Can thyroid problems cause insomnia

7 Ways to Sleep Better if You Have Hypothyroidism

Keeping your bedroom dark and cool can help you fall asleep. Ken Tackett/

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Sleep is important for everyone, but it’s especially important if you have hypothyroidism. That’s because fatigue is a hallmark of the condition.

Hypothyroidism is a deficiency in thyroid hormones that causes metabolism and many other bodily functions to slow down. “Thyroid hormones help regulate metabolism, determine heart rate, and are involved in the function of almost every organ system in the body,” says Kristine Arthur, MD, an internist with MemorialCare at Orange Coast Medical Center in Fountain Valley, California. “Because thyroid hormones are involved in so many bodily processes, when they are low, you can have both daytime and nighttime symptoms, including fatigue during the day and poor sleep at night.”

Besides causing daytime fatigue by slowing metabolism, hypothyroidism increases the risk for some sleep disorders. “About 30 percent of people with hypothyroidism have sleep apnea,” says Robert S. Rosenberg, DO, medical director of the Sleep Disorders Center of Prescott Valley, Arizona, and author of Sleep Soundly Every Night, Feel Fantastic Every Day. “In this group of people, it’s the drop in oxygen and the struggle to breathe against a closed airway that disrupts their sleep.”

Hypothyroidism may also prevent the deepest, most important sleep, Dr. Rosenberg says. This may be another contributor to daytime fatigue in people with hypothyroidism, he says.

How to Get Better Sleep

When it comes to fighting the fatigue of hypothyroidism, part of the answer is simply to sleep more, but knowing what to do and doing it are different beasts. Many people don’t get the sleep they need. Adults should sleep at least seven hours each night, according to the American Academy of Sleep Medicine, but the Centers for Disease Control and Prevention (CDC) says that as many as one-third of adults in the U.S. report not getting the recommended amount of shut-eye.

The first step toward getting better sleep and fighting fatigue if you have hypothyroidism is to get your thyroid hormones back within normal range by taking thyroid hormone replacement medication. “First, anyone with suspected or known hypothyroidism needs to have their hormone levels checked and managed carefully,” Dr. Arthur says. “This needs to be done by a doctor. You shouldn’t try to boost thyroid function on your own with over-the-counter medications or supplements.” It’s also important to keep in mind that if your medication dose is too high, you may feel wired and begin to experience insomnia.

Other conditions that can interfere with your sleep need to be addressed as well. If you suspect you have sleep apnea, talk to your doctor. He or she may recommend lifestyle changes, such as losing weight or quitting smoking, or prescribe a treatment, such as a continuous positive airway pressure (CPAP) machine.

Beyond treating the root cause of hypothyroidism, Rosenberg says the best advice for getting better sleep is the same as it is for anyone who occasionally or regularly lies awake at night. Here are some tips to try.

1. Keep your bedroom cool. “A comfortable bedroom temperature is important, especially while you’re in the process of getting your thyroid regulated,” Rosenberg says. He suggests setting your thermostat between 65 and 70 degrees Fahrenheit.

2. Embrace the dark. “Try turning down all lights at least an hour before you go to bed,” Arthur says. Keep your bedroom dark and cover all bright or flashing lights. “Darkness helps with natural melatonin production,” she says.

3. Calm down. “Having a relaxing presleep routine is one of the most important things you can do to help facilitate good sleep,” Arthur says. “Take a warm bath with relaxing scents like lavender, read a favorite book (not an e-book with a backlit screen), or listen to relaxing music,” she says.

4. Sleep in a comfy bed. “If your mattress is over seven years old, it can cause a problem,” Rosenberg says. Make sure your bed is comfortable and supportive for a good night’s sleep.

5. Avoid nighttime feasts. Indulging in a large meal close to bedtime can disrupt sleep, as can eating something unusual. If you’re struggling with sleep problems, avoid spicy dishes and caffeine — even chocolate.

6. Have a small snack instead. “Eating a little something with a combination of protein and carbohydrates, such as whole-grain crackers and peanut butter, before bed can help keep blood sugars balanced overnight,” Arthur says.

7. De-stress. One of the biggest contributors to sleep problems is stress, and people tend to think about stressful situations instead of closing their eyes when they climb into bed. To address these issues in a beneficial way, try writing in a journal or practicing relaxation techniques, such as meditation.

