Evaluating the Spectrum of Sleep Abnormalities in Patients With Primary Hypothyroidism

Introduction and aim: Primary hypothyroidism is a common endocrine disorder. While thyroid dysfunction is recognized for impacting numerous bodily systems, the connection between thyroid disorders and sleep function remains unclear. Since sleep disorders seldom manifest as the sole presenting symptom of thyroid dysfunction, it is crucial to examine the interplay between thyroid function and sleep when implementing a comprehensive treatment approach for these individuals. This study aimed to assess sleep dysfunction in patients with primary hypothyroidism using validated questionnaires.

This cross-sectional study included 81 participants attending the endocrinology outpatient department. The participants included those with both overt and subclinical primary hypothyroidism who were drug-naive or had a thyroid-stimulating hormone (TSH) level >4.5 µIU/L while on treatment. The study subjects were assessed based on various validated questionnaires for sleep disturbance.

The study predominantly comprised 64 (79%) female participants. Overall, poor sleepers in subclinical and overt hypothyroidism were 66.7 and 60.8%. The Berlin Risk Score Questionnaire showed the occurrence of sleep apnea to be 26.7% and 27.5% in subclinical and overt groups, respectively. However, the occurrence of sleep dysfunction did not correlate with TSH values alone.

Our findings demonstrate that sleep dysfunction is prevalent in patients with both overt and subclinical primary hypothyroidism. Furthermore, the severity of sleep disruption appears independent of the degree of thyroid dysfunction.