Thyroid Disease And Other Causes Of Insomnia In Women

thyroid and insomnia

Sleep disturbance or insomnia is a common disorder when women have trouble falling asleep, staying asleep or both. After headaches and colds it ranks third as the most common complaint in the doctor’s office. One out of 8 people seeks professional assistance for chronic insomnia at least once in their life time. Between 49% and 69% of people reported to have occasional sleep disturbances.

Insomnia is closely connected to thyroid disorders, depression, anxiety and also has been linked to weight gain and poorly functioning immune systems. Sleep disturbances are often indicators of other underlying health condition.

According to a recent research study with participants between 18 and 79 years old who were having trouble falling asleep, difficulties staying asleep or waking up too early, the people with insomnia were more likely to have 2 or more other diseases than those who did not have sleep issues.

thyroid and sleep

10 Health Conditions Associated With Thyroid Problems That Can Cause Insomnia

1. Chronic cardiac disease such as heart arrhythmia can be waking people up in the middle of the night and prevent them from going back to sleep for many hours. About 44% of people with heart disease report that they have insomnia. Hypothyroidism and hyperthyroidism are closely related to heart disease:

  • High level of cholesterol due to mainly under treated or undiagnosed hypothyroidism contribute to building blockages in arteries and development of heart conditions.
  • Too much thyroid hormone due to hyperthyroidism or thyroid medication overdose can trigger underlying heart conditions.

2. Half of the people with chronic pain cannot sleep at night. Many thyroid patients experience muscle and nerve pain, aches and tingling due to altered thyroid hormone metabolism and can develop carpal tunnel syndrome, fibromyalgia, muscle weakness and restless leg syndrome that are all well-known to contribute to sleep disorders and cause insomnia in women. MyoCalm P.M. can help with muscle pain and aches at night.

3. Thyroid disease. Both low and high levels of thyroid hormones can result in a variety of sleep disturbances and be one of hidden causes of insomnia in women:

Mild hypothyroidism is the most overlooked cause of insomnia in women. It also can cause people to sleep lightly and/or experience difficulties to fall and stay asleep.

When hypothyroidism is undiagnosed or under treated, adrenal glands start to work more intensive and produce an excessive amount of adrenaline in order to compensate for the low thyroid function.

The effect of adrenaline is hardly noticeable during the day but at the evening the person cannot fall asleep due to continuous thoughts, worrying, planning or anxiety.

Melatonin and neurotransmitter imbalance is one of common causes of insomnia in women who have hypothyroidism. Melatonin is a hormone that coordinates many functions of the sleeping cycle and is produced by the pineal gland from serotonin.

Adequate levels of melatonin ensure high quality sleep, help to stay asleep for prolonged periods of time and prevent awakening during the night. Light promotes secretion of melatonin but inhibits its release. In opposite, darkness promotes its release and its release at night.

Melatonin does not only participates in sleep/wake cycle but also is a potent antioxidant that protect cells from free radical damage, support normal immune function by helping maintain the activity of circulating natural killer cells and stimulate the production of glutathione peroxidase which is the main antioxidant enzyme of the brain and very important in reducing the inflammation of the thyroid gland in Hashimoto’s disease.

Sleep and mood disorders as well as insomnia are very common in women when the levels of melatonin are low or uncoordinated during the sleep. Levels of melatonin correlate with the rise or fall of TSH and T3 thyroid hormone that plays a key role in the melatonin metabolism. Unbalanced melatonin levels were also found to be associated with other diseases such as depression and seasonal affective disorder (SAD).

Internationally renowned natural health physician Dr. Joseph Mercola talks about melatonin benefits and the importance of melatonin for overall health.

Dr. Mercola Melatonin Sleep Support Spray

To prevent insomnia in women due to low melatonin, thyroid hormones and melatonin precursors should be optimized and no light left on at night in the bedroom that can disturb the release of melatonin.

If you have thyroid related melatonin deficiency other effective way to increase it is taking time- or prolonged release melatonin which is more superior than other melatonin supplements can be very useful for sleep.

It can also be used by those who have disruption of circadian rhythms due to travel across different time zones, experience jet lag, perform shift work or have a vision loss. Time-release melatonin releases slowly in small amounts over a 6 to 8 hour period throughout the night and will help fall asleep easier, get a restful sleep and stay asleep.