If you continue to struggle with sleep issues, talk to your doctor to determine the root cause and address it to help yourself get the quality rest you need.

Thyroid Disorders and Sleep

Hypersomnia & Fatigue

People who suffer from a hypoactive thyroid often report that they always feel tired, despite sleeping more than usual. This fatigue despite prolonged sleep is called hypersomnia.

Thyroid hormones, particularly T3 and T4, help control your metabolism. When you have low levels of these hormones, the drop in your metabolism causes your body to slow down. This slowdown affects your entire body, making you feel sluggish, cold, and tired. You sleep for more hours but feel worse.

Another potential cause for thyroid-related hypersomnia is that hypothyroidism may disrupt slow-wave sleep. Also known as stage 3 or deep non-REM sleep, this sleep stage contains the sleep we describe as “refreshing” and is what resets our feelings of sleepiness. If hypothyroidism does restrict stage 3 sleep in some way, it would explain the persistence of hypersomnia in sufferers.

The sleepiness and exhaustion caused by hypersomnia are not alleviated by daytime naps. No matter how much sleep they achieve at night or how often they nap, sufferers remain exhausted. Some find it very difficult to wake up in the morning, disturbing their circadian rhythm and further disrupting their sleep.

In addition to having a negative impact on quality of life, this excessive daytime sleepiness can also be dangerous. For example, driving drowsy is more dangerous than driving drunk, and was responsible for 44,000 accidents and 800 deaths in 2013 alone.

Thankfully, successful treatment of a hypoactive thyroid usually eliminates fatigue and hypersomnia over time.

Just as low levels of thyroid hormones can cause hypersomnia, the high levels found in people with hyperactive thyroids can cause insomnia.

Experts suggest that adults need six to nine hours of sleep per night, with seven to seven and a half hours being the sweet spot for most people. Insomnia, which can take the form of either struggling to fall asleep or stay asleep, prevents people from achieving the sleep they need.

Hyperthyroidism encourages insomnia in two primary ways:

  • Symptoms like racing thoughts, anxiety, restlessness, and irritability can make it difficult to calm down enough to sleep at night.
  • Before sleeping, most people’s metabolic functions (such as temperature, heart and breathing rate, etc.) slow down. If high thyroid hormones levels prevent this from happening, your body can become confused about whether it should fall asleep.

Insomnia can also result from other symptoms of thyroid disorders, like night sweats. If you regularly wake up damp with sweat, sleep-maintenance insomnia can prevent you from getting enough sleep.

Like hypersomnia, insomnia can also result in extreme tiredness — in this case, sleepiness — which lowers your quality of life and increases the risks associated with sleep loss.

If you are suffering from insomnia which you suspect may be due to a thyroid disorder, consider keeping a sleep diary. This will give you and your care team a more in-depth insight into whether you have trouble falling or staying asleep, whether your insomnia is primarily caused by physical or mental symptoms, and other important factors. Not only will it potentially help treat your insomnia, but it may also provide information on your thyroid disorder.

Obstructive Sleep Apnea

Obstructive sleep apnea, also known as sleep apnea, is a common sleep breathing disorder affecting 3-7% of American men and 2-5% of American women. Sufferers stop breathing multiple times a night when their throat tissue and muscles relax and block their airflow. Snoring occurs from muscle and tissue vibration, blood oxygen levels decrease, and eventually, they wake up to breathe again (whether they are aware of the awakening or not).

The relationship between sleep apnea and hypothyroidism is complex. On one level, having a hypoactive thyroid increases your risk for sleep apnea. There are many possible reasons for this increased risk, including respiratory changes, nerve or muscle damage, chemical imbalance, and even enlargement of the tongue.

On another level, distinguishing between sleep apnea and hypothyroidism can often be difficult for primary care physicians. The two conditions share many symptoms, such as fatigue and mood changes, and both are relatively common.

In fact, there is an ongoing controversy in the medical community about whether to test for both when symptoms occur. For example, in one study of individuals with suspected sleep apnea, 47% were diagnosed with Hashimoto’s thyroiditis, a common cause of hypothyroidism.

If you suspect you may have either or both hypothyroidism and sleep apnea, your doctor may refer you for tests. Sleep apnea is diagnosed by studying your sleep, while hypothyroid diagnosis involves testing your levels of TSH and thyroid hormones.

