When it comes to fighting the fatigue that often accompanies hypothyroidism, part of the answer is simple: Sleep more. But knowing what to do and then doing it are different beasts: Many people simply don't get the sleep they need. Adults need at least seven hours of sleep each night, according to the National Heart, Lung, and Blood Institute, but a 2013 Gallup poll found that 40 percent of Americans don’t get that much sleep.
The Link Between Hypothyroidism and Fatigue
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 at Orange Coast Memorial Medical Center in Fountain Valley, Calif. “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 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, Ariz., 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 also prevents the deepest, most important sleep, Dr. Rosenberg says. This may be another contributor to daytime fatigue in people with hypothyroidism, he says.
Get Better Sleep With Hypothyroidism
The first step in treating sleep problems and fatigue in hypothyroidism is to get thyroid hormones back within a normal range. “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.
Beyond treating the root cause of hypothyroidism, Rosenberg says the best advice for getting better sleep is the same as it is for anyone that 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. Simulate the night. “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 pre-sleep 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 foods or drinks with caffeine, such as chocolate or coffee.
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 like meditation.
If you continue to struggle with sleep issues, talk to your doctor in order to determine the root cause of your insomnia and help you get the quality rest you need.