If you have ever slept nine hours and woken up feeling like you got hit by a truck, you probably assumed you were doing sleep wrong. More magnesium. Earlier bedtime. Better sheets. Time in bed and deep sleep are two different numbers, and only one of them is talking to your immune system. Yes, there is a link between sleep and autoimmune disease.

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Health with Hashimoto’s is your free weekly podcast that sorts this autoimmune condition into thyroid or immune. Each episode is for informational and educational purposes. Please discuss any questions or concerns with your trusted healthcare professional. Some links may be affiliate links, marked as such, at no extra cost to you.

Sleep and autoimmune disease are a chicken and egg situation

Do you have Hashimoto’s? If so, do you know WHY you have Hashimoto’s?

Sleep and autoimmune disease belong in the same conversation, and most women never get told that.

Sleep is one of the root causes. Not the only one, but a real one. And here is the part that makes it confusing.

Was sleep an issue for you before you got Hashimoto’s? Is it an issue now? For most women, the answer to both is yes, and that makes it hard to tell which came first.

It works like this. While you are sleeping, your body does its repair work. An autoimmune problem is when your body is trying to attack invaders and it gets confused, so it starts attacking you instead.

Sleep has a role in that confusion. You need enough sleep for your body to do repair work. Not too much, not too little (everything in your body is a Goldilocks range).

What happens to inflammation when you do not sleep

When you do not sleep well, your inflammation goes up.

At the root of pretty much every single disease is inflammation. Every single one.

You do not have to take my word for it. Head over to PubMed (pubmed.gov). It is like the Google of published medical research.

Type in “inflammation” and then the name of any disease you are curious about and see what pops up.

More than likely there will be hundreds of published articles connecting inflammation to that disease. I first heard about this probably 20 years ago. I read an article and it was very intriguing to me.

Really? There is one thing that all of these have in common? Things that are so completely different, different systems, different organs, different mechanisms.

They really all trace back to one thing.

It is true. Inflammation is huge.

So when your inflammation goes up, that raises your risk for whatever you are genetically susceptible to. You and I are each individual. We have different genes, a different upbringing, a different environment both now and growing up.

No two people have the same risks. So increased inflammation is going to affect each of us differently. But the constant is that when we do not get enough sleep, our inflammation goes up.

The cycle that keeps you tired after nine hours in bed

Here is the weird cycle.

Increased inflammation causes increased fatigue. So obviously you want to sleep more. But then sometimes you do not sleep as well, so you feel like you are getting a lot of sleep (you are in bed) but you are not getting good sleep.

I discovered this for myself when I got my Oura ring.

I got it when I was first diagnosed with Hashimoto’s. I wanted to know my root causes and I wanted to be able to work on them. I knew sleep had to be part of the picture, because I was so exhausted and yet I felt like I was not sleeping well.

The ring told me I was right. My deep sleep was teeny tiny.

I could be sleeping eight, nine, even ten hours and get less than a half an hour of deep sleep. Technically you need about 20% of your sleep to be deep sleep. That is considered “normal.”

I was getting maybe 5%.

It was abysmal. So I really worked on my deep sleep.

That is the thing. Decreased sleep can mean increased inflammation. Increased inflammation can mean increased fatigue.

And increased fatigue can mean you do not sleep well even though you are tired.

These things go in cycles.

If you want practical help with the sleep part specifically, I covered how your sleep can be a trigger for Hashimoto’s and how to sleep better in an earlier episode, and improving sleep one simple step at a time in another.

Pain and insomnia feed each other too

There is a second cycle, and it is the one with pain.

Do you have increased pain with your Hashimoto’s? Some people do. Some have joint pain, some have pain on their skin, and there are different areas where people develop pain when they have Hashimoto’s.

When you have pain, that can lead to increased insomnia.

And when you are not sleeping well, that can lead to increased inflammation, which can lead to increased pain. Increased insomnia can also lead directly to increased pain. Then that cycles back and the pain leads to more insomnia.

Research on fatigue, sleep, and autoimmune disorders has looked at exactly this overlap, and you can read that paper at Frontiers in Immunology.

Why your body stops tolerating itself

One quote from the research says that sleep deprivation can promote a breakdown of immunologic self-tolerance. In other words, when you are sleep deprived, your body cannot tolerate itself as well.

I do not know about you, but I have felt that. I have felt that so deeply.