Restless Leg Syndrome

Approximately 1-15% of people will experience restless leg syndrome (also known as Ekbom’s syndrome, Willis-Ekbom disease, or RLS) in their life. This movement disorder creates an uncomfortable and overwhelming urge to move your legs, particularly at night or when you are lying down. While movement temporarily relieves these feelings, the relief is short-lasting, and the sensations return.

RLS is more than just a minor irritation. The condition raises the risk of heart disease in older women just as much as other risks like smoking and obesity, partially because of the significant impact it can have on how much sleep you achieve.

Abnormalities in the regulation of neurotransmitters, hormones, and nutrients are known to cause RLS, and research indicates that thyroid-stimulating hormone (TSH) may be related to the condition as well. One of the compounds which regulates TSH has been shown to alleviate RLS symptoms, and conditions with high levels of thyroid hormones create a higher risk of developing RLS.

There is a hypothesis that age may also play a factor in the link between RLS and thyroid disorders. Older people metabolize thyroid hormones more slowly than younger people, and they are also 2% more likely to have hyperthyroidism. It is possible that this age-related change to thyroid hormone levels creates a higher risk of RLS as well.

Regardless of its cause, RLS (thyroid-associated or otherwise) can be treated. Severe cases may require medication, but mild to moderate cases often respond well to lifestyle changes and good sleep hygiene (see “Practice Good Sleep Hygiene” below). Treatment of your thyroid disorder may also lead to RLS improvement.

Circadian Rhythms & Melatonin

Circadian rhythms describe the normal cycles of your biological processes. These rhythms not only control when you fall asleep and wake up, but they also control short and long-term cycles of everything from your heartbeat to hormone production.

As part of the endocrine system which regulates hormones, your thyroid is influenced by your circadian rhythms. Studies have shown that the hormone which prompts the release of thyroid hormones (TSH) has a circadian profile, as do the T3 and T4 thyroid hormones. Levels of these are usually higher at night, rather than when we are awake.

This is particularly interesting, as one hormone — melatonin — rises at night as part of the circadian system to help us sleep, but also shows a suppressive effect on thyroid function in some studies.

Produced by the pineal gland in the brain (which is part of the endocrine system and controls the production of TSH), melatonin is well-known as a supplemental sleep aid. However, rats who were given melatonin injections had decreased levels of both TSH and thyroid hormones, while fetal hamsters showed slowed thyroid growth.

Given these studies, it seems unusual that melatonin and thyroid hormone levels both naturally rise at night without the melatonin affecting thyroid function. Further studies are needed, and it may be that supplemental melatonin has an effect whereas natural levels do not.

In some cases, melatonin’s suppressive effect can be useful. There have been some studies which show that melatonin may be useful as a treatment for thyroid cancer due to its ability to slow tumor growth there.

Overall, the research into melatonin and thyroid function is just beginning. However, it does give us a new way to approach the sleep-thyroid connection and offers an exciting direction for further research.

Thyroid and Sleep: Can Hypothyroidism Cause Insomnia?

When it comes to your thyroid and sleep, most people associate an overactive thyroid (hyperthyroidism) with insomnia because it can cause feelings of nervousness and anxiety, making it harder to fall asleep. However, what many patients don’t realize is that an underactive thyroid (hypothyroidism) is more commonly associated with insomnia. In this blog, we will discuss why that is the case and share some tips for how patients with hypothyroidism can get better sleep.

Understanding the Link Between Hypothyroidism and Insomnia

One of the most common symptoms of hypothyroidism is fatigue. One would think this fatigue would make it easier to sleep at night, but often patients feel exhausted all day and then find themselves sleeping poorly at night. This is because your thyroid is part of your body’s endocrine system, releasing hormones that control metabolism and regulate vital body functions (such as heart rate, body temperature, and breathing). Low metabolism during the day contributes to daytime fatigue, and irregular hormones at night prevent the deepest, most important sleep cycles. Additionally, hypothyroidism can increase the risk for some sleep disorders, such as sleep apnea.

Hypothyroidism can also signal a problem with other parts of your endocrine system, particularly your adrenal glands. These glands are responsible for producing cortisol, also called the “stress hormone.” If your adrenal glands are overtaxed or not regulating properly, you may be experiencing high levels of cortisol at night, giving you increased energy and keeping you awake.

