Published March 10 2014
Many people with hypothyroid and hyperthyroid conditions have problems falling and/or staying asleep. Some cases are more challenging than others. Many people rely on nutritional supplements and herbs to help them sleep better, such as melatonin, valerian root, magnesium, and 5HTP. While I think it’s fine to take supplements or herbs on a temporary basis to help with sleep issues, one shouldn’t rely on these for a prolonged period of time. Although I commonly recommend supplements to patients to help with sleep problems, I’ve worked with numerous patients who didn’t receive any benefit from taking natural sleep aids like the ones I mentioned. And so if you are taking supplements such as the ones I listed above and still can’t fall and/or stay asleep, then hopefully the information in this article will benefit you.
Sleep Strategy #1: Control the inflammation. People with autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis have an inflammatory component. Sometimes this is reflected in the blood tests by an increase in inflammatory markers such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). But other times these markers are negative, even when inflammation is present. And there is evidence that inflammation can interfere with sleep, although the physiological mechanisms still remain unclear (1) (2) (3).
Sleep Strategy #2: Stop taking supplements. If you were taking any supplements before you began experiencing sleep difficulties then consider stopping them for a while. And it doesn’t matter which supplements you’re taking, as people respond differently to various supplements. For example, in most people, taking magnesium will help the body to relax and improve their sleep. However, I once had a patient who was having a lot of problems falling asleep, and eventually realized that it was due to the magnesium she was taking. Sometimes it might not be the actual supplement, but perhaps the fillers or other ingredients in the supplements that someone is sensitive to, thus causing problems with sleep (as well as other symptoms). So consider taking a break from your supplements for one or two weeks and see if this helps with the sleep.
Sleep Strategy #3: Make sure your room is completely dark when sleeping…and avoid bright lights prior to going to sleep. Melatonin production is optimal when it’s completely dark. Plus, for those who are having problems falling asleep, being exposed to artificial light from your house one to two hours prior to going to bed can be having an impact. One study showed that exposure to room light before bedtime suppressed melatonin, resulting in a later melatonin onset in 99.0% of individuals and shortening melatonin duration by about 90 minutes (4). I don’t expect anyone to sit in a completely dark room for one to two hours before going to bed, but one strategy that might help is to turn off the main room light at least one hour before going to bed, and use a book light while reading a book or magazine. I realize that these days many people have a Kindle, Nook, or use their IPAD to read books, and this might be fine, although the EMFs from the device might be a factor, as I’ll discuss in more detail shortly.
Sleep Strategy #4: Stop using all electronics 2 hours before going to sleep. For some people, watching television actually helps them to fall asleep. But for many people, watching television or surfing the Internet right before going to bed can interfere with falling asleep. Once again, the EMFs from these electronics might affect the production of melatonin.
Sleep Strategy #5: Do some aerobic exercise 3 to 6 hours before going to bed. Just about everyone should engage in regular aerobic exercise. I realize that some people with thyroid and autoimmune conditions might not have the energy to engage in aerobic exercise. And many people with a hyperthyroid condition need to be cautious about further elevating the heart rate. But for those who are able to participate in aerobic exercise, doing so 3 to 6 hours before bedtime can make it easier to fall asleep. This doesn’t necessarily mean going to the gym, as for many people, taking a brisk walk before or after dinner is sufficient.
Sleep Strategy #6: Be aware of blood sugar issues. High or low blood sugar levels can make it difficult to fall asleep. For most people it’s best to not eat anything within a couple of hours of trying to fall asleep. However, for some people it actually helps to have a small snack that is high in protein about 30 to 60 minutes before going to bed. Remember that everyone is different, and so a strategy which works for one person might not necessarily work for another person.
Sleep Strategy #7: Correct any hormone imbalances. Many people with hypothyroid and hyperthyroid conditions have difficulty falling to sleep, and frequently this is resolved when the hormone levels are in balance. Estrogen dominance can also interfere with sleep. Many women have low progesterone levels, and there is plenty of evidence which shows that progesterone can be an important factor when it comes to sleep (5) (6) (7) (8).
