Lifestyle factors are largely responsible for most people’s fatigue.
When hypothyroidism is added to normal fatigue, however, it can be overwhelming. In these cases, the lifestyle changes that can remedy normal fatigue can help you feel less fatigued while going through a bout of untreated hypothyroidism. Whether you’re euthyroid, hypothyroid, or thyrotoxic, for better sleep try the following tips.
• Regular bedtime hours. Go to bed at the same time every night.
• Regular wake-up hour. Try to wake up around the same time every morning.
• Daily sun exposure. Exposure to natural outdoor light during the day helps with sleep.
• A cool, dark, and quiet room at bedtime. Lower the temperature at night or open a window. Use earplugs if necessary, and pull down shades or draw curtains.
There are two times during a twenty-four-hour period when we are most inclined to feel sleepy regardless of how much sleep we’ve had. The ? rst period is between about midnight and 7:00 a.m., when most of us do sleep. But the second period is after lunch, which in many cultures is siesta or nap time, between 1:00 and 3:00 p.m. If you’re getting less sleep at night, taking a nap between 1:00 and 3:00 p.m. can help to combat fatigue in people with more ?exible hours, or in people who work night shifts.
If you’re getting regular sleep and are euthyroid but ? nd you’re dosing off during the day or still feel tired, this could be a sign of a sleep disorder. A range of sleep disorders can contribute to normal fatigue. Some sleep disorders, such as sleep apnea, can even point to an unrecognized thyroid problem, as the apnea can be caused by a goiter or even a large nodule that may be obstructing breathing at night.
Sleep deprivation refers to being deprived of the recommended hours of sleep for healthy adults. Sleep deprivation can dramatically worsen fatigue in people who are hypothyroid. In people who are thyrotoxic, sleep deprivation can contribute to exhaustion, but sleep is dif?cult anyway because the body is “racing” at night, which interferes with a good night’s sleep.
There are two phases of sleep: rapid eye movement (REM) and nonrapid eye movement. REM sleep is when we dream, an important component of mental health. REM sleep is also our deepest sleep, which is when, researchers believe, various hormones are reset and energy stores are replenished. Sleep is therefore an active state that affects our physical and mental well-being. Insuf? cient restful sleep can result in mental and physical health problems.
There is a misconception that as we get older, we need less sleep.
This is not so; we need just as much as sleep as always, but we often get less sleep. What happens is that our ability to achieve quality sleep for long periods of time diminishes as we age. The older we get, the more fragile our sleep becomes, and thus it can be more easily disturbed by light, noise, and pain (such as arthritis). It’s common for various medical conditions to interfere with sleep; in the case of thyroid disease, this is usually the restlessness, anxiety, and racing heart of thyrotoxicosis.
Sleep disorders are far more common in the general population than hypothyroidism. Many hypothyroid patients, when diagnosed and treated for a sleep disorder, begin to feel better again. The following is a brief overview of common sleep disorders. Sometimes sleep apnea can be diagnosed when a goiter or thyroid tumor is the cause.
Sleep apnea (apnea means “want of breath” in Greek) is a breathing disorder in which breathing interruptions during sleep awaken you. One type of apnea is central and the other type is obstructive.
Central sleep apnea occurs when the brain fails to send the appropriate signals to the breathing muscles that cause you to breathe in and out. More common, however, is obstructive sleep apnea. This occurs when air cannot ?ow in or out of your nose or mouth. This can be linked to a growth or tumor in the neck or throat area, such as a goiter or a large thyroid nodule. In other people, apnea is the result of throat and tongue muscles relaxing during sleep, which can partially block airways. Obesity can also lead to apnea, as an excess amount of tissue can narrow breathing airways. Signs that you may have sleep apnea are persistent loud snoring at night and daytime sleepiness. Frequent long pauses in breathing during sleep followed by choking and gasping for breath is an obvious sign of sleep apnea. Some people may ? nd they wake up frequently due to the brain forcing an arousal each time they stop breathing. Ultimately, this leads to daytime fatigue due to lack of sleep. Far more serious problems are also linked to sleep apnea, including higher rates of hypertension, heart disease, heart attack, and stroke. If you think you have sleep apnea, a pulmonary specialist (a doctor who specializes in lungs and breathing) can treat it with various methods.