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The Sleep Struggle: Hypothyroidism And Sleep Disturbances

Hypothyroidism, a condition characterized by an underactive thyroid gland, affects millions worldwide. While commonly associated with symptoms like fatigue, weight gain, and depression, one often overlooked symptom is the impact hypothyroidism has on sleep disturbances like Insomnia.

Insomnia, the inability to fall or stay asleep, frequently plagues individuals with hypothyroidism, leading to a vicious cycle of exhaustion and frustration.

In today’s article, I will explain the intricate relationship between hypothyroidism and insomnia, exploring key factors such as disrupted sleep patterns, hormonal imbalances, and potential remedies like melatonin, GABA, and L-theanine.

Hypothyroidism and sleep disturbances Insomnia

Hypothyroidism, Sleep Disturbances and Insomnia

The thyroid gland plays a crucial role in regulating metabolism and energy production in the body. When thyroid hormone levels are imbalanced, as seen in hypothyroidism, it can disrupt the body’s internal clock and natural sleep-wake cycle. Studies have shown that hypothyroidism can lead to alterations in sleep architecture, causing difficulties in falling asleep, staying asleep, and achieving restorative sleep. Individuals with hypothyroidism often report experiencing various sleep disturbances, including:

Insomnia: Insomnia, characterized by difficulty falling or staying asleep, is a prevalent issue in hypothyroidism. Disrupted sleep patterns can exacerbate fatigue, cognitive impairments, and mood disturbances in individuals with this condition.

Restless Leg Syndrome (RLS): RLS is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by uncomfortable sensations. Research suggests a potential link between hypothyroidism and RLS, further contributing to sleep disturbances.

Sleep Apnea: Hypothyroidism has been associated with an increased risk of sleep apnea, a serious sleep disorder characterized by pauses in breathing during sleep. Sleep apnea can lead to fragmented sleep, daytime fatigue, and other health complications.

Disrupted Sleep Patterns and The Neurotransmitter GABA:

Individuals with hypothyroidism often experience a disruption in their circadian rhythm, the internal clock that regulates sleep-wake cycles. This dysregulation can manifest as difficulty falling asleep or staying asleep, as well as waking up feeling unrefreshed despite a full night’s rest.

Furthermore, the neurotransmitter imbalances associated with hypothyroidism can interfere with the production of key neurotransmitters involved in sleep, such as serotonin and GABA.

GABA is an inhibitory neurotransmitter that helps regulate brain activity and promote relaxation. Research suggests that hypothyroidism can disrupt the balance of GABAergic neurotransmission in the brain. (*),(*),(*)

Thyroid hormones have been found to affect GABA receptor expression and function, leading to alterations in GABAergic signaling. These changes can contribute to various symptoms associated with hypothyroidism, including fatigue, depression, anxiety, cognitive impairment, and insomnia.

GABA helps promote sleep by inhibiting brain activity, reducing arousal, and calming the nervous system. GABAergic medications, such as benzodiazepines, are commonly prescribed to induce sleep and treat insomnia, however, these medications come with a long list of side effects.

In Functional Medicine, we take a different approach to Thyroid problems when our patients struggle with sleep. Our goal is to find out the Root cause of why our patients are having trouble falling asleep or staying asleep. Dysfunction in the GABA system can disrupt sleep/wake cycles and contribute to insomnia.

Download my Free Thyroid eBook to Learn more about Natural Thyroid Treatments

Disrupted Sleep Patterns and The Neurotransmitter Serotonin

Additionally, thyroid hormones influence the production and activity of neurotransmitters like serotonin. Serotonin is a neurotransmitter that helps regulate mood, appetite, and sleep. In the brain, serotonin is converted into melatonin, a hormone that controls our sleep-wake cycle.

Adequate serotonin levels are essential for melatonin production, which helps promote healthy sleep patterns.

Serotonin also plays a role in thyroid function. It is involved in the production and release of thyroid-stimulating hormone (TSH) from the pituitary gland, which in turn stimulates the thyroid gland to produce thyroid hormones T3 and T4. Imbalances in serotonin levels can impact TSH secretion and thyroid hormone production.

