Sleep quality reduced in hypothyroidism - Thyroid UK
Sleep quality reduced in hypothyroidism
Please add something to let people know why they might want to follow your link!
For example, quote the abstract:
RESEARCH ARTICLE
Comparison of sleep in hypothyroid patients with normal controls
ABSTRACT
Background: Sleep -A complex amalgam of behavioral and electrophysiological process is maintained by organized interaction between neurons, neural circuits, and neurotransmitters. Hypothyroidism is the inadequate secretion of thyroid hormones by the thyroid gland. Hypothyroidism, the 2nd common endocrine disorder, is often accompanied by complaints of daytime fatigue. This chronic fatigue should be managed as it may result in impaired attention with adverse consequences in the classroom, workplace, not to forget the highways. Aims and Objectives: The primary focus of the present study is to evaluate sleep cycle in newly diagnosed overt hypothyroid patients to investigate if this fatigue is the consequence of sleep disorder. Materials and Method: A total of 30 hypothyroid patients of both sexes underwent polysomnography to assess sleep based on bioelectric potentials -electroencephalogram, electromyogram, and electrooculogram. The results were compared with age-and sex-matched euthyroid controls. Results: Hypothyroid patients showed significant changes in sleep stages when compared with normal euthyroid controls. Although their total sleep time was not significantly altered, Stage I and Stage II sleep was significantly increased (P < 0.001) while deep sleep and rapid eye movement sleep were reduced. Conclusion: This research proves that early diagnosis of hypothyroidism and management guarantees an improvement in sleep quality and productivity in life.KEY WORDS: Hypothyroid; Polysomnography; Sleep Stages
I will try to do better, I guess I felt if I put a good title announcing the subject matter, if people were interested they could read the study
I, and I suspect many others, appreciate that you posted it.
By adding a bit more, you really encourage them to follow the link and read the whole paper. Perhaps a word of phrase will grab their attention and they will see the relevance? Or, if it isn't to their interest, enable them not to. 
Hi All,My sleep patterns have been terrible for months now and l feel l am permanently exhausted, lts hard getting in with my GP at the best of times, l was called from the advanced practitioner and they have put me back on HRT but that has been giving me breast tenderness that is so uncomfortable l am going to stop taking it. I put my blood results on the forum and was advised that l am being under treated. The doctors have always messed about with it my levothyroxine l feel l function much better on 200mcgs, they have reduced up and down over the years from this to 175 Dow months to 150mcgs. Last time l refused to go lower than 175mcgms but feel shocking and the brain fog, joint pain and lethargy is making me feel so exhausted. I am going to speak to the GP tomorrow and ask for my dose to go back up. I have only recently discovered this forum and am learning so much from you all. Feel l have been so green for all these years even though l work in health!
Have you tried HRT patches? I can’t tolerate the tablets as they give me migraines every day. Plus the tablets need to be taken well away from thyroid meds.
Hi Lovecake, No l haven’t tried the patches, l was originally on 2 mrs then stopped as was in constant breast discomfort so stopped taking for quite a while then been back on them for almost two months on 1 mg and wasn’t too bad but the discomfort back again. I take my Levothyroxine in the early hours when l get up in the night and my HRT about 6.30 pm after tea.
I have never felt so drained and no motivation at all. I need to loose weight and start well but then it hits a standstill. I usually have better motivation than this it’s making me feel down.
If you get your thyroid levels correct, your vits and minerals all optimal that will be a start. Are you gluten, dairy and soy free? You could try eliminating one of those at a time and see if you feel better. You will lose some weight when your body is ready. If you don’t stress over it and try and eat sensibly (treats occasionally of course) then you are more likely to lose some weight without realising.
Thank you, It’s great to receive all this information and support.
Yes it is. This forum has helped me no end. Just reading answers from time to time can make a huge difference.Take care, I hope you feel some improvement very soon.
Thanks you too.
I've had very similar struggles with the HRT side effect of breast tenderness. It is worth trying some different forms of HRT - as Lovecake says the patches can be better tolerated. I was told that high doses of evening primrose oil can help with breast tenderness - I am trying this now and I think it is working. Apparently some women find starflower oil works better for them. It is worth looking at menopause doctor.co.uk website. Lots of science based info on there.
It can be difficult sorting out which symptoms are due to thyroid and which are due to menopause. Many GP's don't appear to be very knowledgeable about either!
Thank you for your reply, and for the information about the evening primrose oil are you taking this along side the HRT or in place of?I will have a look at the website too, like you say it’s difficult to get a doctor that’s knowledgable about both! I am willing to try anything if it gets the old me back. I don’t expect to be climbing mountains but not even got the energy or motivation to walk upstairs at the moment.
