Table 3.
Risk of Poor Sleep by Thyroid Hormone Status
| Relative Risk (95% CI) by Thyroid Hormone Status | |||
|---|---|---|---|
| Sleep Measure | Subclinical Hyperthyroidism (TSH<0.55 mIU/L) (n = 15) |
Euthyroidism (TSH 0.55–4.78 mIU/L) (n = 629) |
Subclinical Hypothyroidism (TSH>4.78 mIU/L) (n = 38) |
| Objective Measures | |||
| Nightly sleep duration < 6 hours* | |||
| Unadjusted | 1.52 (0.91, 2.54) | 1.00 (reference) | 0.89 (0.54, 1.46) |
| Age+clinic-adjusted | 1.44 (0.87, 2.38) | 1.00 (reference) | 0.83 (0.50, 1.38) |
| Multivariate-adjusted† | 1.41 (0.83, 2.39) | 1.00 (reference) | 0.82 (0.50, 1.34) |
| Nightly sleep duration > 8 hours* | |||
| Unadjusted | 2.34 (0.68, 8.03) | 1.00 (reference) | 1.04 (0.35, 3.14) |
| Age+clinic-adjusted | 1.97 (0.57, 6.81) | 1.00 (reference) | 0.87 (0.28, 2.66) |
| Multivariate-adjusted† | 3.03 (0.87, 10.53) | 1.00 (reference) | 0.84 (0.27, 2.60) |
| Sleep efficiency < 70% | |||
| Unadjusted | 1.51 (0.64, 3.56) | 1.00 (reference) | 0.89 (0.42, 1.90) |
| Age+clinic-adjusted | 1.60 (0.68, 3.74) | 1.00 (reference) | 0.82 (0.39, 1.74) |
| Multivariate-adjusted† | 1.41 (0.58, 3.42) | 1.00 (reference) | 0.80 (0.36, 1.75) |
| Wake after sleep onset ≥ 90 min | |||
| Unadjusted | 1.48 (0.85, 2.58) | 1.00 (reference) | 0.84 (0.49, 1.44) |
| Age+clinic-adjusted | 1.63 (0.95, 2.80) | 1.00 (reference) | 0.75 (0.44, 1.28) |
| Multivariate-adjusted† | 1.62 (0.95, 2.76) | 1.00 (reference) | 0.76 (0.43, 1.35) |
| Sleep latency ≥ 60 min | |||
| Unadjusted | 1.88 (0.67, 5.30) | 1.00 (reference) | 1.23 (0.53, 2.88) |
| Age+clinic-adjusted | 2.20 (0.78, 6.22) | 1.00 (reference) | 1.20 (0.52, 2.80) |
| Multivariate-adjusted* | 1.83 (0.65, 5.14) | 1.00 (reference) | 1.10 (0.45, 2.69) |
| Long wake episodes ≥ 8 | |||
| Unadjusted | 1.17 (0.62, 2.20) | 1.00 (reference) | 0.77 (0.45, 1.32) |
| Age+clinic-adjusted | 1.34 (0.71, 2.51) | 1.00 (reference) | 0.74 (0.43, 1.26) |
| Multivariate-adjusted† | 1.45 (0.75, 2.78) | 1.00 (reference) | 0.69 (0.41, 1.19) |
| Subjective Measures | |||
| Nightly sleep duration < 6 hours* | |||
| Unadjusted | 2.12 (0.89, 5.03) | 1.00 (reference) | 1.05 (0.45, 2.43) |
| Age+clinic-adjusted | 2.18 (0.91, 5.19) | 1.00 (reference) | 1.02 (0.44, 2.40) |
| Multivariate-adjusted† | 1.66 (0.65, 4.21) | 1.00 (reference) | 0.96 (0.41, 2.28) |
| Nightly sleep duration > 8 hours* | |||
| Unadjusted | N/A | 1.00 (reference) | N/A |
| Age+clinic-adjusted | N/A | 1.00 (reference) | N/A |
| Multivariate-adjusted† | N/A | 1.00 (reference) | N/A |
| Poor sleeper (PSQI score > 5) | |||
| Unadjusted | 0.87 (0.46, 1.62) | 1.00 (reference) | 1.08 (0.78, 1.51) |
| Age+clinic-adjusted | 0.94 (0.50, 1.75) | 1.00 (reference) | 1.05 (0.75, 1.46) |
| Multivariate-adjusted† | 0.86 (0.48, 1.54) | 1.00 (reference) | 1.00 (0.72, 1.39) |
| Excessive daytime sleepiness (Epworth score> 10) | |||
| Unadjusted | 0.94 (0.25, 3.47) | 1.00 (reference) | 0.74 (0.29, 1.91) |
| Age+clinic-adjusted | 0.92 (0.26, 3.32) | 1.00 (reference) | 0.78 (0.30, 2.02) |
| Multivariate-adjusted† | 0.74 (0.19, 2.85) | 1.00 (reference) | 0.67 (0.26, 1.73) |
*
Compared with 6–8 hours.
†
Adjusted for age, clinic, race, education, lives alone, IADL impairment, history of diabetes, history of CHF, history of COPD, 3MS score, and BMI.
N/A: unable to determine RR since no one in the hyperthyroid or hypothyroid groups reported sleeping more than 8 hours per night.
3MS = Teng Modified Mini-Mental State Examination; BMI = Body Mass Index; CHF = Congestive Heart Failure; CI = Confidence Interval; COPD = Chronic Obstructive Pulmonary Disease; IADL = Instrumental Activities of Daily Living; PSQI = Pittsburgh Sleep Quality Index; TSH = Thyroid Stimulating Hormone.