The body is not made up of separate systems that operate independently of one another. Every system is intricately connected and attuned to the other. None so much as the thyroid which I’ve described in the past as the Queen bee residing in your throat, producing hormones that circulate all throughout the body playing a vital role in your metabolic, neurological, cardiovascular, musculoskeletal, digestive and hormonal function. Yes, she’s very popular! With her vast influence over the body’s systems it’s no surprise that one of the all important bodily functions – sleep, glorious sleep – can be negatively impacted when there isn’t enough of her to go around as in the case of hypothyroidism.
I talk about this a lot but one of the prevailing patterns I’ve noticed in the women I work with is an A type personality who always has a lot on their plate and their sleep routine can suffer for it. When you’re constantly burnt out with an enormous to-do list it can cause you to be a bit short sighted and put sleep at the bottom of your priority list. Additionally, operating with an empty cup can affect sleep onset and quality too as high cortisol and adrenaline comes with the territory. Chronically high stress hormones are the close acquaintances of insomnia.
Not every person with Hypothyroidism or Hashimoto’s will experience sleep issues or insomnia, but it is common enough to warrant me covering this topic. At a guess I would say 70% of my clients score their sleep quality as 0-5/10. And considering the importance of a good night’s sleep in their recovery, this is a conversation that needs to be had!
Are Hypothyroidism and Insomnia connected?
Research suggests some theories but has no concrete answers. However it’s clear that those with underactive thyroid are more likely to be dissatisfied with their sleep quality and sleep less than someone with healthy thyroid function.
The theories include; stimulation of the hypothalamic–pituitary–thyroid axis causing wakefulness, increased sensitivity to cold and/or joint/muscle pain causing physical discomfort and an inability to fall asleep easily or wake often. Other symptoms of hypothyroidism such as anxiety can of course affect sleep onset and quality too.
Hashimoto’s also increases your risk of suffering with sleep apnoea considerably which will dramatically affect your sleep quality. If you’ve been told that you snore or appear to stop breathing during the night then please speak to your GP about it.
Those with Hashimoto’s tend to have a disordered microbiome composition too which has been associated with poor sleep due to the role of different bacteria in producing neurotransmitters and hormones that promote a healthy circadian rhythm.
As I mentioned above, a huge proportion of women with Hashimoto’s are in a state of chronic fight or flight. When stress hormones are always high it interrupts your circadian rhythm significantly and sleep onset and quality will suffer.
It’s important to note that overmedication of thyroxine can also cause insomnia so please speak to your GP if you are experiencing heart palpitations, shakiness and anxiety in addition to poor sleep patterns.
So while there are no definitive answers, unfortunately there are a plethora of potential causes for the low sleep quality and duration for those with Hypothyroidism and Hashimoto’s disease.
What counts as insomnia?
- Difficulty falling asleep
- Difficulty staying asleep
- Frequently waking or waking too early
- Feeling dissatisfied or anxious about your sleep patterns
- Sleeping patterns that impair the quality of your life
- Sleeping patterns that interfere with daily functioning
Symptoms can include waking unrefreshed, fatigue during the day, irritability, anxiety or depression, difficulty concentrating, making frequent errors or accidents, anxiety about sleep.
The first step can be to see your GP to discuss your concerns. They may ask you questions or refer you for a sleep study to rule out things like sleep apnoea.
Why is sleep so important in Hashimoto’s
Ask anyone afflicted, Hashimoto’s can be hard enough but when you add sleep deprivation on top of the list of symptoms as long as you arm, everything else is exacerbated. Insomnia can exacerbate some of the most undesirable symptoms of Hashimoto’s like weight gain, anxiety & depression, inflammation, poor digestion and bowel motions, lack lustre skin, bags under the eyes, puffiness, fatigue, PMS, mood swings and premature ageing.
Lack of sleep is a major physiological stressor and in the case of Hashimoto’s I’ve found that prolonged stressors make a big impact on my clients ability to shift excess weight in particular.
If you want to improve the quality of your life with Hashimoto’s, 8 hours sleep is a non-negotiable. You must protect your sleep like your life depends on it as very little can compete with sleep for healing & energising abilities.
For those who have trouble prioritising sleep but otherwise sleep well, hopefully I’ve convinced you that sacrificing sleep to get more done is a false economy that will catch up with you. For those of you for whom your relationship with sleep is a lot more complicated read on to discover my top tips.
Sweet Dreams Tips
Firstly, decide when you will wake and when you will go to bed then stick to it and stay consistent. Just like meal times, our bodies thrive on a body clock routine that follows the sun. Generally, going to bed earlier – say before 10pm – and getting up earlier tends to promote better rest and energy throughout the day. I would not recommend going to bed after 11pm as sleep quality drops off after midnight.
- An hour before bed is your quiet, preparing for sleep time. This is a good time to chat, read, bathe, meditate and journal. Not the time for work, doom scrolling or high physical activity.