Thank you for your advice.
I'm taking HRT and the high strength evening primrose oil which is supposed to mitigate the breast tenderness. I think it is helping (takes a while to kick in) but I haven't been on it for that long so I'm hoping it will get even better.I haven't managed to solve the fatigue problem yet either, have just changed my HRT so keeping fingers crossed for that.
Thank you, l will try that and see about changing the HRT as well.
Thanks Gigi,
I would very much like to see a study on those overtly hypothyroid patients to see any improvement once treated with Levo over the next few years.
Yes I think I read in another that it normalized sleep when treated with T4 I’ll have to find that one again! If I remember, it said a few months of T4. You’re welcome
Improved sleep was one of the first real benefits I felt from levothyroxine.
This is one of my pet topics. We know sleep quality is impaired in hypothyroidism. We also know that some patients have T4 to T3 conversion problems and the brain is highly dependent upon type-2 deiodinase. Combined L-T3 / L-T4 studies have generally used L-T3 doses that normalise serum T3 / T4 ratios even though this would not restore brain T3 levels in patients with impaired conversion.
I have lobbied for a study of varying L-T3 doses in patients with suspected conversion problems in order to find the dose that restores normal sleep quality. This would give an indication of the L-T3 doses needed to restore normal brain function. This will probably result in fT3 levels that are too high for the heart and other organs but we will have advanced our understanding of the effects of conversion problems on the brain.
Yes I can’t seem to convert T4 into T3 properly like many. I felt horrible on just synthroid. In 2012 I started getting desiccated thyroid and have done better on that, not perfect but better! Yes I would be very interested in the study you want done.
That is interesting, I will send a copy of that by email. He says there is no reason why I shouldn't sleep well with hypothyroidism., it is probably your attitude towards sleep which is causing it not being hypothyroid!!!!
I am one of the world's worst insomniacs. My head can be drooping before I go upstairs, my eyes closing and I have to prop them up! But I get into bed and I very often lie there for a while. Then I get the fidgets, I am wide awake, restless legs come onto the playing field and I just get up, try a hot chocolate or similar.p & try again later.
And if I am stressed about anything, you can guarantee that I wake up only a couple of hours after I last noticed the time on the clock.
This Article made me laugh! They say that Hypo patients do a great deal of sleeping during the day . All I can say is that I very rarely sleep during the day. I have tried many times, after a longish journey , or after having not have slept at all the previous night. Having to get up for some reason that morning I find it very difficult to go to sleep then as well. But mostly I don't sleep during the day, because I want to sleep the next night,
The brain obtains about 20% of its T3 from the blood and 80% from converting T4 to T3 with type-2 deiodinase. If you restore normal serum T3 levels with some liothyronine it will at best restore the brain T3 that comes from the blood but do nothing for the T3 derived from converting T4 to T3. Similarly, giving high doses of levothyroxine restores blood T3 (and reverse T3 which doesn’t help) but will also do nothing for brain T4 to T3 conversion.
I have found I need higher doses of liothyronine and hence higher fT3 to restore normal sleep and normal brain function.
Yes, I understand you. I sourced my own T3, because my GP refused to consider prescribing it - he said it was an illegal drug.
I found Tiromel last year and started on that, gradually increase my dose 1/4 of a tablet at a time daily.
I am now on 3 full tablets 25mcg 3 times a day, taking the first as near 4am each day as I can manage and 8 hourly after that.
I thought I might have gone too far, maybe might have gone too far. But I was feeling better. So I stayed at that dose to wait and see.
A few weeks ago I noticed my hair growing back, but no weight loss, so I fasted a few days and started adding foods, strictly veg at first and I have lost a stone since I started the fast, about 4 weeks ago at 13st 4lbs!!! Which I am delighted with, (weight was my biggest bugbear)
But as yet I am not seeing too much of a change in my sleep patterns, though I live in hope!!!!!
However hormones are something- trial and error I think. As I was diagnosed in 1997, this is the first light I have seen at the end of my tunnel and I am thrilled to have seen any improvement. I was thinking of trying NDT next, but now that I have a glimmer of hope, I will stick with it for sometime now and hope for more improvement.
I assume you mean you take one tablet three times a day. I'm not sure why you take a tablet at 8 am, it would get into your bloodstream around 6am or 7am which doesn't seemt to offer any advantage unless you want to be at peak condition early morning. I split my doses evenly around 8am, 4pm and bedtime and find that works well.
