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Hypothyroidism & Sleep Apnea: Is There a Link?

For the uninformed, it may be strange to find a connection between sleep disorders such as sleep apnea and thyroid problems. However, health experts believe that thyroid disease, as with most parts of the body that affects the production of certain hormones, causes disturbances in the body as a whole. In the case of the thyroid, it can cause sleep disturbances such as chronic snoring, or sleep apnea. Doctors call it hypothyroidism sleep apnea.


Understanding the link between thyroid problems and sleep apnea

Both sleep disorders like sleep apnea and thyroid disorders like hypothyroidism are common problems in the general population. Both affect people of all backgrounds, ethnicity, age, and gender.


It starts with the hormones

Different hormones play hugely different roles and functions in the body. Circadian rhythm (the body’s sleep and wake cycle) for example, is hugely influenced by a hormone called melatonin. The main role of this hormone is to maintain and adjust the biological clock and body rhythm as necessary. The hormones in the thyroid gland (triiodothyronine (T3) and thyroxine (T4)), on the other hand, control the body’s metabolism. 

They work throughout the body to inform the cells how much energy to use. Both melatonin and thyroid hormones may seem very different in their characteristics and roles, but as with most things in the body, these two are connected.  How?


The Thyroid Gland

To understand the connection, you first need to understand what exactly the thyroid gland is, and its main role in the body.

The thyroid gland is a small gland found at the front of your neck, just under the Adam’s apple. You can’t see or feel it, but if there are problems (i.e. swelling), you can feel that on the front and sides of your neck. This gland is pretty important, as its job is to produce the hormones that control digestion, metabolism, breathing, and heart rate, and determine how your body should use energy. These hormones can also help regulate the body’s sleep-wake cycle. 

In some instances, the thyroid may exhibit problems in its hormone production.

  • Hyperthyroidism – this is when the thyroid becomes overactive and produces excessive amounts of thyroid hormones. This results in fast metabolism, faster heart rate, and increased levels of stress which may lead to anxiety.

Thyroid problems such as thyroid goiter, Grave’s disease, or thyroiditis can cause hyperthyroidism. Symptoms of this include heat intolerance, excess sweating, pronounced hunger, unexplained weight loss, irritability, nervousness, abnormal heart rhythm, hair loss, tremors, and fatigue.

  • Hypothyroidism – this is when the thyroid becomes underactive and produces fewer thyroid hormones. As a result, the body will not have enough hormones to regulate metabolism, which leads to less energy, sluggishness, and constantly feeling tired. People with this condition invariably feel sad, which may lead to depression.

Symptoms include dry skin, increased sensitivity to cold, hair loss, brittle nails, weight gain, irritability, slow heart rate, and sexual dysfunction.

Thyroid Gland and Sleep Apnea Connection


Sleep Apnea 

Now, what is sleep apnea?

Sleep apnea is a common sleep disorder characterized by chronic snoring. While snoring occasionally from time to time is not a cause for concern (as it can be caused by allergies, cold, or even alcohol consumption) sleep apnea is different as it is characterized by loud and excessive snoring that affects normal breathing patterns during sleep. 

This happens when the soft tissues around the air passage collapse and narrow or block the air passage, causing turbulent airflow to vibrate – leading to snoring. 

The most common type of sleep apnea is obstructive sleep apnea (OSA). This condition is characterized by repeated disruption in breathing during sleep. The pauses in breathing (which last for more than 10 seconds) send a “fight or flight” signal to the brain, causing the brain to jolt the body to awaken the body and restore breathing. This happens multiple times a night.

People with this disorder also experience a myriad of symptoms, ranging from weight gain to obesity, hypertension, heart problems, dementia, etc. That is aside from symptoms that resulted from poor sleep quality such as exhaustion and sluggishness, poor concentration, difficulty remembering, brain fog, irritability, lower sex drive, etc. 


 The Thyroid Gland and Sleep Apnea Connection

As noted earlier, an imbalance in one aspect of your health can lead to problems in the other. Scientists have long studied the connection between hypothyroidism and sleeping disorders, specifically sleep apnea. A study in the US in 2007-08 found that there is a significant association between sleep apnea diagnosis and hypothyroidism. 

One of the most significant connections between the two is how hypothyroidism affects breathing. This medical condition may cause changes in the upper airway that affects the breathing pattern during sleep. Thus, people with hypothyroidism experience shallow breathing, especially at night, and when they are lying in bed. The slow and shallow breathing leads to snoring, as the muscles around the airways relax, causing a blockage. 

Again, when the brain senses that the airways are blocked (due to lack of oxygen), it will send a distress signal to the body to try to wake you up from sleep and restore breathing.

Moreover, hypothyroidism can also damage the breathing muscles and nerves in the respiratory system. And since weight gain is its common symptom, fatty tissues around the neck can also contribute to the prevalence of obstructive sleep apnea (OSA) as it narrows or even blocks the airway. 

Also, an underactive thyroid can make you feel too cold at night, which can lead to difficulty sleeping, along with joint and muscle pains. 

association between sleep apnea diagnosis and hypothyroidism


Stress Can Make You Sleep Less

Experts also believe that imbalances in the thyroid can lead to sleep problems. People with hypothyroidism, in particular, have a hard time falling and staying asleep due to high stress and anxiety levels, along with symptoms like night sweats. 


The Takeaway

Hypothyroidism sleep apnea is a serious health condition that requires medical intervention. Fortunately, both hypothyroidism and sleep apnea are easily treatable. That is of course if they are diagnosed early. 

The symptoms of this condition may be difficult to spot at first. And when symptoms appear, they can be easily attributed to other medical conditions. Thus, it is important to see a doctor and have your thyroid gland checked, along with T3 and T4 levels in the blood. 

Developing a good sleeping habit and getting 7 to 8 hours of sleep on a nightly basis can also make a huge difference in managing both conditions. Again, you may need your doctor’s guidance and treatment for that. 

Visit your doctor or a sleep specialist and get that quality sleep you rightfully deserve! 

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