Have you ever had those days when you are so annoyed and you do not want somebody else to go away, you want yourself to go away? Can I just escape myself for a minute, please?

It is kind of like that for your body. When you are sleep deprived, your body cannot tolerate your own body as well.

We want to be able to tolerate our own body. We want to embrace who we are.

You are valuable. You are valuable as a whole person. Your body, your mind, your spirit, and we cannot separate those, because you are a whole person.

I am never going to tell you that just one part of you is valuable.

We know from what the Bible tells us that we will recognize other people when we get to heaven. We will not have these same bodies. It says there will be no more death, pain, sorrow, or tears, and our bodies will be made new.

But we will still have bodies.

I have one baby in heaven I miscarried. My boys used to argue about who was going to meet that baby first.

All of that to tell you this. It is not your body that is bad. You are valuable, all of you.

Things are broken and we want to be able to fix what we can.

The study goes on to say that sleep deprivation increases our risk of developing autoimmune diseases. You can read the full paper on sleep deprivation and immune-related disease risk if you want the mechanism.

We need to sleep. Sleep is a root cause of autoimmune problems. It also makes existing autoimmune problems worse, and then autoimmune problems make sleep hard.

One small thing to add to your bedtime routine

I have a lot of ideas about sleep, and episode 23 covers more of them. Today I want to give you one simple thing:

Chamomile tea.

Chamomile has long been the thing you are supposed to drink at bedtime if you want to sleep better. The research on that is mixed. Some studies say chamomile helps you sleep, and others say not really.

But the ritual of having tea before bed can help you.

A bedtime ritual is so important for kids. It is just as important for you. The things you do toward bedtime help your brain and body and spirit prepare for sleep.

We are built for routine. That is how we are as humans. Doing the same thing each night, hopefully something calming, is going to help you fall asleep better and stay asleep better.

What the chamomile research actually says

Greek researchers ran a case-control study in Athens. They compared 113 people with confirmed thyroid cancer, 286 people with benign thyroid disease, and 138 healthy people, and asked all of them about their tea habits.

People who drank chamomile tea two to six times a week were less likely to have thyroid disease than people who drank none. The study is published in the European Journal of Public Health.

The “almost 80%” figure that gets passed around comes from a different result in that same study. It applies to people who had been drinking chamomile for thirty years, not to people who started this week.

This is a case-control study based on interviews. It found an association. It did not prove that tea causes anything.

My hunch is that part of the reduction in risk is just that ritual of winding down, but I do not have anything to verify that.

So here is where I land. Chamomile tea is a low-cost, low-risk addition to a bedtime routine, and the routine itself is what helps your sleep. That is enough reason on its own.

If you like tea, have it as part of your ritual to wind down. Getting the water hot, steeping the tea, pouring your cup, sitting down and sipping it with a good book—all of that helps you wind down for bed.

My favorite bedtime tea is 40 Winks by Adagio Tea. Their plain chamomile is great too. I am not an affiliate for them, I just like the whole-flower tea better than the flower dust that comes in the bags from my grocery store.

What tracking your sleep can tell you

I would not have known my deep sleep was at 5% without tracking it. I felt tired. I was in bed plenty.

Those two facts together made me think the problem was something other than sleep.

If you want to see your own numbers, I carry the Oura ring in my Fullscript dispensary. (I’m an affiliate for Fullscript, which means I earn a commission on orders placed through my dispensary without raising your cost.) You can find the Oura ring at my Fullscript store.

You do not need a tracker to work on your sleep. A tracker just tells you whether what you are doing is working.

And if fatigue is your biggest problem right now, 5 quick energy boosters to beat Hashimoto’s fatigue and how to take a power nap for Hashimoto’s fatigue are both worth your time.

Sleep is talking to your immune system

You now know something most sleep advice leaves out. Sleep and autoimmune disease are not two separate topics. Sleep is an input to your immune system, and with Hashimoto’s that matters as much as anything on your supplement shelf.

Hours in bed and deep sleep are two different numbers. That one distinction is worth more than another sleep hygiene list.

The lowest-stakes thing you can do tonight is put the kettle on and start a bedtime routine you can repeat.

If you want to understand which of your symptoms belong to your thyroid and which belong to your immune system, that is exactly what I walk through in Hashimoto’s Decoded: Thyroid or Immune. It is $27, it takes about an hour, and it is the framework that makes everything else make sense. Start here.