Hypersomnia and Hashimoto’s

I often receive messages from clients, readers, and other health care professionals about people who are doing everything but are still struggling with their health. I’ve found that often times, it’s about going back to basics that I like to call the fundamental strategies to recovering health…

One of the major fundamentals is sleep, which is our primary healing time for both our body and mind.

When we don’t get enough quality sleep (this could manifest as insomnia but also hypersomnia), our health will suffer. Keep reading for information on my top tips for optimizing sleep to accelerate your healing.

Let’s take a lovely walk down memory lane. I’ll set the stage: The year was 2009, and I was a newlywed. We were living a dreamy life on a coastal beach in Los Angeles. I was married to my soulmate and loved my job. Life was good except that my health was spiraling downward, and I didn’t know what to do about it.

My husband had worked in the stock market since 2007 and had stock market hours… except we were in California, in Pacific time. With the NYSE on an eastern time zone, this meant his California work day started at 4:30 am. It was an intense schedule and usually had him in bed at 9 pm so he could get enough sleep each night. While my husband would wake up at 3:30 am to make his morning commute, I would go to bed with him at 9 pm, then sleep until 8 or 9 am, depending on my work requirements.

I suffered from acid reflux, hair loss, and fatigue. I was so tired that I needed at least 11 hours of sleep each night to feel ready to take on the world. If I got any less sleep, I felt like a zombie or would have diarrhea all day.

I had become used to sleeping this much. It started in my first year of undergraduate studies and never quite let up. When I got accepted into pharmacy school, I remember wondering if there was a pill for hypersomnia (sleeping too much). Unfortunately, there wasn’t. I used to complain about it to friends, family members, and doctors.

Most people were not very supportive. I remember hearing remarks like:
“Wow, Izabella, that must be tough! I wish I had the luxury of sleeping that much.”
“When you get into the real world and have kids, you won’t be so lazy.”  
“You sleep for 11 hours, and you’re complaining? I only slept for 5 hours last night. Give me a break.”
When I was in pharmacy school, I survived by having a very irregular sleep pattern. I’d take naps throughout the day so I could make my morning classes. It was tough, but I was determined to make it through. My close friends were very familiar with my sleep issues.

One of my classmates got offended when she called me at 9 or 10 am to chat, and I was apparently rude to her, hung up, and didn’t call her back. She confided in a mutual friend, and the friend said, “Well, what time did you call her? You never call Izabella before 12 noon, unless you want her to get mad.”

Doctors said that there was nothing wrong with me. They suggested that perhaps I was depressed since hypersomnia was a symptom of depression. But the weird thing was, I felt happy. Everyone said I was lucky to be able to sleep so much.

Eventually, I just kept quiet. I stopped complaining to friends and family and stopped seeking medical advice.

I continued to build my life around my sleep habits. I declined the job and social offers that would require me to wake up too early. I put many dreams on hold because I was just too tired to pursue them. But that all changed with my Hashimoto’s diagnosis.

I remember that week so vividly. I was attending the UCLA Intensive Course In Geriatric Medicine and Pharmacy and Board Review because I was studying to become a Certified Geriatric Pharmacist.

The course was phenomenal, and I loved every minute of it. I enjoyed learning cutting edge information from some of the top minds in geriatric medicine and pharmacy. I was so excited to go back to work and implement what I had learned. At that time, I’d been a pharmacist for three years and had learned that not all healthcare professionals were “created equally.” I’d discovered that some of us loved to learn and give our patients the best while others didn’t mind staying complacent. I felt so privileged and proud to be among a group of people who continued to learn and grow.

At one point, I remember one of the presenters talking about sleep, and he said something that surprised me. He said people should get on average 7-9 hours of sleep. Anything less will contribute to disease, and anything more suggests underlying disease.

This came as a shock to me, as somewhere along the line, I started to believe that my excess sleep was somehow beneficial.

I blurted out to a kind, older doctor sitting next me to that I slept 11 hours or more and every doctor told me that was normal. I’ll never forget what he said next. He told me I needed to look for an underlying cause because my sleep pattern wasn’t healthy. He encouraged me to get more comprehensive testing.

