🥱 Thyroid Sleep Paradox: Fatigued But STILL Can't Sleep at Night | Issue 185
Despite the common symptom of fatigue, many struggle to get a good night’s sleep.
Issues surrounding sleep can be one of the most frustrating parts of having a thyroid condition. In this weeks newsletter, I am breaking down the types of sleep complaints those with hypothyroidism and Hashimoto’s commonly experience and why, plus what we can do about it. Because I am alllll about sharing how we can overcome these frustrating symptoms and impacts to our lives.
Plus, doesn’t everything feel so much harder to navigate when you’re chronically exhausted?!
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Thursday Thoughts
Despite the common hypothyroidism symptom of fatigue, many of us struggle to get a good night’s sleep.
The types of sleep issues I am asked about frequently include:
Not being able to get to sleep. Feeling ‘Tired but wired‘.
Waking up frequently during the night.
Waking up at 3am and not being able to get back to sleep.
Waking up feeling unrefreshed or perhaps ‘more tired’ than when you went to bed the night before.
Thyroid symptoms keeping you awake, such as muscle cramps and aches and pains.
Sleep apnea.
Night Sweats.
Adrenal Health
A lot of the above sleep complaints are often linked back to adrenal health. As well as optimising thyroid hormone levels (especially Free T3 and Free T4 levels), the hormone cortisol often needs consideration in thyroid patients.
Many of us have adrenal dysfunction, where our cortisol slope is altered. This can impact our ability to fall asleep, make us feel ‘tired but wired’, wake up and not be able to get back to sleep, have night sweats, and wake up feeling incredibly unrefreshed and unwell in the morning.
The adrenals’ main hormone, cortisol, is very important when it comes to energy levels. It is at its highest (or at least should be) in the morning to wake us up, gradually declining as the day goes on, before it reaches its lowest point in the evening, so that we’re ready to sleep. However, when someone has adrenal dysfunction, their cortisol levels often do not follow this pattern and instead, their cortisol may be high when it should be low and low when it should be high, creating issues with sleep cycles. Read more about this here.
Blood Sugar
Waking up at 3am can be a sign of blood sugar being imbalanced and this may be helped by having a protein focused snack before bed.
You can also try avoiding caffeine after 3pm, as it can still affect you hours later and contribute to you not being able to sleep. Read more about keeping your blood sugar balanced with hypo and Hashi’s here.
Nutrient Levels
Levels of Vitamin D, B12, Iron etc. shouldn’t be overlooked. A deficiency or low level in any of these can make you feel fatigued, unrefreshed and achey, which can impact sleep quality.
Melatonin in supplement form is also often seen in online forums, as this hormone can be used short-term to improve sleep, However, it is prescription-only and is contraindicated for autoimmune conditions as it can stimulate the immune system.
Hashimoto’s
Sleep apnea in thyroid patients has been linked to having hypothyroidism and Hashimoto’s, as those with these conditions are more likely to develop sleep apnea.
Hashimoto’s can cause obstructive sleep apnea, which occurs when the throat is swollen and inhibits breathing, such as with a goitre (enlarged thyroid gland). Managing Hashimoto’s effectively, often by trying to lower thyroid antibody levels and keeping them low, can help to manage this type of inflammation and improve sleep apnea.
Muscle Aches and Pains
Hypothyroid myopathy e.g. muscle aches and pains can affect sleep too. This pain is often resolved by optimising thyroid levels, vitamin levels, removing food sensitivities (such as gluten) and supplementing with magnesium.
Exercise
Exercising during the day also promotes a good night’s sleep, so even if you’re struggling with thyroid fatigue at the moment, getting in a fifteen minute walk can really help. You don’t need to go OTT with exercise and in fact, doing too much and pushing your body further than is comfortable can worsen any adrenal issues. So listen to your body.
The Right Routine
Creating and sticking to a good bedtime routine is an obvious but important thing to mention too. Too many of us aren’t being conscious about creating a routine which promotes a good night’s sleep and without a routine, your body can’t follow any cues.
Some tips for optimising your sleep routine include:
Stick to a ‘bedtime’ – Try to avoid napping during the day, changing up the time you head to bed or sleeping in on weekends. Pick a window and stick to it. For me, I head to bed at 10pm and get up around 7am, though I often wake up naturally earlier.
For the last hour or two before bed, step away from screens (TV, phone, laptop) and find activities that help you to wind down instead. E.g. meditation, reading a book or taking a bath or shower. Electronics too late in to the evening can interfere with your production of melatonin, the ‘sleep hormone’.
Also, switch bright lights to warm lamps in the evenings.
Short-term Help
Some short-term relief whilst you work on the above suggestions can include:
Taking a bubble bath to relax you
Having a foot soak
Using Epsom Salts in a bath or foot soak
Using a pregnancy pillow to help with aches and pains (they’re not just helpful to pregnant women!)
Using a hot water bottle to ease aches and pains
There are herbal supplements which may help, such as holy basil, ashwagandha etc. Always consult a pharmacist or doctor before starting any supplements, though.
Personal Health Check-in
My Medichecks finger prick blood test came back.. My iron continues to increase (woohoo) but my Vitamin D and B12 have dropped quite a bit since I stopped supplementing them a while back (I wanted to check whether I still need them), so I have resumed them again.
Social Media Spotlight
My most popular online posts in the last week were:
Follow Rachel on » Facebook | Instagram | Threads
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I have just updated this article with information about my own experiences with very heavy periods and my diagnosis last year.
That's all for this issue of The Invisible Hypothyroidism Newsletter, but you can find more information and support by:
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Thanks for this Rachel. The sleep-thyroid connection is so often overlooked, appreciate!