Get Better Sleep with Hypothyroidism

The first step to treating your thyroid and sleep problems is to bring your thyroid hormones back within their normal range. At Anchor Wellness Center, we use advanced thyroid hormone testing along with a nutritional evaluation to customize your personalized treatment plan. Our bioidentical thyroid hormone replacement treatment helps to optimize your thyroid levels, decrease side effects, and improve your body’s response to treatment. Dr. Malhotra, MD, FAARM, ABAARM, takes a holistic approach to patient care, addressing the underlying causes of your disease to restore your health and well-being.

As you begin to treat your hypothyroidism, you can follow these tips for better sleep to help you find even greater relief from insomnia:

  • Keep your bedroom cool – Having a comfortable sleeping environment is important, especially while your thyroid is in the process of being regulated. Keeping your room between 65 and 70 degrees Fahrenheit will help your body rest.
  • Turn off the lights – and your devices! – Darkness tells your body to produce more melatonin, which is a natural hormone that helps you sleep. The blue light produced by technological devices (TVs, smartphones, computers) interferes with melatonin production, and using these devices before bed can overstimulate your brain and make it harder to fall asleep.
  • De-stress – Having a calm, relaxing pre-sleep routine helps you unwind from the day and signals to your body that it is time to rest.
  • Go to bed when you are tired – Pushing yourself to stay awake can cause a surge of cortisol that will keep you up far longer than you intended. You should also go to bed at the same time every night and wake up at the same time every day to get your body accustomed to a regular sleep schedule.

Improve Your Thyroid and Sleep at Anchor Wellness

As a Board Certified physician in Family Medicine, as well as Board Certified with the American Board of Anti-Aging and Regenerative Medicine, Dr. Minni Malhotra offers a patient-centered approach to healthcare. If you are ready to restore balance to your thyroid and experience restful sleep, call and schedule a consultation today: (832) 246-8437.

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I’m a sleep expert, sure. But would it surprise you to learn that the majority of my clients don’t just have sleep issues?

Most of the time, poor sleep is simply an unpleasant side effect of an underlying, unaddressed health issue.

The most common underlying health issue in clients I work with? Thyroid disorders.

Ninety percent of the clients I work with have an underlying thyroid condition…and many of them don’t even realize it before working with me or come to me completely misinformed about their issues.

Your thyroid’s effect on sleep

Many of my new clients are surprised to learn that thyroid health can affect our sleep in many ways.

This is because our thyroid controls the metabolic function of almost all our body’s cells. Any imbalance in our thyroid impacts the systems that can trigger insomnia and related health issues.

A thyroid imbalance can also cause hormone levels to oscillate erratically. In the case of hypothyroidism, sex hormones like estrogen levels drop, resulting in troubled sleep.

The potential for insomnia is further increased in women because menopause can lower estrogen and progesterone levels.

Both estrogen and progesterone are important in regulating sleep quality. Lower levels of estrogen can result in hot flashes, preventing women from falling asleep and waking them up abruptly throughout the night.

Falling progesterone levels are highly likely to contribute to the onset of sleep apnea and even sleep anxiety.

Lower testosterone levels brought on by a compromised thyroid function can also undermine sleep quality. A curtailed sleep cycle due to a testosterone deficit poses challenges for the body in regenerate muscle tissue, causing people to wake feeling tired and sluggish.

In addition, insomnia is a common symptom of hypothyroidism caused by poor cortisol balance. The thyroid is linked to the adrenal glands; therefore, when the thyroid is suffering, the adrenal glands can become imbalanced.

When the body is stressed, cortisol is released by the adrenal glands. This hormone tells the body it is time to be alert and wake in the morning (not what we want at 3am!).

As cortisol levels drop during the day, we experience fatigue and eventually drop off to sleep when our cortisol levels hit their lowest ebb. If thyroid hormones are out of balance, the adrenal glands can produce too much cortisol, making it difficult to drop off to sleep because the body is tricked into thinking it is still daytime.

So, as you can see, sleep is directly impacted by your thyroid health.

How to Know if Your Thyroid Health is to Blame

Some clients who come to me have already been diagnosed with a thyroid disorder, but others have not.

I will tell you that if you suffer from poor sleep and any of the following symptoms, YOU may be at risk for a thyroid disorder.