Thyroid hormones also directly affect production of a brain neurotransmitter serotonin which participates in chain reactions involved in the sleep mechanism. Melatonin is produced by the pineal gland from serotonin which is converted from a simple amino acid tryptophan. Having enough serotonin is crucial for melatonin production, restful sleep and to prevent insomnia in women.

Active thyroid hormone T3 ensures adequate production of serotonin in the the brain. If T3 levels are low because of any reason it can induce a serotonin deficiency and result in the sleep disturbances and diminished quality of sleep.

To improve symptoms of insomnia in women due to hypothyroidism thyroid medication should be optimized so that healthy thyroid hormone levels can stimulate more serotonin release.

To ensure necessary serotonin production hypothyroid patients can also take L-tryptophan which is a precursor of serotonin to help induce the night sleep easier and stay asleep.

L-tryptophan is an amino acid that naturally occurs in our bodies and does not have any typical side effects such as drowsiness that many other sleep aids and synthetic sleeping pills have. It can be taken on a short- and long-term basis in a safe dose of 2 to 3 g or more without causing dependence.

Another option for increasing serotonin levels is to take between 100 mg and 200 mg 5-hydroxytryptophan or 5-HTP which is also a precursor of serotonin. Taken at bed time 5-HTP increases serotonin and helps to sleep and overcome insomnia in women.

One 50 mg capsule of 5-HTP is the approximate equivalent of 500 mg of tryptophan. Research studies have shown that 5-HTP is safe to use at levels as high as 900 mg and can effectively increase brain serotonin levels.

Severe hypothyroidism can result in continual sleep. A patient feels very tired and wakes up unrefreshed despite many hours of sleep. Another group of thyroid patients who sleep for extended hours and still are unable to function and perform their daily tasks can have low adrenals and underactive thyroid at the same time.

The body can completely shut off and go into an energy saving mode when only the most important body functions are supported. A person can have difficulty getting out of bed for more than a few hours per day. In this case the key to solving sleep problems and insomnia in women is to address the adrenal imbalance first and add thyroid hormones after the adrenals start to recover.

At hyperthyroidism overreaction to excessive thyroid hormones keeps a person agitated and shaky making it difficult to fall and stay asleep. Grave’s disease has an overstimulating effect on the thyroid gland due to an ongoing autoimmune process that results in hyperthyroidism that often causes insomnia in many women who have this condition. Mild hyperthyroidism can result in light sleep while severe hyperthyroidism can lead to complete lack of sleep and mania.

Some people with Hashimoto’s disease also develop hyperthyroid symptoms and sleep disturbances due to the deterioration of the thyroid gland and the release of excess thyroid hormone into the bloodstream.

Usually there are a series of temporary events of hyperthyroidism that are followed by hypothyroidism when more of the thyroid gland gets destructed during the autoimmune process.

Overdose or too much of thyroid medication can result in hyperthyroid symptoms and be one of the causes of insomnia in women at night. To avoid this effect thyroid drugs are usually taken in the morning.

4. Mood disorders. A recent study found that 20% of people with insomnia report a clinically significant incidence of depression and 19.3% have anxiety disorders. Stress and thyroid disease are two major factors that can cause medical problems that lead to increased anxiety and depression which in turn contribute to insomnia especially in women.

There are 59! physical causes of depression that can be
 misdiagnosed as a psychological condition and should be ruled out first before anyone is put on antidepressant. Anti-depressants are often prescribed to the thyroid patients as a sleep aid and to improve symptoms of depression.

Some brands can help sleep because they increase the levels of the key neurotransmitters, however this process is less effective for those who have undiagnosed hypothyroidism and do not take thyroid medication. Many thyroid patients can wean off sleep aid after the optimal thyroid balance has been restored.

Adequate levels of T3 thyroid hormone can normalize serotonin production and help with symptoms of depression and insomnia in women and most of them can also relieve themselves of anti-depressants.

5. Hormonal imbalances

Estrogen dominance that occurs due to imbalances of progesterone and estrogen can be a cause of insomnia in young women with hormonal imbalances or women during menopause. Adequate levels of progesterone support relaxation and healthy sleep pattern while unbalanced high and erratic estrogen levels contribute to insomnia in many women.

These hormonal changes can occur not only during menopause but also at peri-menopause and at the late-luteal phase of the menstrual cycle in women who are in their 30s and 40s.

At estrogen dominance thyroid function becomes suppressed and low levels of thyroid hormones can cause mild hypothyroidism and result in insomnia especially in women around menopause. Balancing estrogen by adjusting progesterone levels using bio-identical hormone therapy can help to restore thyroid function and sleep.

