Sleep and Thyroid Eye Disease

Reviewed by: HU Medical Review Board | Last reviewed: October 2021

Sleep hygiene is a group of habits that can improve your chances of falling asleep, staying asleep, and sleeping well. Clean, comfy sheets are only 1 part of sleep hygiene. If you have a chronic (long-term) condition, your sleep can suffer.

How does TED impact sleep?

If you have thyroid eye disease (TED), you already know that your symptoms and treatment get in the way of a good night’s sleep. If you have problems with your thyroid gland in addition to TED, your sleep problems may be worse.

Thyroid dysfunction and sleep

While it is possible to have a normal functioning thyroid gland (euthyroid) and have TED, many people with TED have thyroid dysfunction.1

Hypothyroidism and hyperthyroidism

Two common thyroid gland problems are hypothyroidism and hyperthyroidism. Hypothyroidism, or an underactive thyroid gland, results from an inadequate amount of thyroid hormones in the blood. Hyperthyroidism is an overactive thyroid that occurs when there is an excessive amount of thyroid hormones in the blood.2

Both hypothyroidism and hyperthyroidism can lead to sleep issues, including:2-4

  • Insomnia, including having trouble falling and staying asleep.
  • Obstructive sleep apnea (OSA), which is caused by tissue blocking the airway. This leads to a temporary stop in breathing during sleep and may cause snoring, choking, or gasping for breath.
  • Restless leg syndrome (RLS), which is a sleep disorder that causes unpleasant sensations in the legs. People with RLS often have trouble falling or staying asleep.

TED treatments

Some treatments for TED, like steroids, can lead to problems with sleep. These sleep issues can get worse if you have to take steroids long-term, like many people with TED need to.5

TED symptoms

The pain, swelling, and discomfort from TED can interfere with your sleeping patterns. Along with these issues, some people with TED have a hard time closing their eyes because of extreme swelling in the eyelids. Some people find it helpful to tape their eyelids or use a sleep mask. Talk to your doctor or TED specialist about your sleep problems and for solutions.6

Common sleep barriers

Many people see sleep as something separate from the rest of their day. The fact is, what you eat and drink during the day, your lifestyle habits, and your environment all impact how well you sleep at night. Common things that may impair your sleep include:7

  • Late-night snacking, which can trigger indigestion or heartburn. Heavy, rich, or spicy foods can make it hard to get to sleep or stay asleep. If you are hungry at night, try to eat foods that you know do not keep you up.
  • Caffeine, which can be found in coffee, tea, soda, chocolate, and some pain relievers. If you are having trouble sleeping, you might want to track how much caffeine you have during the day or avoid caffeine at least 6 hours before bed.
  • Alcohol, which can make sleep apnea worse and make it harder to stay asleep. Avoid drinking at night if you are having problems sleeping.

Lifestyle habits matter when it comes to your sleep. Common lifestyle factors that can stand in the way of you and a good night’s sleep include:8-10

  • Smoking, which may make sleep apnea worse. It can also worsen the long-term health effects of sleep apnea since both reduce the amount of oxygen in the body. Tobacco is a stimulant that will interfere with sleep.
  • Exercise, which can help you sleep better when you stay active but can impair sleep if you exercise too close to your bedtime. Aim for at least 30 minutes of activity a day, but find a balance as to when the timing of exercise is best for you.
  • Napping, which should be limited to about 20 to 30 minutes per day when needed. If you need a nap to manage your fatigue, aim to nap early in the day to avoid interfering with nighttime sleep.

Creating an environment that promotes sleep can be helpful. Some things to keep in mind about your environment include:4,9

  • Sunlight, which helps your body maintain its circadian (sleep-wake) rhythms. If you tend to spend all day indoors, try to grab a few minutes outside each day. In the evening, limit your exposure to overhead lights and the lights from electronics.
  • Bedroom considerations, including noise, temperature, and lighting. A cool, dark, and quiet room promotes the best sleep for most people.

Sleep routines

It may sound simple, but your body needs a sleep-wake routine. This means going to bed at the same time every night and waking up at the same time every morning, weekends included. It may take some time, but eventually, your body will be trained to sleep and wake at certain times.9,10

If you do not fall asleep after 20 minutes, do not try to force it. Get up and find a quiet, relaxing activity until you are sleepy again.9

An evening routine can also help you sleep. An hour or 2 before bedtime, turn down the lights and turn off all electronics. De-stress by reading or listening to music. Many people find it helpful to perform a gentle yoga routine, stretch, meditate, or breathe deeply.9,10

Finally, if you snore or kick during sleep, talk to your doctor about treatment.

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