Short-term sleep deprivation effects on thyroid and heart

For the first time, heart and thyroid function have been analyzed in the context of short-term sleep deprivation.

In a small study done by the Radiology Society of North America, twenty radiologists who work extremely long hospital shifts were tested in Bonn, Germany. In addition to blood, urine, and blood pressure, other parameters were analyzed. The subjects were tested before and after their 24-hour shifts with an average of three hours of sleep. All of the subjects were considered healthy.

Overall, the study found that the heart rate, blood pressure, and cardiac contractility had significantly increased after the 24-hour shift. Moreover, there were changes in thyroid function that could explain hypothyroid-like symptoms such as sluggishness or fatigue. On top of that, cortisol, the hormone we produce when under stress, significantly increased in levels; although this may in part be due to the stressful nature of the radiologist’s job.

Even though this study uses a small sample on a short-term basis, it suggests detrimental long-term effects of sleep deprivation on thyroid, heart, and adrenal glands that may be become harder to undo later on. Dr. Arem’s take on the effects of sleep on thyroid and immune system health is that it is as crucial as taking thyroid medication or eating a well-balanced diet.

“Sleep disorders such as sleep apnea are unsurprisingly more common in patients with Hashimoto’s thyroiditis and hypothyroidism. That is why in his thyroid program, he strongly urges his patients who struggle with sleep issues to address them as soon as possible. It is the only way you can fully resolve your thyroid and immune system-related symptoms.”


Short-term Sleep Deprivation Affects Heart Function –

Don’t Let Your Thyroid Steal Your Sleep

  • Sleep
  • Thyroid Health
  • Uniquely Female

Women. Wisdom. Wellness. May 17, 2017

Do you lie awake at night, eyes wide open, waiting for the sleep fairy to sprinkle her magic dust? Or, perhaps you’re so tired during the day that you nap and then can’t fall asleep at night.

Everyone experiences occasional daytime sleepiness or a night of bad sleep. When sleep disturbances become the norm, however, it may be time to investigate a medical cause such as thyroid disease.

Your body’s many organs and systems rely on your thyroid gland, located at the base of your neck just below your Adam’s apple. When your thyroid produces too little or too much thyroid hormone, it throws off your body’s metabolism, which can affect your sleep.

Too much hormone production causes an overactive thyroid, or hyperthyroidism. This can lead to anxiety, rapid heart rate and insomnia. You may have difficulty falling asleep and staying asleep, and you may even sleep walk.

Too little thyroid hormone causes an underactive thyroid, or hypothyroidism. This may result in fatigue, lack of energy and excessive daytime sleepiness.

Regardless of what’s causing you to toss and turn, a sleep overhaul might be in order.

Team Up With Your Doctor

Good sleep can be elusive since many different factors can contribute to sleep problems. That long list includes, among others, chronic physical conditions, mental health disorders, neurological disorders and medications.

If thyroid disease is a culprit behind your restless nights, your doctor can determine this fairly easily through a physical exam and blood test. Help your doctor help you by sharing any new or unusual physical symptoms and by keeping a sleep journal.

Tips for Better Sleep

We spend a third of our lives sleeping. Getting sleep right will help increase your productivity, energy and physical and emotional well-being.

Regardless of what’s causing you to toss and turn, a sleep overhaul might be in order. These strategies can help turn your pillow problems into pillow peace:

  • Try to go to sleep and get up at the same time everyday
  • Get as much natural sunlight as possible
  • Avoid bright screens within one to two hours of going to bed
  • Move vigorously during the day—don’t sit for more than an hour
  • Limit caffeine, nicotine, alcohol and big meals at night
  • Take time for relaxing activities before sleep
  • Create a calm and restful sleep environment

Source: American Association of Endocrine Surgeons;

Is Your Sluggish Thyroid Affecting Your Sleep? How to Tell and What You Can Do


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You are dragging all day long, yet when it’s finally time to turn in for the night, you can’t sleep.

What gives? It could be an underactive thyroid.

Hypothyroidism occurs when this all-important gland is not working as well as it should or could be. The thyroid gland is responsible for producing thyroid hormones to keep all of your organs functioning normally. Signs that yours is sluggish may include: fatigue, lack of energy, excessive daytime sleepiness, weight gain, dry skin, constipation, and hair loss. In addition, hypothyroidism can affect your ability to get a good night’s sleep in several ways.

