Association Between Thyroid Function and Objective and Subjective Sleep Quality in Older Men: The Osteoporotic Fractures in Men (MrOS) Study.
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).


CONCLUSIONS
Neither subclinical hypothyroidism nor hyperthyroidism is significantly associated with decreased sleep quality.
Division of Endocrinology, Gerontology and Metabolism, Stanford University School of Medicine, Stanford, California.
Haruko
H
Akatsu
Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
Susan K
SK
Ewing
Stanford Preventive Research Center, Stanford University School of Medicine, Stanford, California.
Marcia L
ML
Stefanick
Veterans Affairs Medical Center, Minneapolis, Minnesota.
Howard A
HA
Fink
Research Institute, California Pacific Medical Center, San Francisco, California.
Katie L
KL
Stone
Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, California.
Elizabeth
E
Barrett-Connor
Department of Pulmonary, Critical Care and Sleep Medicine Case Western Reserve University School of Medicine, Cleveland, Ohio.
Reena
R
Mehra
Department of Psychiatry, University of California at San Diego, La Jolla, California.
Sonia
S
Ancoli-Israel
Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Susan
S
Redline
Division of Endocrinology, Gerontology and Metabolism, Stanford University School of Medicine, Stanford, California.
Andrew R
AR
Hoffman
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D006801:Humans; D006980:Hyperthyroidism / Q000503:physiopathology*; D007037:Hypothyroidism / Q000503:physiopathology*; D008297:Male; D058866:Osteoporotic Fractures / Q000209:etiology*; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D013961:Thyroid Gland / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood
D013972:Thyrotropin