Association Between Thyroid Function and Objective and Subjective Sleep Quality in Older Men: The Osteoporotic Fractures in Men (MrOS) Study
Open accessAbstract
Objective To determine the association between thyroid hormone levels and sleep quality in community-dwelling men. Methods Among 5,994 men aged ≥65 years in the Osteoporotic Fractures in Men (MrOS) study, 682 had baseline thyroid function data, normal free thyroxine (FT4) (0.70 ≤ FT4 ≤ 1.85 ng/dL), actigraphy measurements, and were not using thyroid-related medications. Three categories of thyroid function were defined: subclinical hyperthyroid (thyroid-stimulating hormone [TSH] <0.55 mIU/L), euthyroid (TSH, 0.55 to 4.78 mIU/L), and subclinical hypothyroid (TSH >4.78 mIU/L). Objective (total hours of nighttime sleep [TST], sleep efficiency [SE], wake after sleep onset [WASO], sleep latency [SL], number of long wake episodes [LWEP]) and subjective (TST, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score) sleep quality parameters were measured. The association between TSH and sleep quality was examined using linear regression (continuous sleep outcomes) and log-binomial regression (categorical sleep outcomes). Results Among the 682 men examined, 15 had subclinical hyperthyroidism and 38 had subclinical hypothyroidism. There was no difference in sleep quality between subclinical hypothyroid and euthyroid men. Compared to euthyroid men, subclinical hyperthyroid men had lower mean actigraphy TST (adjusted mean difference [95% confidence interval (CI)], -27.4 [-63.7 to 8.9] minutes), lower mean SE (-4.5% [-10.3% to 1.3%]), and higher mean WASO (13.5 [-8.0 to 35.0] minutes]), whereas 41% had increased risk of actigraphy-measured TST <6 hours (relative risk [RR], 1.41; 95% CI, 0.83 to 2.39), and 83% had increased risk of SL ≥60 minutes (RR, 1.83; 95% CI, 0.65 to 5.14) (all P>.05). Conclusion Neither subclinical hypothyroidism nor hyperthyroidism is significantly associated with decreased sleep quality.
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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 [9]
The Discussion (page unavailable) explicitly identifies a small number of subjects, especially in the subclinical hyperthyroid group. The Methods describe analyses of associations between thyroid function and sleep outcomes, not tests of a biological mechanism. This paper does not establish the parallel claims about Song et al.; it also does not establish a mechanism by which lower thyroid hormone levels affect sleep quality. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAkatsu et al. did not show a relationship between subclinical hypothyroidism and sleep quality.
“However, a study by Akatsu et al. (9) did not show a relationship between subclinical hypothyroidism and sleep quality.”
From Thyroid Dysfunction and Sleep Disorders (2021) · cites this paper as [9]
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References 22 · Cited by 27
Research works printed but not linked: 19
- [1]Hollowell JG Staehling NW Flanders WD Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) J Clin Endocrinol Metab 2002 87 489 499 11836274
- [4]Ram S Seirawan H Kumar SK Clark GT Prevalence and impact of sleep disorders and sleep habits in the United States Sleep Breath 2010 14 63 70 19629554
- [5]Kraemer S Danker-Hopfe H Pilhatsch M Bes F Bauer M Effects of supraphysiological doses of levothyroxine on sleep in healthy subjects: a prospective polysomnography study J Thyroid Res 2011 2011 420580 [Epub July 7, 2011]. 21765990 PMC3134320
- [6]Koehler C Ginzkey C Kleinsasser NH Hagen R Reiners C Verburg FA Short-term severe thyroid hormone deficiency does not influence sleep parameters Sleep Breath 2013 17 253 258 22411172
- [7]Ruíz-Primo E Jurado JL Solís H Maisterrena JA Fernández-Guardiola A Valverde C Polysomnographic effects of thyroid-hormones in primary myxedema Electroencephalogr Clin Neurophysiol 1982 53 559 564 6177500