Night Sweats

Some people with hypothyroidism may experience drenching night sweats—the kind that involve changing your sheets and your pajamas. Treating the underactive gland may help, but it’s also a good idea to keep your bedroom chilly, dark and cave-like. This promotes healthy sleep and also keeps you cool enough to ward off some night sweats.

Sleep Apnea

Hypothyroidism can lead to sleep apnea, which is characterized by pauses in breathing during slumber. How does that happen? An underactive thyroid may weaken the respiratory muscles and decrease lung function, causing sleep apnea. If you have sleep apnea, you are not getting a good night’s sleep. You likely have difficulty staying asleep and your bed partner probably ribs you to stop snoring all night long. A thorough evaluation may be warranted. Treating your underactive thyroid and possibly the sleep apnea can make a big difference in your sleep habits and overall quality of life.


Yes, an underactive thyroid gland can make you feel tired all day, but some of the medications used to treat hypothyroidism may result in insomnia or the inability to fall and stay asleep. Talk to your doctor about your medication including when you take it to see if it’s playing a role in your sleeplessness. Tweaking your regimen may improve your sleep.


When you don’t feel well, you worry. If you have been experiencing some of the symptoms of hypothyroidism, you could be concerned about your health, and that may keep you awake at night. Talk to your doctor about your concerns. He or she may test your blood levels of thyroid hormones to see if your thyroid gland is working as it should be. If it is underactive, treatment will help you feel better and relieve some of your anxiety so that you sleep more soundly.

Once you determine that your sleeplessness is linked to your thyroid and begin treatment, you can also take some other more general steps for a better night’s sleep.

Eat a Healthy Diet

Eating a healthy, well-balanced diet will help keep your energy up all day long. Don’t eat a large meal before bed as that can keep you awake. As the adage goes, eat breakfast like a king, lunch like a prince and dinner like a pauper.

Skip the Night Cap

A glass of wine or cocktail may help you fall asleep faster, but it makes it harder to stay asleep.

Keep a Set Schedule

Choose and stick to firm wake and bed times—even on weekends and holidays.


Getting regular exercise throughout the day can help you sleep better at night. If exercise stimulates you too much, make sure you do it well in advance of your bedtime.

Cut Out Caffeine in the PM

Caffeine can help you get through the workday, but if you drink it past 2 PM, it may sabotage your sleep.

Know When to Give In

If you can’t sleep, get out of bed and go do something in another room. Your bed should only be used for sleep and sex.

Always discuss any sleep issues with your doctor. He or she will be able to determine if it is a result of your hypothyroidism, its treatment or something else.

Melatonin: Hashimoto’s friend or foe?

Melatonin, or the “darkness hormone”, plays a major role in our well being. It helps us to achieve balanced sleep/wake cycles and has been marketed as a medicine that can fix many additional problems, such as severe headaches. People have even claimed it helps resolve some, if not many, modern diseases, such as autoimmune conditions.

But a lot of things remain unclear about melatonin’s connection to and impact on Hashimoto’s. Scientific research on Hashimoto’s has been limited. However, melatonin has a direct impact on thyroid function, as well as on several autoimmune diseases. This effects as reported in scientific literature might have a conflicting impact on the overall well being of Hashimoto’s patients. Melatonin can also be taken as a medication. People diagnosed with hypothyroid disorder are in general advised to check their thyroid levels if they start regularly using melatonin.


Melatonin helps the body to maintain its circadian rhythm, an internal 24-hour “clock”. It is produced by the pineal gland, a tiny gland located near the center of the brain.

Melatonin is normally produced at night, if we live under normal light/dark conditions. The main function of melatonin is to transfer information about day and night cycles to the body’s cells and organs. This helps with timing functions of the cells, such as regulating our core body temperature, blood sugar regulation, hormone production and sleep/wake cycles. Our immune system depends on the melatonin’s signals, too.

What is the difference in function between one’s own and medical melatonin? Research has not conducted enough studies, and has focused only on some aspects of it (dose, but not the duration).

Disruptions in melatonin production can be a sign of high stress or an illness, and the other way around: an illness can disturb melatonin production. All of this can lead to a more severe symptoms, or impair success of the treatment or disease management .