Hi I’ve just started introducing T3 to T4 after having vanishingly small TSH results (0.01 approx) for 15 years yet feeling ok on my dose of T4 and feeling hypo when reduced my dose of T4. Endo asked if I had brain fog ...I said not sure as was used to how I felt and thought it could just be just aging!
Thank you so much for this!I slept poorly for many many years, and did not really find it improved until I started T3 recently. This has been shown on improved sleep quality in my Fitbit.
I always thought it was stress/ children/ work and did not consider my undertreated thyroid for a minute. People really need to know these things and studies definitely needs to be done. So glad you posted this…. Will be printed out and put in my folder. 😆
Oh nice! Glad it was helpful! I’m glad your sleep has improved! It is so important for our health, my sleep is still not optimal at all I tend to go to sleep and wake around 2-3am and am up for several hours. I may or may not sneak in an extra hour around 7
I’d say it is imperative for our health.
Yes seems so! If we don’t get good sleep it increases our health risks tremendously.
It’s also why sleep deprivation is used as a method of torture 😱
So it sounds like my doctor is my torturer for keeping me under medicated lol
My sleep is the same as yours…awake for several hours in the night….drop off around 7am if I’m lucky.My sleep got worse on starting 50mcg levo but has improved a little with two dose increases.
I’ve been focusing on length of sleep. This study shows, depressingly, that quality is affected, too.
When you wake up at 2:00 - 3:00 am, is it because of night sweats? Just curious because that's the time I used to experience them. Sweating profusely, heart racing and intractably hungry. Getting back to sleep could often take a while.
No I’ve never had night sweats but my blood sugar seemed to drop and wake me. I also tend to be a light sleeper so any little noise will wake me.
Ah, okay.What would you estimate is your total time asleep during each night?
Well majority of time probably 4-5 hours it’s bliss when I get the occasional 6-7. I’ve slept poorly for decades. More than likely because of my thyroid issues.
Have you had your adrenal function evaluated? There is an adrenal saliva test available. Mine showed elevated levels in the morning, afternoon and at bedtime.When this began (insomnia) for me in 2013, my heart would pound so hard at night that it was as if I was trying to sleep while riding a mechanical bull.
Are you currently on thyroid medications and if so, how much T4 and T3?
I have always wanted to get adrenals tested but haven’t. I have recently started NP thyroid and am liking it. I previously took Armour and my numbers went below range and I felt badly. Before that I took thyroid-s from Thailand and it did very well from 2012-2018 then my numbers went below bottom range. It’s been difficult to find potent natural thyroid. In 2018 I had the strangest symptoms I’ve ever had that I felt were adrenal related, I would go outside and if the sunshine hit my skin my heart would pound and my heart rate would be 180-200 and blood pressure 200/160. I did research and a Dr. Lam said that showed adrenals completely collapsed anyway I experienced that for several months and as I raised Armour it went away but I never felt well on Armour. I presently take 2 grains NP thyroid.
I long for the night that I sleep normally. I am envious of those who do.
Oh yes me also! It’s 3am here and I just woke at my usual time! I’ll be up till probably 7am and sneak in an hour maybe two sigh.
I read somewhere a while ago that a persons immune system works mostly at night up to around 5am. This fitted with my pattern, if I woke at 2 or 3 then I couldnt get back to sleep till after 5. Before I was diagnosed hypo I hardly slept for years felt really rough then with levo it got slightly better though still never managed more than around 5 hours and was permanently tired. In 2019(after10 years on levo) I took the plunge to self medicate and on NDT I now sleep sooo much better not perfect but get 7 h most nights and no daytime tiredness, in fact at 73 I am less tired and do more than at 50😃
Having slept really badly for years, I now realise why! I had always thought it was stress at work that stopped m sleeping, I would try everything...mindfulness, eating early, having a routine, exercising more but nothing worked. I would be so so tired, but then when I got to bed couldn't sleep, or did drop off only to wake up at 3am and have to go to the sofa...I do sleep sooooo much better now on levo and take magnesium in the evening.
As an aside, there was an interesting programme about sleep on Radio 4 a while back and the idea of sleeping all night and in one block is a very modern western thing. It was taken in shorter blocks in say the Middle Ages. People got up up at around 2am and did things before going back to sleep again. Afternoon kipping is supposed to be very beneficial too. When I was untreated I could not sleep at all until 6am - fat lot of good if you are working and I would struggle to stay awake from 11am! My solution was to not sleep at all every other day. I just did things all night long, as lying there awake in bed was simply awful. Mind you the whole business was simply awful.
I feel very lucky that now that I’m in the land of nodd within 10 minutes of going to bed, but sometimes don’t even make it to the bed sleep comes to me so readily…I do a fair bit of fly catching on the sofa!