- [8]Blank JB Cawthon PM Carrion-Petersen ML Overview of recruitment for the osteoporotic fractures in men study (MrOs) Contemp Clin Trials 2005 26 557 568 16085466
- [9]Orwoll E Blank JB Barrett-Connor E Design and baseline characteristics of the osteoporotic fractures in men (MrOs) study—a large observational study of the determinants of fracture in older men Comtemp Clin Trials 2005 26 569 585 16084776
- [10]Waring AC Harrison S Samuels MH Thyroid function and mortality in older men: a prospective study J Clin Endocrinol Metab 2012 97 862 870 22238396 PMC3319205
- [13]Jean-Louis G Kripke DF Mason WJ Elliot JA Youngstedt SD Sleep estimation from wrist movement quantified by different actigraphic modalities J Neurosci Methods 2001 105 185 191 11275275
- [14]Cole RJ Kripke DF Gruen W Mullaney DJ Gillin JC Automatic sleep/wake identification from wrist activity Sleep 1992 15 461 469 1455130
- [15]Blackwell T Ancoli-Israel S Gehrman PR Schneider JL Pedula KL Stone KL Actigraphy scoring reliability in the study of osteoporotic fractures Sleep 2005 28 1599 1605 16408420
- [16]Buysse DJ Reynolds CF 3rd Monk TH Berman SR Kupfer DJ The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research Psychiatry Res 1989 28 193 213 2748771
- [17]Johns MW A new method for measuring daytime sleepiness: the Epworth sleepiness scale Sleep 1991 14 540 545 1798888
- [18]Johns MW Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the Epworth sleepiness scale: failure of the MSLT as a gold standard J Sleep Res 2000 9 5 11 10733683
- [19]Washburn RA Smith KW Jette AM Janney CA The Physical Activity Scale for the Elderly (PASE): Development and evaluation J Clin Epidemiol 1993 46 153 162 8437031
- [21]Teng EL Chui HC The Modified Mini-Mental State (3MS) examination J Clin Psychiatry 1987 48 314 318 3611032
- [22]Pahor M Chrischilles EA Guralnik JM Brown SL Wallace RB Carbonin PU Drug data coding and analysis in epidemiologic studies Eur J Epidemiol 1994 10 405 411 7843344
- [23]Greenland S Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies Am J Epidemiol 2004 160 301 305 15286014
- [24]Zou G A modified Poisson regression approach to prospective studies with binary data Am J Epidemiol 2004 159 702 706 15033648
- Authors
- Akatsu, H., Ewing, S. K., Stefanick, M. L., Fink, H. A., Stone, K. L., Barrett-Connor, E., Mehra, R., Ancoli-Israel, S., Redline, S., & Hoffman, A. R.
- Affiliations
- Stanford Medicine (US)
- University of California, San Francisco (US)
- Minneapolis VA Medical Center (US)
- California Pacific Medical Center (US)
- University of California San Diego (US)
- Case Western Reserve University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Akatsu, Haruko
- ORCID
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 20
- Issue
- 6
- Pages
- 576-586
- ISSN
- 1530-891X (ISSN-L)
- PMC
- PMC4363141
- OpenAlex
- W1964460920
- Cited by
- 27
- References
- 22
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2016: 3 · 2015: 2
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000128)
- National Institute on Aging (U01AG018197, U01AG027810)
- National Heart, Lung, and Blood Institute (R01HL070847, R01HL070839, R01HL070838, R01HL070841, R01HL070848, R01HL071194, R01HL070837, R01HL070842)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR045583, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647)
- National Center for Advancing Translational Sciences
- 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
- thyroid function, sleep quality, subclinical hyperthyroidism, subclinical hypothyroidism, thyroid-stimulating hormone, older men, actigraphy, sleep efficiency, wake after sleep onset, sleep latency, total sleep time, subjective sleep quality, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, community-dwelling men, MrOS study
- MeSH terms
- Aged, Aged, 80 and over, Humans, Hyperthyroidism, Hypothyroidism, Male, Prospective Studies, Sleep, Thyroid Gland, Thyrotropin, Cohort Studies, Osteoporotic Fractures
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