Impact of melatonin on the thyroid gland

Science has focused mostly on one specific function of melatonin in regard to the thyroid gland function; melatonin is, like vitamin C, an antioxidant. Antioxidants remove potentially damaging reactive oxygen species (ROS) from our cells and organs.

ROS are very important for everyday cell functioning; they trigger so called oxidative reactions in our cells, and they occur in all tissues and organs. When in excess, ROS causes oxidative damage to molecules in our cells, making them dysfunctional.

In the thyroid gland they are necessary for completing synthesis of thyroid hormones.

Some research showed that specialized cells, called C-cells, that are found in thyroid gland are capable of production of melatonin, and that this is under thyroid stimulating hormone (TSH) control. It seems that melatonin and TSH balance themselves out.

Melatonin blocks thyroid cell proliferation and thyroid hormone synthesis and if used as a medicine for prolonged periods of time one should check thyroid hormone levels .

Impact of melatonin on the immune system and its role in autoimmunity

Melatonin plays a very important role in the immune system function. It interacts with many, if not all, the cells of the immune system, and can activate some and suppress other functions.

Melatonin suppresses molecules that promote inflammation. Importantly, melatonin modulates the immune system in a dose-dependant way. The differences in it’s function come from the dose when it is taken as a medication, which can be 10 or 100 times higher than the levels produced by healthy body.

Melatonin regulates the immune system in our gut and protects against inflammation, and possibly reduces the immune reaction in the body. This was so far shown in ulcerative colitis (UC), a chronic inflammatory disease of the colon .

Melatonin production is deregulated in multiple sclerosis (MS), and treatment with melatonin blocks onset of the flare-ups. The role of melatonin in systemic lupus erythematosus (SLE) is more complicated and it seems to be gender dependant. Melatonin has a disease-promoting effect in rheumatoid arthritis (RA), and is also gender dependant. Melatonin can be beneficial in type 1 diabetes, as it stimulates insulin production. Lastly, melatonin helps in irritable bowel syndrome (IBS), reducing the flare-ups in intensity and duration .


Melatonin therapy in autoimmune diseases has been studied in many animal models and in a few human clinical trials. For all the conditions except rheumatoid arthritis (RA), melatonin has been shown to have the potential to reduce the severity of symptoms.

These findings indicate that melatonin treatment could be an important strategy for the Hashimoto’s condition, too. However, the research on this topic is lacking, especially in light of melatonin’s potential dual role in thyroid function and in immune response.

In the case of opposing effects, research should dig deeper and understand what is more beneficial: blocking the autoimmune part of Hashimoto’s while tampering with the thyroid hormone production, or the other way around? And how can the optimal effect be acchieved with the proper dosing of melatonin.

More research is needed to better understand the delicate balance between melatonin and the thyroid gland function. Hopefully in the future there will be more research geared towards understanding this connection.

The connection between sleep apnea and Hashimoto’s

Interrupted sleep can lead to an underactive thyroid

Sleep apnea is a sleep disorder, where breathing stops during sleep for a period of 10 seconds or longer for a few times a night. Some symptoms of sleep apnea are similar to Hashimoto’s symptoms.

Breathing is automatically regulated during sleep, maintaining the healthy balance between oxygen and CO2. If the breathing is interrupted, oxygen levels drop — causing a lot of problems with brain capacity, hormonal balances, and healthy blood pressure (1, 2).

Sleep apnea can be mild, moderate, or severe, depending on how many episodes of interrupted sleep a person experiences (2).

Symptoms of sleep apnea (3)

  • Fatigue
    When breathing stops during sleep, thebrain is left without oxygen, and starts sending an SOS wakeup signal. Waking up for a few seconds — even without recognizing or remembering — disturbs the sleep cycle and will likely cause next day exhaustion. This can make it easy to fall asleep anytime, anywhere.

  • Memory problems
    Sleep apnea can cause memory and concentration difficulties as it interrupts deep sleep. Deep sleep aids in memory function.

  • Loud snoring
    Although not everyone that snores has sleep apnea, and not everyone who has sleep apnea snores. Sleep apnea can make sleep quite light, which can make it easier to be woken up by a full bladder.

  • Waking up with a headache
    Lack of oxygen can cause morning headaches, they usually resolve within a few hours after waking up.

  • Waking up with a dry throat and mouth
    Snoring and breathing mainly through the mouth, can inhibit the production of saliva by the salivary glands.