Women with hypothyroidism frequently have increased insensitivity of progesterone receptors resulting in low progesterone levels. Optimizing thyroid hormones in women with underactive thyroid function can support adequate progesterone production and healthy sleep pattern.

6. Insomnia in pregnancy often occurs in women during the first trimester and is mainly attributed to hormonal changes. Raising levels of progesterone can have a sedative effect making a woman very tired so that she can fall asleep during the day and not able to sleep at night.

In the first 3 months of the pregnancy the uterus is still fairly small and pushes against the bladder. It can result in frequent urination and need to get up during the night resulting in interrupted sleep and frequent insomnia in those women. This problem usually resolves itself during the second trimester as the uterus continues to grow and pops up out of the pelvis.

Insomnia in pregnant women can arise again during the third trimester due to more pressure on the lungs, becoming tired more easily and the increase in size of the abdomen makes it difficult rolling over and getting comfortable.

Pregnancy can trigger thyroid disease. Requirements for thyroid hormones and iodine increase during first trimester. If a women cannot compensate for these changes hypothyroidism car occur.

Rapid raising levels of progesterone and estrogen as well as shifts of the immune system during the pregnancy can cause Hashimoto’s disease and/or postpartum thyroiditis later on. These hormonal and metabolic changes can cause either insomnia in some women or prolonged hours of sleep depending on the type of dysfunction and/or natural course of pregnancy.

7. Cortisol imbalances. The adrenal hormones are essential for energy production and their imbalance can result in fatigue, excessive sleep, lethargy or can cause insomnia in women. Adrenals and thyroid gland are closely connected and at the times of adrenal fatigue the thyroid gland slows down the production of thyroid hormones as well.

The adrenal cortex produces cortisol, aldosterone, DHEA and progesterone. The inner part of the adrenal gland is the medulla that releases the hormones involved in sympathetic reactions such as adrenaline and epinephrine which drive the “fight or flight” stress response.

Our body was designed to use adrenal glands during the times of acute stress or danger and it cannot keep up with a chronic stress for prolonged periods of time without causing harm to our health.

As a part of the body’s natural response to stress adrenal glands produce cortisol and adrenaline. During the times of chronic stress these two hormones remain constantly elevated that can negatively affect thyroid function, suppress immune system,  cause sleep disturbances and insomnia in women.

There are 3 main mechanisms how cortisol imbalances can cause sleep issues:

  • A very common pattern is when the 24 hour circadian rhythm is altered. The adrenals should be at their maximum cortisol production in the morning after awakening and then gradually slow down during the day to rest and repair over night. When adrenals are in the initial stage of exhaustion due to chronic stress cortisol levels are low in the morning making it difficult to get out of bed and then spike at night preventing you from falling asleep.
  • Sleeping is a fasting state for the human body without hours of any food intake. During the night time cortisol secreted by the adrenals supports steady blood sugar levels. As adrenal fatigue progresses blood sugar issues arise because adrenals are not able to produce adequate amounts of cortisol. A drop in cortisol causes low blood sugar or hypoglycemia and wakes the person up between 4 and 5 a.m. in the morning. The woman is exhausted but at the same time is not able to fall asleep any more.
  • When adrenal fatigue advances to a severe stage the body goes into a saving mode and uses cortisol and energy to support only the most important life functions such as sleep, digestion, breathing and heart beat. The person can have only enough energy to get out of bed for 2 to 3 hours per day and enters a lethargic condition even after they have had many hours of excessive sleep.

Stimulants such as coffee, diet pills, alcohol, cigarettes, recreational drugs, sugar and caffeine containing drinks, energy drinks, inappropriate use of immune support and thyroid boosters can cause insomnia in women mainly due to high cortisol and the stimulating effects of adrenaline.

L-theanine is an amino acid that has calming properties and acts as an antagonist against the stimulatory effects of caffeine on the nervous system. It reduces stress and anxiety, enhances the moods and has been shown to help induce sleep in approximately 30 to 40 minutes after ingestion.

L-theanine does not cause drowsiness and sleepiness and supports relaxation and deeper sleep. Recommended doses of theanine vary from 100 to 600 mg or more daily depending on the level of anxiety and difficulty of sleeping.

8. Blood sugar irregularities especially hypoglycemia which is low blood sugar are often an indicator of adrenal fatigue and can cause insomnia in women. However, hypoglycemia can also be due to a diet high in carbohydrates and sugars.

