Elevated thyroid-stimulating hormone levels are associated with poor sleep: a cross-sectional and longitudinal study

Area of Science:

• Endocrinology
• Sleep Medicine
• Circadian Biology

Background:

• Thyroid stimulating hormone (TSH) secretion follows a circadian rhythm.
• Elevated TSH levels are sometimes observed alongside poor sleep quality.
• The precise relationship between sleep disturbances and TSH elevation requires further investigation.

Purpose of the Study:

• To investigate the association between poor sleep and elevated TSH levels.
• To determine if improving sleep quality leads to TSH normalization.
• To conduct both cross-sectional and longitudinal analyses of this relationship.

Main Methods:

• Recruited participants with isolated elevated TSH (N=168) and normal TSH (N=119).
• Assessed sleep status using the Pittsburgh Sleep Quality Index (PSQI).
• Conducted longitudinal follow-up for subjects with isolated TSH elevation, remeasuring TSH after sleep improvement.

Main Results:

• Subjects with isolated TSH elevation reported significantly higher rates of poor sleep (70.24%) compared to normal TSH groups (49.58%).
• Elevated TSH group showed worse scores in subjective sleep quality, sleep latency, duration, and efficiency.
• Poor sleep was independently associated with isolated TSH elevation (OR=2.396, p=0.001).
• TSH normalization occurred in 85.42% of subjects with improved sleep versus 6.45% who still slept poorly.

Conclusions:

• Isolated elevated TSH concentrations can normalize with improved sleep status.
• Clinicians should assess patient sleep quality when TSH levels are elevated.
• Remeasuring TSH after addressing sleep issues is recommended for accurate thyroid assessment.