Can Hashimoto’s cause sleep apnea?

People that have Hashimoto’s or an underactive thyroid are more likely to develop sleep apnea (4). About 4 in 10 people with an underactive thyroid also have sleep apnea (5–10).

Hashimoto’s can usually causes a type of sleep apnea called obstructive sleep apnea (OSA), occurring when the throat is swollen and inhibiting breathing. Other health conditions, such as obesity, polycystic ovary syndrome (PCOS), and pituitary gland problems may cause OSA.

Hashimoto’s causes the thyroid to become bigger (goiter) and this narrows the throat’s airway passage, making it harder for air to pass through. Even if no goiter is present, there is still an ongoing inflammation — which means a lot of molecules causing inflammation can also affect the throat causing swelling (11).

With good health management — including regularly taking prescribed therapy, balancing TSH levels, reducing TPO and TG antibodies, and lifestyle adjustments — sleep apnea can be reduced (12–14).

Can sleep apnea cause Hashimoto’s?

Severe OSA can be present even with normal TSH levels, if thyroid antibodies TPO and TG are high. Sleep apnea causes inflammation, which triggers other autoimmune conditions. It’s possible that sleep apnea is one of many environmental factors that can trigger Hashimoto’s (15, 16).

What increases the risk of developing OSA? (17–20)

  • Being overweight and obese

  • Polycystic ovary syndrome

  • Type 2 diabetes

How to diagnose sleep apnea?

Sleep apnea is usually diagnosed after being observed during one or more nights of sleep in a hospital’s sleep lab. The first steps in diagnosis can be analyzed at home: recording snoring with apps like SnoreLab, detecting any variations in sleep pattern through wearables like FitBit and Oura ring, and tracking fatigue and memory in the BOOST Thyroid app.

Your healthcare provider may ask you additional questions and perform a physical examination of your throat (21–23).

Practice sleep hygiene: There are some self-care approaches you can take to improve your sleep. Known as “sleep hygiene,” these tips can help you get better rest.

Some sleep hygiene tips include:

  • Having a sleep schedule, and aiming to go to bed and wake up around the same time daily

  • Avoiding naps

  • Avoiding caffeine, nicotine, heavy exercise, heavy or greasy foods, and stimulating screens (television, smartphone, computer) before bedtime

  • Keeping your sleep environment as dark as possible. Blackout shades/curtains and a sleep mask can help.

  • Keeping your bedroom cooler, ideally between 60 to 67 degrees — considered the temperature “sweet spot” for good sleep.

  • Wearing ear plugs, or using a sound machine if noise is interfering with sleep

One particularly helpful approach is to use guided audio meditation to help you fall asleep and experience more refreshing sleep. There are many CDs and audio download programs designed to help with sleep. Check out two favorites: Belleruth Naparstek’s Healthful Sleep CD/MP3 and Demo DiMartile’s Ultimate Deep Sleep Experience CD/MP3.

Get extra help: If you still have difficulty falling asleep or staying asleep, you may want to explore over-the-counter supplements or sleep aids, including:

  • Melatonin — A nightly dose of 5 mg or less can help you fall asleep more quickly.

  • Magnesium — A nighttime dose of magnesium relaxes muscles. For extra sleep-promoting benefits, soak in a warm tub and add some magnesium oil.

  • Valerian Root — this plant is found in a variety of sleep supplements and can help you relax, with some mild sedative properties.

  • GABA — If a racing mind is keeping you from falling asleep, think about gamma aminobutyric acid — GABA. This neurotransmitter fights anxiety and induces calm. Look for a patented formulation that crosses the blood-brain barrier, like Gabatrol or Kavinase.

  • Antihistamine-based sleep aids — over-the-counter antihistamines like diphenhydramine (Benadryl, Unisom SleepGels, others) and doxylamine succinate (Unisom SleepTabs) — can help you get a better night’s sleep. (But keep in mind that these medications can make you drowsy during the day, and cause thirst and a dry mouth.)

And, when nothing else works to help you fall asleep and stay asleep, talk to your healthcare provider about prescription drug options. Sleep is so essential that some practitioners feel like any risks or side effects of sleep medications are outweighed by the proven benefits of getting enough sleep. A medication like eszopiclone (Lunesta), zaleplon (Sonata), or zolpidem (Ambien) could be just what you need to get your ZZZZs.

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