When too much carbs are consumed it causes spikes of insulin levels that quickly fall and result in a hypoglycemic effect such as feeling tired and hungry all the time. The person has carbohydrates and sugar cravings and wakes up at night.

Many people develop sugar addiction and feel that they are dependent on chocolate, sugary drinks and foods, however they do not get relief by craving sweets. This type of behaviour has physiological reasons and can be broken with a special diet such as Hypoglycemic Diet Stabilizing blood sugar levels in these patients is the key to restoring a balance and to achieve a restorative sleep.

9. Lung disease such as sleep apnea can cause an individual to wake up during the night with the inability to breathe and result in feeling fatigued during the day. The patient may or may not be aware of the pause in breathing.

About two thirds of patients with breathing issues suffer from insomnia. Sleep disturbances due to breathing problems can also contribute to thyroid disease and can cause insomnia in women.

Both upper airway resistance syndrome and sleep apnea can result in hormonal changes such as low cortisol and leptin levels, raise glucose levels, lead to weight gain and lower thyroid hormones driving hypothyroidism. By overcoming sleep apnea some people can correct their thyroid and other types of imbalances.

There are several methods that can help you to recover from sleep apnea without using CPAP.

10. Gastrointestinal problems such as gastroesophageal reflux (GER) and leaky gut syndrome are most hidden causes of insomnia in women. Patients with GER often report poor sleep and frequent waking up at night because of acid reflux. It is a common condition in patients with obstructive sleep apnea.

Leaky gut syndrome is a most undiagnosed cause of many chronic symptoms and diseases including autoimmune thyroid disease. Increased intestinal permeability of your gut contributes to Hashimoto’s disease and hypothyroidism that result in low thyroid function and can also be a  cause of insomnia in women.

In the guest article 9 Natural Ways to Improve Sleep and Get Back to Sleeping Like a Baby holistic nutritionist Karen Brimeyer explains how leaky gut can cause insomnia in women and what you can do to improve your sleep naturally.

A Better Sleep Solution

According to the recent research, there is a new technique that shows very promising results in overcoming insomnia in women. This method is based on scientific facts how the brain works during sleep and is called brainwave entrainment. This sleep techniques uses the rhythmic nature of the pulses embedded into the audio sessions that safely and gently guide your brain into sleep and help it stay asleep.

As Dr. Mercola has already mentioned above in the video about melatonin, sleeping pills and drugs have a lot side effects and work only for a short period of time. Long term pharmaceutical sleeping aid causes more harm than benefits.

Brainwave entrainment no negative side effects unlike the sleeping pills most doctors tend to prescribe to those who have insomnia or other sleeping disorders. Using this method can help to become healthier, easier fall asleep, stay asleep, wake up rested, overcome anxiety and stress that may be causing insomnia in many women.

To learn more about brainwave enterainment and get a FREE evaluation of your sleeping problems click here

P.S. Do you like what you read? Subscribe to the Outsmart Disease thyroid blog updates and get your FREE e-mail course Nutritional guide for Hashimoto’s disease


Thyroid mind power: The Proven Cure for Hormone-Related Depression, Anxiety, and Memory Loss by Dr. Richard Shames, MD, Karilee Shames, PhD, Georjana Grace Shames, LAc, Rodale Books, 2011

Sleep, interrupted: A physician reveals the #1 reason why so many of us are sick and tired by Dr. Steven Y. Park, Jodev Press, 2012

I Can Make You Sleep: Overcome Insomnia Forever and Get the Best Rest of Your Life! Book and CD by Paul McKenna, PhD, Sterling, 2009

Insomnia in women. Clin Cornerstone. 2003;5(3):41-50.

Comorbidity of chronic insomnia with medical problems. Sleep. 2007 Feb;30(2):213-8.

Serotonin: How Naturally Harness the Power Behind Prozac And Phen/Fen by Syd Baumel,  McGraw-Hill, 1999

5-HTP: The Natural Way to Overcome Depression, Obesity, and Insomnia by Dr. Michael Murray, ND, Bantam, 1999

About Marina Gutner, PhD

Marina Gutner, PhD, researcher, medical writer, thyroid blogger, founder and Admin of Outsmart Disease who writes about life-changing treatments for hypothyroidism, Hashimoto's thyroiditis and autoimmune disease and how to balance hormones in women