Thyroid hormones, particularly T3, play a role in the conversion and activation of tryptophan (an amino acid precursor to serotonin) into serotonin. (*) In other words, if you have Low T3 or low Free T3, your body will not convert Tryptophan into serotonin.

These changes in serotonin could also potentially lead to changes in mood, sleep disturbances, and overall well-being. For this reason, in my clinic, I always run a comprehensive thyroid panel that checks the levels of total T3 Free T3, and Reverse T3.

Here’s What You Should Remember about Sleep, Low Thyroid Levels, and Serotonin.

Sleep deprivation or poor sleep patterns can disrupt the body’s hormonal balance, including thyroid hormones. Chronic sleep disturbances often contribute to thyroid dysfunction or exacerbate existing thyroid conditions.

Serotonin influences sleep patterns and is involved in regulating thyroid hormone production. Thyroid hormone levels especially Low T3, Low total T3, or elevated Reverse T3, can impact serotonin levels and the body’s sleep-wake cycle.

Maintaining optimal Total T3, Free T3, and Reverse T3 thyroid hormone levels is crucial for the overall well-being of your thyroid but also in the production of serotonin.

Disrupted Sleep Patterns and Elevated Cortisol

Thyroid hormones have an interesting relationship with our Adrenal glands. Cortisol is a steroid hormone that plays a crucial role in the body’s response to stress. It is produced by the adrenal glands, which are located on top of each kidney.

Cortisol levels follow a daily pattern, with higher levels in the morning to help wake you up and lower levels in the evening to prepare you for sleep. It works in conjunction with other hormones such as melatonin to regulate the sleep-wake cycle.

While cortisol is essential for maintaining various bodily functions and managing stress, chronic or prolonged elevation of cortisol levels due to ongoing stress can have negative effects on health, including immune suppression, weight gain, high blood pressure, and disrupted sleep patterns. It is essential to maintain a balance in cortisol levels to support overall health and a good night’s sleep.

Hypothyroidism and Cortisol levels

In hypothyroidism, the body’s overall metabolism slows down, and when this happens it can potentially affect how cortisol is broken down and cleared from the body. (*),(*) Many of my hypothyroid patients have higher evening salivary cortisol levels on testing.

Since hypothyroidism can reduce the body’s metabolism and energy levels, the body might have a heightened response to physical or psychological stress. This enhanced stress response can stimulate the hypothalamic-pituitary-adrenal (HPA) axis, resulting in increased cortisol production. High cortisol levels can make falling asleep and staying asleep a struggle. (*),(*)

If hypothyroidism and cortisol levels are a concern, it is advisable to consult with a Certified Functional Medicine Practitioner.

In my Functional medicine Clinic, I take a Root Cause-based approach to sleep problems with my patients. I will often run a comprehensive thyroid assessment including thyroid markers like TSH, T3, T4, Reverse T3, Free T3, and total T3), as well as evaluate adrenal gland function, including measurements of cortisol levels through blood tests or saliva tests, if I suspect abnormal cortisol production.

How To Naturally Improve Sleep When You Have Hypothyroidism:

Managing sleep disturbances including insomnia in the context of hypothyroidism often requires a multifaceted approach. An understanding of the pattern of thyroid dysfunction is important starting point. Next, I think about the connection between the thyroid and adrenal glands, and how serotonin levels might be affecting the production of melatonin. Natural supplements that are safe and effective at targeting sleep disturbances can provide much-needed relief. Natural supplements can be very effective in improving sleep quality and promoting relaxation, including melatonin, GABA, and L-Theanine. Let’s Review how these supplements work, and how they can help with sleep disturbances including insomnia when you have hypothyroidism.

1. Melatonin

Melatonin is another supplement that can help patients who have hypothyroidism sleep better. Melatonin is a hormone naturally produced by the body’s pineal gland, playing a crucial role in regulating sleep-wake cycles. Supplementing with melatonin can help individuals with hypothyroidism regulate their sleep patterns and improve overall sleep quality. I recommend starting with 1mg of melatonin for several weeks to see if sleep improves. If sleep does not improve you can increase your melatonin levels to 3mg per night.