Sleep Strategy #8: Improve your stress handling skills. There is plenty of evidence which shows that stress can interfere with sleep. And I think this is a big factor that is overlooked by many people. Many healthcare professionals, including myself, have seen a correlation between high nighttime cortisol levels and sleeping difficulties. However, a couple of studies have shown that depressed morning cortisol levels is associated with people who have insomnia (9) (10).
Sleep Strategy #9: Wean off of the caffeine, alcohol, and/or nicotine. Fortunately most of my patients don’t smoke, and so nicotine usually isn’t a factor with regards to sleeping difficulties. I do work with a lot of people who love drinking coffee, and so this can definitely be a factor. But of course there is also caffeine in tea, as well as soda, and chocolate. This doesn’t mean that everyone who drinks one or two cups of coffee per day will have sleep problems, but once again, everyone is different. You might have one person who drinks a few cups of coffee each day and sleeps great, while another person might not drink coffee but eats a small piece of dark chocolate on a daily basis, and this could potentially be interfering with their sleep. As for alcohol, some people might sleep better when drinking a glass of wine at night, but for many others, drinking alcohol at night can cause sleep disturbances.
Sleep Strategy #10: Engage in sexual intercourse before going to sleep. Having sex before going to bed might help you to sleep better. One reason is because having sex can be beneficial for stress reduction (11).
Sleep Strategy #11: Get rid of all EMFs in the bedroom. There is evidence that electromagnetic fields (EMFs) can interfere with the production of melatonin (12). This is far from conclusive, but if you have tried doing everything to improve your sleep yet still have problems falling and/or staying asleep, then you should seriously consider reducing the EMFs in your bedroom. If you have any electronic devices in your room then you want to either get them out of the bedroom, or if this isn’t feasible then at the very least I would unplug all of the devices right before going to sleep. Simply turning them off isn’t sufficient. If you must use a cell phone or alarm clock to wake you up in the morning, make sure it’s at least six feet away. Or better yet, put the cell phone/alarm clock in an adjacent room.
Sleep Strategy #12: Make sure your bed is comfortable. This might seem obvious, but having an uncomfortable mattress and/or pillow can lead to sleep problems. If the bed is too small this can be an issue. Many people don’t put much thought into purchasing a bed and mattress, but when you consider how much time you spend in your bed then you probably want to invest as much time into getting a bed and mattress as you would when purchasing a new car. Many people will spend weeks and sometimes even months test driving cars before making a decision, but won’t spend enough time when it comes to purchasing a bed or mattress.
Sleep Strategy #13: Purchase an air purification system for your bedroom. Sometimes the air quality can be interfering with your sleep. If this is the case, then investing in a quality air purification system can be beneficial and might help you to sleep better. I personally have a BlueAir air purification system, but there are other good quality ones out there as well. There is evidence that air pollution can lead to sleep-disordered breathing, which can affect up to 17% of adults (13).
Sleep Strategy #14: Take a hot bath 2 hours before going to bed. There have actually been a few small studies which have demonstrated that taking a hot bath 1.5 to 2 hours before going to bed can help to improve sleep (14) (15) (16). A big reason for this seems to be the change in body temperature, although taking a hot bath can also be very relaxing and a way to manage stress.
Sleep Strategy #15: Adjust the temperature of your bedroom. If the temperature in your bedroom is either too hot or too cold, then this very well can affect sleep quality. And so you can try adjusting the temperature of your bedroom one degree at a time and see if this helps to improve sleep.
Sleep Strategy #16: Clear your mind before going to bed. The primary reason why many people have problems with sleep is because they have too many thoughts going through their mind. Frequently these thoughts are stressful in nature, as one might go to sleep worrying about financial issues, health problems, and other stressful factors. When this is the case, improving one’s stress handling skills will play a big role in this.
In summary, while taking supplements can help many people to overcome their sleep issues, many times people can improve their sleep quality without taking supplements. Some of the different strategies that can help with sleep include controlling the inflammation, making sure your room is completely dark when going to sleep, improve your stress handling skills, correcting any hormone imbalances, and to stop using all electronics two hours before going to sleep. If you or someone you care about is experiencing problems falling and/or staying asleep, then hopefully the information provided in this article will help you to achieve a better night’s sleep.