Sleep Apnea and Hypothyroidism

Also known as Hashimoto’s disease, hypothyroidism is a disease wherein the thyroid is underactive and is prevented from functioning exactly as it should. The thyroid is a small gland, shaped like a butterfly, which sits at the front of the neck. Hypothyroidism is often related to sleep disorders, including sleep apnea, and can cause a myriad of problems related to hormone production, enlarged thyroid (goiter), heart problems, nerve problems, infertility, and other possible conditions with varying degrees of danger.

Sleep apnea is a sleep disorder in which the person’s airway is blocked during sleep, causing problems with breathing and possibly a loss of oxygen to the brain the rest of the body. This may be caused by an obstruction that occurs in the airways, which may be exacerbated by hypothyroidism. The reduced ability to breathe at night minimizes the oxygen received by the brain and body, which can cause a myriad of health problems.

Both sleep apnea and hypothyroidism (or Hashimoto’s) are relatively common health conditions. Continued research has identified a link between these two conditions but some confusion remains as to how the two are linked. Various studies continue to provide information about the relation of the two conditions, but an unequivocal argument has not been shown as of yet. Even so, if you suspect that you have either or both of these conditions, you certainly should seek the attention of a medical professional.

The fact that the signs and symptoms of sleep apnea and hypothyroidism are so similar (or occurring simultaneously) means that the two diagnoses are sometimes confused or crossed. And since these symptoms and signs may also simply be written off as a part of aging, many people tend to have problems with both of these conditions that may go completely undiagnosed, particularly because they can often be vague and nondescript.

Common symptoms and signs of both conditions include:

  • Gaining weight with no explanation
  • Sleeplessness or insomnia
  • Waking feeling unrested
  • Fatigue
  • Stress
  • Changes in mood such as irritability or depression

Studies have shown that at least 25-35% of people who suffer from hypothyroidism also have sleep apnea. And one study (2012 Endocrine Journal) showed that more than 53% of the people studied who has obstructive sleep apnea were in some stage of Hashimoto’s disease.

Connections between hypothyroidism and sleep apnea may be related to:

  • Enlargement of the tongue (macroglossia)
  • Disruption of the upper airway muscles
  • Protein deposition or thickening of walls in the upper airway

Some patients who suffer from hypothyroidism may find themselves with a higher risk of sleep apnea development whether due to respiration problems, decrease chemical change response in the blood, or even irreversible nerve or muscle damage related to the reduction of oxygen. Diagnosis of sleep apnea is completed through a sleep study that can be performed either at home or at a sleep study clinic. These tests should be painless, involving the measurement of oxygen levels, rate of breathing, heart rate, REM sleep, and other functions of the body during sleep. A video camera may also be used to narrow down problems with sleep disorders.

Because there is a high incidence of relationship between sleep apnea and hypothyroidism, patients who have been experiencing signs and symptoms of (or have been diagnosed with) sleep apnea may benefit from asking their doctor to check for thyroid problems as well. This is particularly true if sleep apnea has been treated with CPAP or other therapies, but common symptoms have not subsided. Blood tests and other types of diagnostic tests might be used in order to determine if hypothyroidism is also affecting your health.

Some symptoms that may indicate the presence of hypothyroidism occurring alongside sleep apnea:

  • Dry skin
  • Constipation
  • Sensitivity to cold
  • Hair loss or thinning
  • Brittle fingernails
  • High cholesterol
  • Slow heart rate
  • Irregular uterine bleeding
  • Sexual dysfunction
  • Muscle weakness, aches, stiffness, and tenderness
  • Joint stiffness, swelling, or pain
  • Puffy face
  • Hoarseness
  • Impairment of memory

Enlarged Thyroid Sleep Apnea Connections

One of the links between sleep apnea and hypothyroidism may be related to an enlarged thyroid. Sometimes, people who have hypothyroidism develop a goiter (enlarged thyroid) because the thyroid gland is working so hard to produce the thyroid hormones that the body needs. One of the most common causes of Obstructive Sleep Apnea (OSA) is a physical blockage of airways that interrupts the body’s ability to inhale oxygen at night. If a goiter gets so enlarged that it compresses the airway, the result is sleep apnea.

Solutions for Sleep Apnea and Hypothyroidism

Some people with goiter or enlarged thyroid may choose to have surgery in order to remove the growth. This, in turn, may be the solution to sleep apnea problems by eliminating the compression on the airway. Many people with hypothyroidism are prescribed synthetic hormones in order to reduce the stress on the thyroid gland, but this probably will not change the problems related to sleep apnea.

For sleep apnea, doctors often prescribe CPAP (Continuous Positive Airway Pressure) therapy which supplies air pressure in the throat to keep it open. Other therapies for milder cases of sleep apnea include changing the sleep position with an adjustable mattress or memory foam pillow to encourage sleeping on the side or the stomach instead of on the back.


Losing weight and living a healthier lifestyle can help to reduce the symptoms of sleep apnea, but the challenge of this can be the fact that people with hypothyroidism can make it much more difficult for a person to lose weight. So if you have both conditions, you’ll certainly want to check with your doctor to determine the best course of action to help you minimize the risks of sleep apnea as well as hypothyroidism. The two conditions, if left unchecked, can be responsible for a significant number of health problems. But there is certainly hope for restored health if the conditions are able to be appropriately treated.

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