I felt validated for the first time in almost nine years.

I knew that I was in a room full of remarkable people and that he was right. I needed to find the cause. The conference gave me confidence for two reasons: I wanted to ace my certification exam and figure out why I was so tired all the time.

I didn’t have to wait long to get the answer to the second one, but the first one never happened.

I scheduled an appointment with a doctor that was willing to look for underlying causes of my health challenges and was surprised to learn that, finally, I had an abnormal test result after many years of hearing that all of my tests were “normal.” I had an elevated TSH: 8 mIU/mL. The doctor told me I had Hashimoto’s and that my thyroid was scarring itself away… I was referred to an endocrinologist to begin thyroid medications.

Like many people who finally get a diagnosis, I felt validated and hopeful. But while the medications helped, I still struggled with numerous symptoms and felt like my health continued to decline. Instead of sleeping for 11-12 hours each night, I was now sleeping for 10-11 hours… I decided that I needed to take my health back and get to the underlying cause of my condition.

I put my geriatric exam on hold. The truth is, I didn’t have enough energy (or time) to focus on more than one thing outside of work and home life then.

I chose my health. In retrospect, that was a wise choice. While a certification in geriatrics would have been quite an accomplishment, and I would have been able to help many patients with my new knowledge, it would not have given me the one thing I wanted most. I’m thankful I chose my health because it gave me my life back. Now I have the energy to follow all of my passions, and this has allowed me to help even more people!

Back to sleep…

Sleep is an important part of recovering your health. Deep sleep holds the key for us to heal our bodies, while REM sleep helps us to recover our mental energy.

Lack of sleep is a huge stressor on the body and is the quickest way to adrenal dysfunction which can initiate — and perpetuate — autoimmune thyroid disease. A 2006 study found that third shift workers, who typically have disrupted sleep patterns due to the nature of their jobs, were found to be at greater risk for developing thyroid antibodies compared to daytime workers.

When you have insomnia, it’s obvious that you don’t get enough sleep due to the sheer quantity of time spent sleeping.

You may be surprised to learn that you’re also not getting enough sleep when you have hypersomnia, which is likely due to poor sleep quality.

The reason that our bodies need to sleep as much as they do in hypersomnia is that they are often missing the deep sleep and REM sleep. While you may be offered stimulant drugs (like I was), or you may be self-medicating with sleep, these strategies won’t solve your sleep debt…

Lifestyle changes can. Here are a few lifestyle changes to consider for both hypersomnia and insomnia:

1. Set a bedtime. You might think that bedtimes are only for children, but it’s been found that setting a bedtime (and sticking to it) promotes a healthier life. Going to bed between 9 and 10 pm will increase your likelihood of getting more deep sleep, which is regenerative for the body and tends to happen in the early part of the night.
2. Avoid the use of screens in bed. It’s a great rule of thumb not to use your smartphone or laptop in bed. Using either of these close to bedtime can suppress your natural melatonin production, delaying your ability to fall asleep. Consider a particular time to be a “no phone” time where you allow your mind, eyes, and thumbs a rest. 🙂
3. Sleep in total darkness. I recommend sleeping in a completely dark room. Lights at night can hinder your sleep cycle, preventing you from getting adequate amounts of deep sleep and REM sleep. Lights will delay deep sleep and also delay brain regenerative REM sleep which takes place after the majority of deep sleep has occurred for the night. Furthermore, not sleeping in total darkness can make it more difficult for us to get up in the morning. Cortisol is a hormone that helps us wake up bright eyed and bushy tailed in the morning. A person with healthy adrenals will have a boost in cortisol in the morning to help them wake up. Most people don’t realize that cortisol begins to rise in the middle of the night, while it’s still dark, and any light could delay the morning cortisol rise!
4. Set the right room temperature. Make sure the room temperature where you’re sleeping is between 60-70 degrees Fahrenheit. If the room is too hot, you’re more likely to wake-up in the middle of the night, toss and turn and have nightmares leading to unrestful sleep or early awakening. A room that’s too cold may also disrupt sleep as our bodies try to regulate our internal temperature.
5. What are you dreaming about? If you can’t remember your dreams, you may be deficient in vitamin B6. B6 is required for melatonin production and may help with sleep onset and maintenance.
6. Change your eating habits. Digestion is our body’s biggest job. It’s a parasympathetic activity, just like sleeping and healing. If you’re having a hard time digesting your food, you’re likely suppressing your sleeping and healing. In addition to getting rid of foods like gluten, dairy, and soy, which are notoriously difficult to digest, consider eating more pureed and easy to digest foods (like my green smoothie), lighter meals at dinner time, eating dinner earlier in the day, and using Betaine and Pepsin with protein containing meals.
7. Don’t sleep with your furry friends. 71% of pet owners in the United States sleep with their pets… but our furry friends can be significant sleep inhibitors, so you may want to evaluate whether their habits are impacting your sleep. My brother used to have the cutest cats. Whenever I would sleep over at his place, however, I never felt rested. The cute nocturnal creatures would claw my head in the middle of the night and purr. I know this was a sign of love, but it woke me up and prevented me from getting the regenerating sleep I needed, so I ended up having to lock them out of the bedroom where I slept. My own sweet dog, Boomer, used to wake me up multiple times each night to go potty. Then we changed his diet from the “healthy” dog food to home-cooked lamb, vegetables, and blueberries and — voila — he sleeps through the night and his potty problems are gone! Yes, I have to cook more, but at least I get my sleep!
8. New Moms – New moms have a hard time with sleep routines, especially when the infant first comes home. It’s hard to get on a sleep schedule with an infant and though it may seem like this season will last forever, it won’t. There will be a day when your sweet baby sleeps through the night, and you do too! My girlfriend Wendy swears by the E.A.S.Y. schedule to get her girls sleeping so she herself can have some rest and much-needed mommy time. 🙂
9. Sleep apnea – Sleep apnea, when you stop breathing for fractions of a second, multiple times throughout the night, can be a trigger for Hashimoto’s and can be worsened by hypothyroidism. Some symptoms of sleep apnea include snoring, nasal congestion, restless sleep, stopping breathing in the middle of the night, and brain fog. You can get tested for sleep apnea at an overnight sleep lab though your health insurance.
10. Parasites: Thieves of Sleep – You might have read that sentence and considered skipping this section, but I’m glad you didn’t. Parasites are a big contributor to intestinal permeability and have been connected to the middle of the night awakenings as well as early morning awakenings. Read more about parasites in this article: 6 Different Hashimoto’s Root Causes.
11. Sleep Supplements – As a starting point for insomnia, in addition to all of the above supplements like melatonin or magnesium citrate to help with falling asleep, but some people may need additional interventions…
12. Sleep environment – I discuss bromide in my book, as studies have found that bromine-containing substances — polybrominated diphenyl ethers (PBDEs) — are connected to an increased incidence of Hashimoto’s and can trigger or accelerate the condition. Unfortunately, most mattresses contain PBDE based flame retardants! The retardants are used to prevent a fire from engulfing the bed, but in the process of trying to save us, this toxin is very harmful to us. As we spend ⅓ of our lives sleeping, I recommend choosing a mattress that is free of PBDE based flame retardants. Mattress manufacturers have to meet flame resistant guidelines by law, but there are two ways to get around that. The first one is to get a prescription from your doctor to get a flame-retardant mattress and order directly from a manufacturer that will provide a mattress without flame retardants — or purchase a mattress that has natural flame retardants. In doing my research, I chose the second option. 🙂 I love the Sweet Dreams Latex and Organic Mattress because it’s PBDE free and made with natural materials like botanical latex, organic cotton, and natural wool (which is a natural flame retardant and, thus, bypasses the government requirement). I sleep better knowing that I’m protected in case of a fire and that I’m not absorbing toxins each night while I sleep. The mattress is also dust mite resistant and anti-microbial. 🙂

I hope you are able to use these hacks to improve your sleep cycle and accelerate your healing!