The thyroid, while small, oversees a whole lot. It helps your metabolism and body temperature and regulates your body’s reaction to hormones.
“Think of your thyroid as your body's thermostat,” says Steve Gendron, Ph.D., a researcher in Physiology-Endocrinology and founder of Mindful Living Choice. “It regulates things like your metabolism, energy, and even how warm you feel.”
But while it may be common, thyroid dysfunction can wreak havoc on the way your body functions — and that includes your sleep.
So how, exactly, does thyroid dysfunction impact sleep — and if you’re living with thyroid issues, how can you overcome your symptoms to get the sleep you need?
What is thyroid dysfunction?
To know how thyroid dysfunction impacts your sleep, first, you must dive into what exactly thyroid dysfunction is.
When your thyroid is functioning normally, it’s like a thermostat turned to the perfect temperature. But when you have a thyroid dysfunction, your thyroid can’t properly regulate your body’s processes — and it can lead to a variety of symptoms.
There are two main types of thyroid dysfunction: underactive thyroid, known as hypothyroidism, and overactive thyroid, known as hyperthyroidism.
If you have hypothyroidism, “it's like your thermostat is set too low,” says Gendron. Your body doesn’t produce enough of the thyroid hormones it needs to function, “which can slow down all sorts of body processes,” says Gendron. “You might feel cold, tired, or have trouble concentrating.”
On the flip side, if you have hyperthyroidism, “your thyroid is like a thermostat cranked up too high,” says Gendron.
If you have hyperthyroidism, your body produces too much thyroid hormone. “This overactivity speeds up your body's processes,” says Gendron. As a result, “you might feel like you're running on high gear all the time — restless, anxious, experiencing weight loss, or having a rapid heartbeat.”
How does thyroid dysfunction impact sleep?
As mentioned, when you have thyroid dysfunction, your thyroid either produces too much (hyper) or not enough (hypo) thyroid hormone for your body to function properly. And both the lack and overabundance of thyroid hormones can impact your sleep in different ways.
Hypothyroidism and sleep
“It’s common for people with underactive thyroid to have trouble falling asleep or staying asleep,” says Comite.
Why? Because while hypothyroidism can make you feel tired, it can also cause symptoms that makes it difficult to get the high-quality sleep you need to feel your best. “Despite feeling tired, you might struggle to get deep, restorative sleep — often due to discomfort like joint pain or feeling too cold,” says Gendron.
Hypothyroidism can also impact sleep hormones, which further contributes to sleep challenges. “With hypothyroidism, the low levels of thyroid hormone can disrupt the balance of other hormones — including cortisol and melatonin, which are crucial for sleep,” says Gendron.
Hyperthyroidism and sleep
Hyperthyroidism can make it harder for you to fall asleep due to the increased production of hormones.
“Hyperthyroidism ramps up everything — including your stress hormones like cortisol,” says Gendron. “This can make it hard to unwind and fall asleep.”
And “because excess thyroid hormones speed up metabolism, hyperthyroidism often makes people too aroused and jittery to fall asleep,” says Comite.
Hyperthyroidism can also cause things such as frequent urination and night sweats, both symptoms that make it hard to sleep through the night.
How to get better sleep with a thyroid dysfunction
Clearly, thyroid dysfunction can impact your ability to get the rest you need to feel your best. But the good news? Treating your thyroid dysfunction and managing symptoms can help you get better sleep — whether you’re living with hypo- or hyperthyroidism.
Get treatment
Thyroid dysfunction isn’t something that heals on its own. If you want to feel better, getting treatment is an absolute must.
However, you can’t get treatment until you know what you’re dealing with. “The first step, of course, is to have a blood test to see what’s going on,” says Comite.
When you get tested for thyroid dysfunction, most doctors will start by testing your Thyroid Stimulating Hormone (TSH). If your TSH is high, it can indicate hypothyroidism — and if your TSH is low, it can signal hyperthyroidism.
But looking at TSH alone can be misleading — which is why Dr. Comite recommends also asking doctors to test your T-4 and Free T-3 levels, which will give you a clearer picture of what’s happening with your thyroid.
Once your doctor has confirmed what’s going on, they can put you on the proper medication —synthetic hormones for hypothyroidism or antithyroid drugs for hyperthyroidism — to get your hormone level within a healthy range.
Just keep in mind that it can sometimes take a while to get the dosage right — so don’t get discouraged!
Make positive lifestyle changes
Getting the right medication is non-negotiable for treating hypo- or hyperthyroidism. But “beyond that, lifestyle changes can help,” says Gendron.
Making healthy lifestyle changes may help keep symptoms under control and prevent thyroid disease from progressing.
For example, “moderate, consistent exercise can regulate hormones and improve sleep quality,” says Gendron.
A thyroid-friendly diet may also help. “Foods rich in selenium, iodine, and zinc support thyroid health,” says Gendron.
Manage symptoms before bed
If your thyroid symptoms are preventing you from getting good sleep, it’s important to do everything you can to manage those symptoms before you get into bed.
For example, if you have hyperthyroidism — and find yourself feeling nervous and anxious before bed — make sure to include plenty of relaxing activities in your nighttime routine, like deep breathing, yoga, and meditation.
Or let’s say you have hypothyroidism — and your joint pain makes it hard to fall asleep. In that case, you’d want to treat your pain before bed to increase your chances of falling asleep — for example, by taking a hot bath, massaging the affected joints, or taking an NSAID.
Or let’s say you struggle with feeling too cold (hypothyroidism) or too hot (hyperthyroidism) in bed. In that situation, you can experiment with different thermostat settings to find the ideal sleep temperature for you — and then make sure that your thermostat is turned to that temperature each night before you go to sleep.
The point is, if your symptoms are keeping you awake, making efforts to treat or manage those symptoms before bedtime can help you get better rest.
