Thyroid Problems Affect Sleep - The Facts Many Don't Know

The thyroid gland plays a significant role in the quality of sleep, and its dysfunction can greatly impact your nightly rest. The two main thyroid issues are hypothyroidism and hyperthyroidism. Hypothyroidism is when the thyroid gland produces too few hormones, while hyperthyroidism is when it produces too many hormones. Hyperthyroidism can result from overactive thyroid nodules or goiter.

Recognizing Thyroid Problems:

Symptoms of hypothyroidism can appear rapidly or develop gradually, depending on how low thyroid hormone levels become and how quickly they decline. Some common symptoms of hypothyroidism include:

• Sensitivity to cold

• Constipation

• Dry skin

• Brittle nails

• Hair loss

• Unexplained weight gain

• High cholesterol levels

• Irritability

• Sexual dysfunction

• Slow heart rate

• Irregular menstrual bleeding

It's important to note that not all symptoms need to be present for a diagnosis of hypothyroidism.

On the other hand, hyperthyroidism, where the thyroid gland is overactive, can present a different set of symptoms, such as:

• Excessive sweating

• Heat intolerance

• Excessive hunger

• Weight loss

• Mood swings

• Panic attacks

• Irritability

• Anxiety

• Nervousness

• Irregular heartbeat

• Palpitations

• Fatigue

• Insomnia

• Irregular or short menstrual cycles

• Bulging eyes or swollen eyes

• Diarrhea

• Hair loss

• Muscle weakness

• Tremors

Again, not all symptoms need to be present to diagnose hyperthyroidism.

Impact on Sleep:

Both hypothyroidism and hyperthyroidism can have significant effects on sleep.

• Obstructive Sleep Apnea: Hypothyroidism, like obstructive sleep apnea, is relatively common. People with obstructive sleep apnea often experience symptoms like excessive daytime sleepiness, apathy, and lethargy—symptoms also seen in hypothyroidism. This overlap can make it difficult to distinguish between the two conditions based solely on patient history and physical examination. Additionally, hypothyroidism can increase the risk of obstructive sleep apnea due to factors affecting breathing, such as nerve or muscle damage, an enlarged tongue (macroglossia), or impaired muscles controlling the upper airway. Obesity, often associated with hypothyroidism, is another risk factor for obstructive sleep apnea.

• Insomnia: Some individuals with hypothyroidism and sleep apnea suffer from insomnia. Sleep apnea can disrupt breathing, leading to sudden awakenings during sleep, particularly in the early morning hours during REM sleep. This can result in frequent awakenings and non-restorative sleep. Poor sleep quality might cause individuals to spend more time in bed, which can lead to difficulty falling asleep early in the night. If the time spent in bed exceeds the amount of sleep needed to feel refreshed, chronic insomnia can develop.

• Night Sweats: Hyperthyroidism can cause night sweats due to difficulties in regulating body temperature, which can disrupt sleep. Night sweats are often associated with menopause, but breathing disturbances during sleep may also play a role.
  

Diagnosis and Treatment:

Thyroid problems are relatively easy to diagnose and treat through blood tests that measure various thyroid function markers. For those already diagnosed with hypothyroidism and experiencing symptoms of sleep apnea, a sleep study might help determine if sleep apnea is present. During a sleep study, medical professionals will monitor your sleep either in a lab or at home using portable equipment.

Patients with sleep apnea symptoms who are referred for evaluation or diagnosed can request blood tests to check thyroid levels, especially if symptoms persist despite appropriate sleep apnea treatment. The most common treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP) therapy. Alternatives include oral devices from dentists, surgery, positional therapy, and weight loss.

If hypothyroidism is causing sleep apnea or breathing difficulties, these issues typically improve with thyroid hormone replacement therapy.

Thyroid disorders are common and can significantly impact sleep. Sleep apnea is also prevalent, and there is a connection between these two conditions. If symptoms persist despite normal thyroid hormone levels according to blood tests, it's important to rule out sleep apnea through a sleep study.