- Use lamps, low lighting or better yet a fire after the sun goes down to ensure bright lights and screens aren’t confusing your body about whether it is night or day. Melatonin (your sleep hormone) is triggered by darkness.
- Conversely, when you wake (weather permitting) get some sun on your face ASAP.
- Your bedroom is a sanctuary, keep it calming, uncluttered and a place you want to be.
- Keep the temperature comfortable and ensure you can block out light from street lights.
- No screens or devices in the bedroom, for the sake of your sleep banish the TV.
- Are you due for a new mattress or pillow? A proper neck supporting pillow is crucial.
- Are your doona & pj’s right for the season to keep your temperature regulated?
Chronic Insomnia Tips
- If you get stuck in an anxious thought loop about not being able to fall asleep and how tired you’ll feel tomorrow, don’t allow yourself to lie there for any longer than 15mins. Keep a book by your bedside and read for 20 mins before trying again or play a mediation or sleep story to break the cycle. Don’t start scrolling, turn bright lights on or seek a snack.
- If worrying thoughts are an issue for you then a brain dump before bed or journaling can help give your mind a clean slate for bedtime.
- Keep exercise to morning activities only, physical activity at night may be too stimulating.
- Tire yourself out during the day by expending energy via a vigorous walk or other movement, this is especially relevant if you have a desk job. Similarly, ensure you are getting up early enough that your body is tired by bedtime. Sleeping in can affect your sleep that night.
- Avoid napping.
- Avoid caffeinated drinks and foods like chocolate by 12pm or trial stopping caffeine altogether – sorry, for some this is necessary.
- Cut alcohol at night, enjoy a glass at lunch on a special occasion only until you get a handle on your sleep.
- Address chronic stress to reduce the high levels of cortisol & adrenaline coursing through your system which will be impairing sleep. Your situation will be unique to you, you’ll know what will need to be done so start taking action. Here are some ideas: delegate chores so you aren’t up late, develop firm work boundaries and put the laptop and phone away before dinner, refusing to answer the phone to that difficult person close to bedtime – let’s keep that heart rate down! – lowering your expectations for how much you can achieve in a day and scheduling in meditation and breathing exercises.
- Double check any medications or supplements aren’t causing wakefulness with your GP or practitioner.
- Try a candlelit lavender bath or an aromatherapy shower before bed. Apply a few drops of lavender oil to a face washer and leave it at the base of your shower.
- Plus all of the excellent sleep hygiene advice above.
It should be noted that supplements can be helpful but if you aren’t following the lifestyle advice above, they are unlikely to be a magic pill for your sleep woes.
Magnesium glycinate combines the muscle relaxing, calming and sleep inducing magnesium with a glycine molecule which has also been shown to help sleep quality.
L-Theanine is an amino acid that promotes relaxation and calm and has been shown to improve sleep.
Similarly GABA can help with calming the mind and relaxing the body although I’ve not had as much clinical success with this one and clients as the above two options.
Vitamin D, B12 and B6 deficiencies have all been linked with insomnia so assessment for these deficiencies and subsequent supplementation if necessary may be helpful.
Please note that I have not included melatonin here because in Australia it is prescription only and should ideally only be used short term under the guidance of a doctor.
Making meals your sleep ally
I know, I know, you’re probably sick of me saying this but balanced eating shines when it comes to sleep too. Ensuring your three meals per day are protein rich while also featuring complex carbohydrates and healthy fats will keep you off the blood sugar roller coaster. Unstable blood sugar has been shown to affect sleep quality. Blood sugar too high due to unbalanced meals, overeating and over consumption of simple carbohydrates can negatively impact sleep quality but inversely blood sugar dropping too low due to undereating or skipping meals can also affect sleep quality. So skipping breaky may be affecting your shut eye, another good reason to stop skipping meals.
Further advice would be to stop eating by 8pm and ensure you aren’t overeating. Hara Hachi Bu is a Confucian saying that translates to ‘eat until you are 8 parts full’. And there is a lot of wisdom in that saying, especially when it comes to blood sugar regulation and a good night’s sleep.
Protein in particular needs to be the hero of your plate to ensure there is a rich supply of the essential amino acid tryptophan and amino acids GABA & glycine to support a healthy sleep wake cycle. Tryptophan rich foods include turkey, chicken, tuna, cows milk, nuts & seeds.
If you’ve tried all of the above and remained consistent with your bed/rise times then I would recommend finding an integrative GP who can run tests and get to the bottom of your sleep concerns. Also seeking the professional help of a herbalist or Naturopath as herbs can really shine when it comes to aiding sleep. I have a few practitioners I can recommend, feel free to get in touch and I can direct you to them.
So I’m sorry to say this but if you aren’t prioritising sleep you are putting yourself at a serious disadvantage. Admittedly for some hypothyroidism or Hashimoto’s sufferers that is much easier said than done, hopefully this advice will help you get more shut eye if sleep is not going smoothly for you.
Because everything looks a little brighter, more hopeful and shinier after a good night’s sleep.