Thyroid eye disease can cause eye discomfort and other symptoms that may make it hard to sleep. Managing these symptoms and addressing underlying thyroid conditions can help.

Thyroid eye disease happens when your body makes too much thyroid hormone.

This condition can make it harder to sleep because it can lead to eye discomfort, and an inability of the eyelids to close completely. It can also occur in individuals with hypothyroidism, a condition in which your thyroid gland does not produce enough thyroid hormone.

In addition to eye symptoms, thyroid disease can also cause changes to your sleep patterns. Taking steps to manage your eye symptoms and treat underlying thyroid conditions can lead to better sleep.

Thyroid eye disease can occur in people who already have a diagnosis of Graves’ disease, which is an autoimmune condition. Graves’ disease also causes the body to produce too much thyroid hormone.

Thyroid eye disease can cause the eyes to bulge. Symptoms usually last 1 to 2 years, but in some people might cause permanent damage, such as vision loss. Thyroid eye disease can lead to:

  • eyelids that pull back
  • eyelids that do not fully close
  • eye pain or pressure
  • light sensitivity
  • puffy eyelids
  • double vision
  • redness, dryness, irritation, or a gritty feeling in the eyes
  • trouble moving the eyes

These symptoms of thyroid eye disease can affect your sleep. Eye pressure, pain, and discomfort can be disruptive enough to prevent you from falling into a state of good quality rest.

When your eyelids do not close all the way, you can experience intense eye dryness. And when your eyes remain even partially open, you can still see light, which makes it challenging to fall asleep.

In addition to these symptoms specific to thyroid eye disease, thyroid dysfunction in general can contribute to sleep disorders. Specifically, hyperthyroidism, which is at work in Graves’ disease, can lead to insomnia.

A delay in getting to sleep and problems staying asleep might be a factor in other symptoms associated with Graves’ disease, such as anxiety, changes in appetite, and changes in bowel movements. Higher thyroid hormone levels are also associated with a higher prevalence of symptoms of restless legs syndrome.

Although obstructive sleep apnea is associated with low thyroid levels (hypothyroidism), there’s some research that connects the condition to thyroid eye disease. A 2023 study of 100 people with thyroid eye disease and 138 controls found that the rate of obstructive sleep apnea risk was greater among those with thyroid eye disease.

Doctors recommend the following steps to manage sleep challenges while living with thyroid eye disease. They cannot cure the condition, but might help you to manage your symptoms and achieve better rest.

1. Protective eye wrap

An ophthalmologist or other doctor can help you to create a protective eye wrap to wear at night. This might involve wearing an eyepad moisturized with an eye lubricant. A headband can help keep the eyepad in place.

A dressing using saran wrap can not only help keep the eyelids shut, but keep moisture inside the eye. You can also try taping your eyelid shut using a medical tape that’s safe for the area around the eyes. A pharmacist can recommend an appropriate over-the-counter tape.

2. Sleep mask

An over-the-counter sleep mask that one might purchase for travel is another option. Depending on how well the mask fits, it can block out some or all of the light that might otherwise get into your eyes.

The mask might also provide some protection from dryness, although it likely won’t keep in as much moisture as a protective wrap a doctor helps you to make.

3. Head elevation

Thyroid eye disease can cause your eyelids to become puffy. This can cause discomfort and irritation. Sleeping with your head elevated can reduce puffiness. If your bed is adjustable, try raising up the head end at night. You can also prop up your head with pillows.

4. Keeping eyes moisturized

Thyroid eye disease can cause extreme dryness, which over time can lead to corneal damage. You can use gels, ointments, or artificial tears at night to help with lubrication.

While many of these products are available over the counter, you might want to consult a doctor or pharmacist to inquire about which specific solutions are appropriate for long-term use.

They may be able to recommend other treatments for dry eye as well, based your symptoms, on the severity of your condition, and your medical history.

5. Addressing other thyroid issues

If you have hyperthyroidism, you might also work with a doctor to find the best way to manage the condition. This might help prevent other issues that affect sleep, such as restless leg syndrome and insomnia, that are associated with high thyroid hormone levels.

If you have hypothyroidism, you may need to take hormone replacement medication.

If you have new or worsening eye symptoms or new symptoms of a thyroid condition, you might want to speak with a doctor.

If you’re already receiving treatment for thyroid issues, including thyroid eye disease, a doctor might be able to change your medication or dose to help you manage your symptoms.

If you do not have a diagnosis, these symptoms might indicate a condition for which you can get treatment.

In addition to medication, you can also make lifestyle changes that can help you to manage hyperthyroidism. People with Graves’ disease are also at higher risk for eye problems if they smoke. A doctor can help you to find resources to quit.

Thyroid eye disease occurs in some people with Graves’ disease, where the body makes too much thyroid hormone. It can also be present in individuals with hypothyroidism.

Eye symptoms include dryness, pain, discomfort, and an inability of the eyelids to completely close. This leads to sleep disruption.

You can manage the sleep disruption with measures like eye taping, sleep masks, eye lubrication, elevating the head at night, and working with a doctor to treat underlying thyroid conditions.