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Cited by 49Thyroid Disorders and TreatmentsSleep and related disordersCircadian rhythm and melatonin

The Association Between Subclinical Hypothyroidism and Sleep Quality: A Population-Based Study

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Song, Linlin, Lei, Jianyong, Jiang, Ke, Lei, Yali, Tang, Yuting, Zhu, Jingqiang, Li, Zhihui, Tang, Huairong·2019·Risk Management and Healthcare Policy
DOI 10.2147/rmhp.s234552PMC PMC6927586
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Abstract

BACKGROUND AND AIM: The relationship between subclinical hypothyroidism (SHYPO) and sleep quality is still unclear. Our objective was to compare the sleep quality between SHYPO patients and a control group with normal thyroid function. METHODS: A total of 2224 patients with SHYPO and 12,622 euthyroid (EUTH) control group patients were included in the present study. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The sleep outcomes were compared to explore the association between SHYPO and sleep quality. Furthermore, we tried to identify the risk factors of poor sleep in SHYPO patients. RESULTS: Compared to the EUTH control patients, SHYPO patients had a higher PSQI score (6.83 ± 2.67 vs 6.64 ± 2.63, p =0.004) and a higher proportion of poor sleepers (67.09% vs 64.75%, p =0.033). Moreover, subjects with SHYPO were associated with poorer sleep (Odd Ratio (OR) 1.120, 95% Confidence Intervals (CI) 1.016 to 1.235, p =0.023), longer sleep latency (OR 1.162, 95% CI 1.053 to 1.282, p =0.003), and shorter sleep duration (OR 1.148, 95% CI 1.019 to 1.293, p =0.023) after adjusting for potential confounders. Furthermore, we found that lower age, lower body mass index, and women were risk factors for poor sleep quality in SHYPO patients. CONCLUSION: Our findings suggest a relationship between SHYPO and poor sleep quality in a large Chinese population.

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  • Song et al. showed that people with lower thyroid hormone levels or even subclinical hypothyroidism generally have longer sleep latency, shorter sleep duration, and lower satisfaction with their sleep quality compared with euthyroid individuals.

    “Song et al. (8) showed that people with lower thyroid hormone levels or even subclinical hypothyroidism generally have longer sleep latency, shorter sleep duration, and lower satisfaction with their sleep quality compared with euthyroid individuals.”

    From Thyroid Dysfunction and Sleep Disorders (2021) · cites this paper as [8]

    The Results report that the subclinical hypothyroidism group had lower subjective sleep quality and longer sleep latency than the euthyroid group; adjusted analyses also found a greater likelihood of sleeping less than five hours. The Methods define subclinical hypothyroidism by elevated TSH with normal fT3 and fT4, so the study does not establish the same sleep pattern for people with lower thyroid hormone levels generally. (LLM, conf=0.88)

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  • Both Song et al. and Akatsu et al. had relatively small sample sizes, and neither study effectively investigated or identified the actual mechanisms by which lower thyroid hormone levels might affect sleep quality.

    “Both studies had relatively small sample sizes, and neither study effectively investigated or identified the actual mechanisms by which lower thyroid hormone levels might affect sleep quality.”

    From Thyroid Dysfunction and Sleep Disorders (2021) · cites this paper as [8]

    Song et al.’s Discussion says their cross-sectional study could not establish causality and offers hypotheses rather than identifying a mechanism, supporting that part of the claim. But the Methods report 14,846 participants, and the Discussion calls this a large population—not a relatively small sample. This verdict addresses Song et al.; their paper does not establish whether Akatsu et al. investigated mechanisms. (LLM, conf=0.88)

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Cites

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Research works printed but not linked: 19

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Cited by

Sorted by citations

Authors
Song, L., Lei, J., Jiang, K., Lei, Y., Tang, Y., Zhu, J., Li, Z., & Tang, H.
Affiliations
  • West China Hospital of Sichuan University (CN)
  • West China Medical Center of Sichuan University (CN)
Corresponding author
Tang, Huairong
ORCID
Venue
Risk Management and Healthcare Policy
Publisher
Informa UK Limited
Published
2019-12
Volume
Volume 12
Pages
369-374
ISSN
1179-1594 (ISSN-L)
DOI
10.2147/rmhp.s234552
PMC
PMC6927586
OpenAlex
W2996590547
Cited by
49
References
7
Citations by year
2026: 8 · 2025: 4 · 2024: 13 · 2023: 11 · 2022: 6 · 2021: 6 · 2020: 1
FWCI
2.64
Type
journal article
Language
en
Open access
Licence
Locations
  • Risk Management and Healthcare Policy (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
subclinical hypothyroidism, sleep quality, sleep latency, sleep duration, risk factors for poor sleep, thyroid function, body mass index, sex differences, age

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