Wednesday, October 6, 2010

Hyperthyroidism or Hypothyroidism and Sleeping

If you’re not getting a good night’s sleep your thyroid might be to blame. Your thyroid is a gland in your throat, just under the Adam’s apple. It releases hormones that control the body’s metabolic rate. Your metabolic rate is a chemical process that occurs within the body necessary to maintain life and provide energy. The thyroid gland is self-regulated by thyroid stimulating hormones (TSH) made in the pituitary gland which is at the base of the brain. Hyperthyroidism occurs when the thyroid gland becomes overactive, making an excess amount of thyroid hormones. It is more likely to happen in woman then men. Other risk factors include type 1 diabetes, anemia, family history, eating too much iodine, if you are 60 or over and have had goiter or thyroid surgery. Hypothyroidism is when you have an underactive thyroid and don't produce enough hormones.

Graves’ disease happens when the immune system produces an abnormal antibody that stimulates the thyroid releasing higher levels of thyroid hormones. Graves’ disease is the most common cause of hyperthyroidism and inflammation in the eyes which can make the eyes bulge out. In severe cases you can develop double vision and have significant damage to the eyes. Sometimes, the skin over the shins becomes thicker .

Another form of hyperthyroidism is toxic nodular goiter which grows abnormal tissues or nodules in the thyroid. When the thyroid is inflamed you can develop a condition known as thyroiditis. The inflammation can cause the thyroid to release stored hormones and over a period of time can lead to hypothyroidism. If you take medications like amiodarone that contain high amounts of iodine this may cause you to have too much thyroid hormone and lead to hyperthyroidism.

Rarely the pituitary gland can make too much TSH leading to the constant stimulation of the thyroid. This condition is also known as secondary hyperthyroidism. The pituitary gland can also become too insensitive to thyroid hormones and no longer know when levels are high and when it should stop producing TSH.

Too much thyroid hormone will speed up metabolism. When this happens, the following symptoms may occur:

• increased heart rate

• abnormal heartbeat rhythm (palpitations or "pounding")

• increased body heat, causing one to feel warm even in a cool room

• moist skin because of perspiration

• increased activity of nerves, leading to nervousness or slight trembling of hands

• increased activity level despite feeling tired and weak

• increased appetite (but usually accompanied by weight loss)

• interrupted sleep

• frequent bowel movements, sometimes with diarrhea

• development of puffiness around eyes, increased tears, an intense stare, or a sensitivity to light

• increased risk of bone loss (osteoporosis)

• development of a bulge in the neck (goiter) because of the enlargement of the thyroid gland

• cessation of menstrual periods (women)

If you are 60 years or older it is imperative that these symptoms are less likely to occur. Older people can experience depression or dementia, irregular heart rhythms, fainting, weakness and/or heart failure. If not treated, a life-threatening complication known as thyroid storm may occur. Thyroid storm needs to be treated immediately especially when symptoms include rapid heartbeat, shaking, sweating, fever, restlessness, diarrhea, confusion, and loss of consciousness. It can be triggered by trauma, infection, surgery, uncontrolled diabetes, pregnancy, labor, or failing to take thyroid medication.

Your doctor will perform many thyroid gland functioning test to determine if you have hyperthyroidism. Levels of TSH will be measured as low levels indicate that the thyroid is overactive and is stopping production of TSH by the pituitary. Ultrasounds and thyroid scans can also be used to examine the gland for nodules. A radioactive iodine uptake test or RAIU can be done to determine how much iodine your thyroid collects from the bloodstream. An iodine treatment may be necessary to bring a thyroid storm under control. Low levels of radioactive iodine can be used to destroy some of the thyroid gland to control hyperthyroidism, but if too much is destroyed hypothyroidism will occur and thyroid hormone replacement therapy will be necessary to regulate your thyroid. Radioactive iodine is not recommended for pregnant women as it will destroy the fetus’s thyroid gland.

Thyroid oral medication can bring hyperthyroidism under control within 6 weeks to 3 months. Large doses work more quickly but may increase the risks of side effects like skin rashes, nausea, loss of taste, and very rarely, suppression of blood cell production in the bone marrow. These side effects usually go away when you stop taking medication. Some symptoms of hyperthyroidism can be controlled by medications for instance propranolol, but they do not affect the thyroid function. A thyroidectomy or surgical removal of the thyroid may be necessary in which thyroid hormone replacement will be needed for the rest of a person’s life.

With all the side effects of hyperthyroidism it is not surprising that people suffer from sleep disorders. Do you think your inability to sleep is related to a thyroid problems? Could the reason your heart rate increases and can't sleep be due to an overactive thyroid? A thyroid hormone deficiency slows down many of the bodily processes, and hypothyroid patients often face a daily struggle with fatigue, weakness, and a lack of energy. In some cases, the fatigue associated with hypothyroidism can result in a disorder known as Excessive Daytime Sleepiness (EDS). This debilitating syndrome can make it nearly impossible for patients to complete their daily tasks and responsibilities.

The fatigue linked with hypothyroidism is often worsened by the fact that patients with this disorder often have difficulty sleeping due to thyroid-related sleep disorders. One of the most common sleep disorders reported by thyroid patients is obstructive sleep apnea (OSA). This sleeping disorder can disrupt rest and, in some cases, can be life threatening. Patients with obstructive sleep apnea stop breathing for a few seconds periodically during the night and can lead to heavy snoring, restless sleep, and feeling restless during the day. Although researchers are still examining the exact ways in which hypothyroidism causes or increases the risk of obstructive sleep apnea, they are fairly convinced that there is a contributing connection. Similarly, there is an increased risk of chronic fatigue syndrome among patients with hypothyroidism. This disorder causes fatigue so severe that it often results in a debilitating inability to function normally.

