Higher healthy sleep scores were associated with lower risks of incident overall thyroid disease, hypothyroidism, nontoxic goiter, and thyrotoxicosis, with the absence of frequent daytime excessive sleepiness showing the strongest association with lower thyroid disease risk.
Key Findings
Results
Participants with the healthiest sleep pattern (score of 5) had a 24% lower risk of overall thyroid disease compared to those with poor sleep patterns (scores of 0-1).
The study included 499,084 adults aged 37-73 years from the UK Biobank.
Risk reduction for overall thyroid disease was 24% (95% CI: 17%-31%) for those with a sleep score of 5 versus 0-1.
The association was dose-dependent, with higher healthy sleep scores associated with progressively lower risks.
Results were adjusted for multiple covariates.
Results
Participants with the healthiest sleep pattern had a 25% lower risk of incident hypothyroidism compared to those with poor sleep patterns.
Risk reduction for hypothyroidism was 25% (95% CI: 17%-32%) comparing sleep score of 5 versus 0-1.
The association was dose-dependent across the range of sleep scores.
Hypothyroidism was one of the specific thyroid disease outcomes tracked prospectively.
Results
Participants with the healthiest sleep pattern had a 26% lower risk of nontoxic goiter and a 32% lower risk of thyrotoxicosis compared to those with poor sleep patterns.
Risk reduction for nontoxic goiter was 26% (95% CI: 7%-41%) for sleep score of 5 versus 0-1.
Risk reduction for thyrotoxicosis was 32% (95% CI: 15%-45%) for sleep score of 5 versus 0-1.
Both associations were statistically significant after adjustment for multiple covariates.
No significant associations were reported for thyroiditis, thyroid cancer, or iodine deficiency-related diseases.
Results
Among the five individual sleep components, the absence of frequent daytime excessive sleepiness showed the strongest association with lower risk of thyroid disease.
The five sleep components scored were: chronotype, sleep duration, insomnia, snoring, and daytime excessive sleepiness.
The absence of frequent daytime excessive sleepiness showed 'a particularly evident association with lower risks of thyroid disease' compared to other sleep components.
Each sleep behavior was self-reported by participants.
Results
The inverse association between healthy sleep score and overall thyroid disease risk was modified by sex, BMI, and diabetes status.
More pronounced associations were observed among women compared to men.
Individuals with obesity showed stronger associations than those without obesity.
Participants without diabetes showed more pronounced associations than those with diabetes.
These differences were identified through interaction analyses.
Methods
The study constructed a healthy sleep score ranging from 0 to 5 based on five self-reported sleep behaviors.
The five components were: chronotype, sleep duration, insomnia, snoring, and daytime excessive sleepiness.
Participants with missing information on sleep behaviors were excluded from the healthy sleep score construction.
The study was a prospective cohort design using UK Biobank data.
Participants were aged 37-73 years at baseline.
What This Means
This research suggests that people who maintain healthier sleep habits are less likely to develop thyroid diseases. Using data from nearly 500,000 adults in the UK Biobank, researchers tracked sleep habits across five dimensions—morning versus evening preference, sleep duration, insomnia, snoring, and daytime sleepiness—and created a combined 'healthy sleep score.' They then followed participants over time to see who developed thyroid conditions including hypothyroidism (underactive thyroid), nontoxic goiter (thyroid enlargement), and thyrotoxicosis (overactive thyroid).
The findings showed a clear dose-response relationship: the better the overall sleep score, the lower the risk of thyroid disease. Compared to people with the poorest sleep patterns, those with the best sleep patterns had about 24-32% lower risks across several thyroid conditions. Among all the individual sleep habits measured, avoiding frequent daytime excessive sleepiness was most strongly linked to thyroid health. The associations were particularly pronounced in women, people with obesity, and people without diabetes.
This research suggests that sleep quality and patterns may play a meaningful role in thyroid health, though as an observational study it cannot prove that poor sleep directly causes thyroid disease. The findings highlight daytime sleepiness as a potentially important factor to consider in thyroid disease research and public health discussions about sleep. Future studies would be needed to understand the biological mechanisms that might link sleep behaviors to thyroid function.
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Sun J, Wu Y, Zhao X, Sun L, Lv H, Sun R, et al.. (2026). Healthy sleep pattern is associated with reduced risk of incident thyroid disease: a prospective cohort study from the UK Biobank.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1859828