I had not heard that about the Middle Ages! Interesting tidbit there! Now I’m curious about how people in other parts of the world sleep, it’s great you sleep well now. That will improve your health on many levels
Yes I’m sure continuous sleep is a modern idea. Most animals have to keep a watch out for predators, sleep listening to others, dose during the day.
I tend not to worry about how long each period of sleep is but add up the total. If I’m awake I no longer actually try to sleep as that way madness lies. Of course now I’m retired it’s easier but I found when I let go of trying to sleep, listened to podcasts, did puzzles I actually slept better.
Of course when I was severely hypo it was a different matter, tired all day sleepless nights and when very hyper often tired but walking miles. Until dosed properly with the correct meds you’ve got to take one day at a time and not be fobbed off.
Really interesting article and thanks for sharing it.
Sleep is one of the key signs to me of when I am under medicated. Struggled with insomnia for years before a diagnosis. It makes such a difference to my quality of life when I get consistently better sleep.
Oh yes my mood and energy much better when I sleep well. I’ve been on thyroid meds since 2001 and the majority of that time I’ve had bad sleep, there has been a year here and there it was ok. That shows me I’ve been under medicated a lot. Batches vary in potency and docs are loathe to give a proper amount
Thank you for sharing- it’s my next read after replying. We have changed the way we live. We have removed the TV and it is in a room upstairs in the main building (we run a guest house). Our owners accommodation is now peaceful and we do not listen to the radio either we do read and do use our computers but that stops at about 9 pm.
For both of us our sleep has improved and if we are a little tense we use high-strength CBD 15% but generally I lie in bed focus on my breath and count the ins and the outs slowly I can’t remember getting past seven last night. I found when I was undermedicated my biggest problem was actually waking up! It was nothing for me to sleep 14 hours a day and I actually did one stint straight through! Now I seem to be on an even keel at the moment I am getting a sufficient amount of sleep to function and feel good when I wake up in the morning. I would’ve thought this unachievable a few months ago. As I said before thank God for this forum.
Sounds like you have the right idea! My grandkids seem to need their iPads when they go to sleep! I tell my daughter that blue light isn’t good for them at bedtime but oh well, she doesn’t listen to me. I remember when I was a kid I had a tv to put in my room and was excited lol. It’s good it’s now known to put the electronics away and sleep is important!
Absolutely 😊👍
I wake up every night every 2 to 3 hours on the dot through out I do fall back to sleep but it's a broken sleep I would love even if I woke up once or twice I'd be happy sleep is so important
It's interesting reading the comments and hearing how different the experiences are just from the people on this forum. I find Levothyroxine is horrible for my sleep. The higher the dose, the worse I sleep.
I sleep better now I have some T3 added. Plus I take a magnesium capsule 4 hours before bed (then I can take my 2nd dose of T3 at bedtime). But if I over do it, then I don’t sleep well even though I need it.
I had been reading articles on how to get a good nights sleep & worrying over the number of hours I was getting. Then it finally dawned on me I had spent the past 30 years working irregular, very variable rotating shifts (Days, PMs, Nights). So why was I even expecting to just settle into a regular sleep pattern following retirement? I lowered my expectations, that alone seems to have helped my sleep.
One doctor told me when she has trouble sleeping she counts backwards, starting at 100. Believe it or not this has helped.
Thanks for posting on this subject, as I wasn't even considering thyroid as a factor.
I have been having lot of trouble sleeping even though I am active all day. I try counting backwards from 1000, slow deep breathing, relaxing your muscles from toe to head and aromatherapy help. Last resort some sleep music or meditation music!
Hi, thank you for posting this! I bought myself a Fitbit and it monitors sleep (not sure how accurate really but Google is quite positive about it). It is now my new obsession - checking my sleep quality when I wake up.
Fitbit tells me that I need to be in bed for AT LEAST 10 hours to get a 'good' result. This is pretty tricky because I don't have time for 10 hours in bed! I'd need to go to bed at 8pm to be up at 6am. Sigh.
The other thing it does is monitor heart rate and breathing which others might find useful (but be careful because it can become obsessive!)
My heart rate is over resting heart rate for a good few hours after I go to sleep (which always makes me wonder if I'm overmedicated). This is even with 'deep sleep' recorded. Then it occasionally spikes at times later on at night. Then eventually it goes down below resting heart rate - but doesn't go up again (which it should) which means grogginess in the morning.
The breathing thing tells you if you have 'spikes' as well - I do occasionally, so could be sleep apnoea, but my dog can't tell me...
I have a Apple Watch that tells me similar things. I turn the watch off at night as I
Have iPhone by my bedside
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