Like hypothyroidism, hyperthyroidism also causes sleep disturbances. Hyperthyroidism is caused when excess thyroid hormones are pumped into the body as a result tend to "rev up" the entire body and patients report feelings as if they have too much energy, resulting in feelings of anxiety and restlessness. All of this excess energy can be tiring. As a result, hyperthyroid patients, much like their hypothyroid counterparts, often complain of fatigue. However, it is usually not the same level of fatigue that is common among individuals with hypothyroidism.

Insomnia is one of the most commonly reported sleep disorders among patients with hyperthyroidism. The excess energy associated with this disease can make it difficult for the body to know when it is time to fall asleep. As such, hyperthyroid patients often find themselves wide awake, with mind racing and heart pumping, at two or three in the morning. The insomnia, not surprisingly, can also worsen the ongoing fatigue experienced by patients with hyperthyroidism.

Even when hyperthyroid patients are able to get to sleep, they often have difficulty staying asleep. It's not uncommon for a hyperthyroid individual to wake up dozens of times in the course of a single night. Restless sleep characterized by a great deal of movement and activity are also common among patients with hyperthyroidism.

As with all symptoms of thyroid diseases, the single most important step you can take is sticking strictly to your prescribed treatment regimen. Your thyroid medication helps your body regulate its production and distribution of thyroid hormone, and this, in turn, helps eradicate unwanted symptoms.

Experts also recommend that you set a strict sleeping schedule -- and stick to it. About an hour before your bedtime, begin to wind down with some relaxing activities, such as reading, taking a bubble bath, or turning down the lights and listening to soft music. Try to give your body clear cues when you want to go to sleep.

If you are a thyroid patient with ongoing sleep problems, be sure to talk to your doctor for additional recommendations. You can use the following checklist to bring to your doctor to help him properly diagnosis your thyroid condition so you can fall asleep easy.

My risk factors for hyperthyroidism include:

____ I have a family history of thyroid disease

____ Parent(type of thyroid problem __________________)

____ Grandparent (type of thyroid problem ______________)

____ Sibling (type of thyroid problem __________________)

____ Child (type of thyroid problem __________________)

I have had my thyroid "monitored" in the past to watch for changes

____ I had a previous diagnosis of goiters/nodules

____ I currently have a goiter/enlargement in my thyroid and/or thyroid nodules

____ I was treated for hypothyroidism or hyperthyroidism in the past

____ I had post-partum thyroiditis or hyperthyroidism during pregnancy in the past

____ I had a temporary thyroiditis in the past

____ I have another autoimmune disease

____ I am pregnant now, or I have had a baby in the past nine months

____ I have a history of miscarriage

____ I have had radioactive iodine in the past due to Graves' Disease/hyperthyroidism

____ I have taken anti-thyroid drugs in the past due to Graves' Disease or a diagnosis of hyperthyroidism

I have the following symptoms of hyperthyroidism, as detailed by the Merck Manual, the American Association of Clinical Endocrinologists, and the Thyroid Foundation of America

____ My heart feels like it's skipping a beat, racing and I feel like I'm having heart palpitations

____ My pulse is unusually fast

____ My pulse, even when resting or in bed, is high

____ My hands are shaking, I'm having hand tremors

____ I feel hot when others feel cold, I am feeling inappropriately hot or overheated

____ I'm having increased perspiration

____ I am losing weight inappropriately

____ I am losing weight but my appetite has increased

____ I feel like I have a lot of nervous energy that I need to burn off

____ I am having diarrhea or loose or more frequent bowel movements

____ I feel nervous or irritable

____ My skin looks or feels thinner

____ My muscles feel weak, particularly the upper arms and thighs

____ I am having difficulty getting to sleep, staying asleep, or going back to sleep after awakening in the middle of the night

____ I feel fatigued, exhausted

____ My hair is coarse and dry, breaking, brittle, falling out

____ My skin is coarse, dry, scaly, thin

____ I have a hoarse or gravelly voice

____ I have pains, aches in joints, hands and feet

____ I am having irregular menstrual cycles (shorter, longer, or heavier, or more frequent, or not at all)

____ I am having trouble conceiving a baby

____ I have had one or more miscarriages

____ I feel depressed

____ I feel restless, or anxious

____ I have had panic attacks.

____ I've recently been diagnosed as having panic disorder, anxiety disorder, or panic attacks

____ I have puffiness and swelling around the eyes and face

____ My eyes seem to be enlarging, or getting more "bug-eyed" looking

____ My moods change easily

____ I have feelings of worthlessness

____ I have difficulty concentrating or focusing

____ I have more feelings of sadness

____ I seem to be losing interest in normal daily activities

____ I'm more forgetful lately

I also have the following additional symptoms, which have been reported more frequently in people with hyperthyroidism:

____ My hair is falling out

____ I can't seem to remember things

____ I have no sex drive, or am having sexual performance problems

____ I am getting more frequent infections, that last longer

____ I feel shortness of breath and tightness in the chest

____ My eyes feel gritty and dry

____ My eyes feel sensitive to light

____ My eyes get jumpy/tics in eyes, which makes me dizzy/vertigo and have headaches

____ I have strange feelings in neck or throat

____ I have tinnitus (ringing in ears)

____ I get recurrent sinus infections

____ I have vertigo

____ I feel some light headedness

____ I have severe menstrual cramps

The content in Hyperthyroidism or Hypothyroidism and Sleeping is for information purposes only, intended to raise the awareness of different solutions for sleep disorders and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.
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