the condition are responsible for sleep disturbances. Nervousness and irritability can make it difficult to get to sleep. Plus, an overactive thyroid can contribute to conditions like anxiety or depression, which can also impair sleep and are linked to insomnia [4,5].  

Elevated thyroid hormones are associated with several components of sleep dysfunction, including [6]: 

• Prolonged sleep latency (taking longer to fall to sleep) 
• Difficulty maintaining sleep 
• Reduced sleep quality

An overactive thyroid can cause [7]:  

• Nervousness and irritability, making it difficult to fall asleep 
• Feeling too hot and sweating at night
• Frequent urination, which can disrupt sleep 
• Muscle weakness and feeling tired all the time 

Underactive thyroid and insomnia
 

Hypothyroidism (an underactive thyroid) is where the thyroid does not produce enough hormones. In terms of sleep, you’re more likely to find yourself wanting to sleep more, with feelings of fatigue and lethargy. But, although no direct biochemical connection has been found between an underactive thyroid and insomnia, they can sometimes co-occur. 

If you have an underactive thyroid, you may find it more difficult to tolerate the cold or experience joint or muscle pain at night. And even if a thyroid condition is not directly causing insomnia, the vast range of symptoms with thyroid dysfunction can quite easily exacerbate sleeping difficulties and reduce your ability to get quality, restful sleep [8].  

An underactive thyroid can cause: 

• Joint or muscle pain that disrupts sleep 
• Trouble tolerating cold at night, making it difficult to fall or stay asleep 
• Poor sleep quality, affecting the time it takes you to fall or stay asleep 

Top tips for sleeping better with a thyroid condition
 

If your thyroid condition is causing insomnia, calming your anxiety, soothing pain, and managing your metabolism are the best ways to cope. Here’s a few tips to try and sleep better.

Keep your cool

Having your room at the right temperature when you’re going to sleep is important for anyone, especially if you have a thyroid condition. 

Naturally, our body temperature peaks in the late afternoon and drops as we head into the evening, kickstarting the production of melatonin to prepare your body for sleep. However, this may not be the case when you have a thyroid condition, so try to keep cool as you head into the afternoon and beyond. 

Optimal sleep temperatures are said to be between 16-18°C. However, you may find that yours falls outside the usual range if you experience night sweats or sensitivity to the cold – and that’s okay. Still, room temperatures over 24°C (71°F) are likely to cause restlessness, and sleeping in a cold room of about 12°C (53°F) will likely make it difficult to fall asleep.  

Check your magnesium levels

Magnesium can’t cure thyroid insomnia, but a magnesium deficiency may affect your sleep and can worsen other symptoms associated with thyroid conditions [9].

A simple blood test like our Magnesium (serum) Blood Test can help identify if your levels are low. Don’t start taking any magnesium supplements without first consulting your GP – some research suggests that magnesium may reduce the absorption of thyroid medications such as levothyroxine [10,11].

Practice sleep hygiene

Sleep hygiene is the habits and practices that form your sleep routine. Good sleep hygiene involves establishing an effective sleep routine (like going to bed and waking up at regular times and taking time to wind down).

Simple tips for sleep hygiene include:

• Only use your bed for sleeping – no checking emails or watching TV, your brain will associate your bed with these activities making falling asleep even harder, which brings us to our next tip…
• Avoid screens an hour or two before bed – if you absolutely have to use a device, check your display settings and use “night mode”; this turns down the blue light which disrupts your melatonin production.
• Don’t exercise to close to bedtime – exercise is important, and can even help you sleep better, but intense exercise before bed can raise your heart rate and trigger cortisol release – not ideal for winding down for bedtime!
• Keep lighting low as bedtime approaches – this signals to your body it’s time to wind down. You can even get a small battery-powered lamp to use in your bathroom, so you can have gentle lighting while you brush your teeth before bed.

Consider diet changes

You may not think so, but a healthy diet is vital for a good night’s sleep. Have you ever been out for a heavy meal and then tried to go to sleep straight after? It can be very uncomfortable (and that’s aside from any meat sweats you may experience).

Stick to light evening meals before bed to avoid any added discomfort when trying to fall asleep. If you have a thyroid condition, you’ll likely want to pay particular attention to some standout nutrients, like your iodine intake. Too much or too little iodine in your diet can affect your thyroid function. Good iodine sources include fish, shellfish, and dairy products [6].

For more information on what you should eat with a thyroid condition, head to our thyroid-friendly diet blog.  

Keep an eye on your biomarkers

Monitoring your condition with a full blood panel can help catch imbalances that may be affecting your sleep.

Aside from the thyroid-related biomarkers such as TSH, T4, and T3, you might also want to check minerals like ferritin, and vitamin levels such as vitamin B12 and vitamin D, imbalances of which can also impact your thyroid function.

Our Optimal Health Blood Test checks all these biomarkers and more, for a comprehensive look at your health.

Limit alcohol and caffeine close to bedtime 

Too much caffeine has been linked to worsening or developing insomnia symptoms — this is especially true if you have an overactive thyroid. And consuming caffeine to stay awake may lead to sleeplessness, anxiety, frequent night-time awakenings, and poorer sleep quality [12,13]. 

Likewise, alcohol is a depressant that can affect your mood, and it also supresses  rapid eye movement (REM) sleep reducing your sleep quality and increasing night time disruptions [14].

So, stick to the safe alcohol guidelines, limit yourself to under 300 mg of caffeine a day, and avoid both before bed.

Keep active

You will be glad to hear that exercise can improve sleep for many people and alleviate sleep-related problems, helping you get enough rest. However (what can feel like a kick in the guts), getting enough exercise is not always easy if you have not had a good rest the night before. If you have a poor night’s sleep, you are more likely to get lower levels of physical activity the following day [15].  

By helping you to stay at a healthy weight, exercises that decrease your risk of excessive weight gain can make it less likely for you to experience symptoms of obstructive sleep apnoea (OSA) – 60% of OSA cases are attributed to obesity [16]. 

Check out our blog for top tips on exercising with a thyroid condition.

Exercise tips:

• Make time for moderate-to-vigorous exercise most days. The NHS activity guidelines recommend at least 150 minutes of moderate-intensity activity a week or 75 minutes of vigorous-intensity activity.  
• Be aware that exercising close to bedtime could have the opposite effect. Monitor whether this is making you feel too alert to fall asleep. If so, try getting active earlier in the day instead.  

 

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References

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