With this said, it’s essential to consult with a healthcare provider before starting melatonin supplementation, as it can interact with certain medications and may not be suitable for everyone.


Gamma-aminobutyric acid (GABA) is a neurotransmitter that functions as a natural calming agent in the brain and has been shown to help patients who suffer from many thyroid symptoms, sleep being one of those symptoms.(*)

GABA, which stands for gamma-aminobutyric acid, is a neurotransmitter that plays a crucial role in regulating brain activity and promoting relaxation.

Some neurotransmitters heighten brain activity, while others inhibit it. In the human brain, GABA is a key inhibitory neurotransmitter.

Individuals with hypothyroidism often experience symptoms such as anxiety and stress, which contribute to sleep disturbances. In fact, some studies show that up to 50% of patients who have thyroid disease struggle with depression or anxiety. (*)

GABA helps inhibit the transmission of excitatory signals in the brain, leading to a calming effect.

By reducing anxiety and stress levels, GABA may help promote relaxation and create a more conducive environment for falling asleep and staying asleep. (*)

For individuals with hypothyroidism who struggle with insomnia or difficulty falling asleep, GABA supplementation at night before bed may support the natural sleep process and improve sleep onset.

Here’s what You should Remember About GABA.

Research supports that GABA supplementation can help reduce anxiety and promote relaxation, making it a great natural alternative in the fight against sleeping and insomnia.

3. L-Theanine and Hypothyroidism

L-theanine is an amino acid found in green tea known for its relaxing and stress-reducing properties. Like GABA, L-theanine helps promote relaxation and improve sleep quality by modulating neurotransmitter activity in the brain.

L-Theanine is an amino acid found in tea leaves, particularly in green tea, and is commonly known for its relaxing and calming effects.

L-Theanine supplementation is known to promote relaxation by increasing alpha brain waves, which are associated with a state of wakeful relaxation.

For individuals with hypothyroidism who may experience heightened anxiety or stress, L-Theanine’s calming effects can help reduce these symptoms, thereby creating a more conducive environment for restful sleep.

L-Theanine has been shown to improve sleep quality by enhancing the production of GABA, a neurotransmitter that promotes relaxation and sleep.

By increasing GABA levels, L-Theanine may help individuals with hypothyroidism achieve deeper and more restorative sleep. A deeper more restorative sleep has wide-ranging health benefits for people with hypothyroidism.

L-theanine has another benefit for patients who struggle with hypothyroidism and sleep disorders.

Chronic stress and elevated cortisol levels, which can be common in individuals with hypothyroidism, often disrupt sleep patterns.

L-Theanine has been shown to help regulate cortisol levels and reduce the negative impact of stress on the body.

By moderating high cortisol levels, L-Theanine can help promote a more balanced sleep-wake cycle.

Here’s What You Should Remember About Today’s Article.

If you have thyroid disease and you struggle with staying asleep and falling asleep you have Insomnia, I understand this frustration.  Not getting a restful night of sleep impacts the quality of life in so many ways.

The good news is that Functional Medicine has a different set of tools that can help uncover why you can’t get a restful night of sleep.

Understanding the intricate relationship between hypothyroidism and sleep disturbances is crucial for effective management.

While understanding why your thyroid hormone levels are off, getting to the root cause remains the cornerstone of treatment.

Adjunctive therapies like melatonin, GABA, and L-theanine can provide much-needed relief for those struggling to get a good night’s sleep.

As always, it’s essential to consult with a healthcare provider before starting any new supplement regimen, especially for individuals with underlying medical conditions like hypothyroidism.

With proper management and support, individuals with hypothyroidism can overcome insomnia and achieve restful, rejuvenating sleep once again.

If You Liked this Article, Check These Articles out.

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  2. Low T3 Symptoms and Causes
  3. The Stress Hormone Cortisol and Blood Sugar
  4. Patterns of Thyroid Dysfunction- Why You Still Struggle with Thyroid Symptoms
  5. 10 Steps To Supporting Your Thyroid Naturally| Dr. Hagmeyer
  6. Insomnia- 6 Overlooked Areas Causing Your Sleep Problem
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