Iron Deficiency Insomnia: The Connection Between Anemia and Sleep

Iron is an essential nutrient that your body needs to function at optimal levels. Unfortunately, over 1.6 billion people worldwide suffer from an iron deficiency. Iron is responsible for your overall growth and development. It also creates two important proteins in the body – hemoglobin and myoglobin. Hemoglobin is found in your body’s red blood cells and carries oxygen from your lungs to other parts of your body. Myoglobin is responsible for supplying your muscles with much-needed oxygen. Without iron, your body can’t produce important hormones needed for daily function, including sleep.

Any hormone or nutrient deficiency can cause sleep disorders and disturbances, including insomnia. If you’re suffering from an iron deficiency, you may notice changes in your sleep patterns. In this article, we’ll discuss the role iron plays in your sleep quality, how to prevent and treat iron deficiency anemia, and insomnia treatment options to help restore your overall health and wellbeing.


What is Iron Deficiency Anemia?

Before we discuss the effects of anemia on sleep, it’s important to clarify that iron deficiency is a type of anemia but that both conditions are triggered by different things. Anemia describes any condition where the body’s red blood cells lack sufficient oxygen. An iron deficiency is associated with a lack of iron in the blood. Iron deficiency anemia, specifically, is caused by both low iron levels and a lack of protein in your blood cells.

Iron deficiency anemia is the most common form but not the only one. Others include vitamin deficiency anemia, sickle cell anemia, and anemia of inflammation. Regardless of the type of anemia, many of the side effects are the same. The most common signs of anemia include excessive fatigue, weakness, shortness of breath, dizziness, and chest pain. These same symptoms are apparent in most patients with iron deficiency anemia as well. While you may feel weak and fatigued, many individuals with iron deficiency also experience insomnia symptoms, struggling to fall and stay asleep despite feeling tired. 

As the name suggests, iron deficiency anemia is caused by low iron levels, but why do these dips in iron happen? The most common causes of low iron are poor diet, problems absorbing iron, certain infections, and extreme blood loss. Pregnancy can also trigger anemia since expecting mothers require higher doses of iron in their diet to supply the fetus.

Causes and Risk Factors of Iron Deficiency Anemia

Iron deficiency anemia can affect anyone at any time – but certain people are at higher risk than others. Things like age, gender, ethnicity, and certain socioeconomic factors can all increase your risk of developing iron deficiency anemia. Low iron levels are the result of either not consuming enough iron or losing too much.

Lack of Iron in Your Diet

We get most of our iron supplies from the foods we eat. Iron-rich foods like eggs, meat, and green leafy vegetables should be a staple in your diet. Some people take an iron supplement to ensure they receive enough of this vital nutrient. This is especially important in children and the elderly who need it for sufficient growth, development, and strength. 

Inability to Absorb Iron

Even with consuming a well-balanced diet, some people struggle to absorb iron into their blood. Iron in the foods you eat is absorbed through the small intestine. People with certain gastrointestinal disorders that affect how well the small intestine works may also suffer from iron deficiency. Celiac disease, for example, affects how the digestive system absorbs nutrients from the foods you eat and puts you at greater risk for low iron. If you’ve had part of your small intestine removed or bypassed during surgery, this may also make it difficult for you to get enough iron through diet alone.

Blood Loss

Similar to women losing excess blood during their menstrual cycle, other instances of blood loss can impact iron levels. That’s because iron is stored in your red blood cells. When you lose a lot of blood, you’re also losing iron. Those who suffer from slow or chronic blood loss such as an hiatal hernia, colon polyp, peptic ulcer, or colorectal cancer, can develop iron deficiency over time. In addition, gastrointestinal bleeding can be triggered by the long-term use of over-the-counter pain relievers.

Gender and Socioeconomic Status 

Women are at much greater risk of developing anemia than men, with 20% of the adult female population experiencing iron deficiency anemia at some point in their lifetime. Another 50% of pregnant women exhibit low iron levels. Hispanic and black individuals as well as those living in low-income areas are also at increased risk for iron deficiency anemia. It’s interesting to note that sickle cell anemia is the most common type of anemia among these demographics.

Infants and the Elderly

Iron deficiency anemia can impact anyone but the very young and much older are at the highest risk. Infants who are born underweight or premature may not get enough iron from formula or breast milk to compensate for low iron levels. Children require high iron levels to promote numerous growth spurts. Avoid iron deficiency anemia in children and the elderly by promoting a healthy, balanced diet. 


Vegetarians and vegans are at higher risk for iron deficiency due to their dietary choices. Individuals who don’t eat meat and other iron-rich foods like eggs are at higher risk of developing iron deficiency. Vegetarians and vegans can compensate for this loss of dietary iron by eating plenty of leafy green vegetables and taking an iron supplement.

Diagnosing Iron Deficiency Anemia

Most people recognize iron deficiency symptoms relatively quickly. Increased fatigue, lethargy, dizziness, and weakness are all telltale signs that your body is missing important nutrients. In this case, that nutrient is iron. Without adequate iron in your red blood cells, your muscles and organs won’t get the vital oxygen they need to work efficiently, negatively impacting overall body function including sleep. Other symptoms include cold hands and feet, brittle nails, increased heartbeat, pale or yellow skin, cognitive difficulty, loss of appetite, and unusual cravings for items that provide no nutritional value like ice or starch.

If you suspect you have iron deficiency anemia, your doctor will recommend a routine blood test to measure both your red blood cell and hemoglobin levels.

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You may assume that iron deficiency anemia causes you to sleep more when, in fact, it can disrupt your sleep in a variety of ways. Insomnia and iron deficiency anemia share many symptoms including extreme fatigue and an overall sense of feeling weak and rundown. Other shared symptoms include impaired focus, cognitive difficulties, and mood swings. Over time, some people experience depression and anxiety symptoms as well. 

Iron Deficiency Anemia and RLS

The most common connection between iron deficiency and insomnia is the presence of a specific gene that’s also associated with RLS – restless leg syndrome. RLS is one of the leading causes of insomnia and may cause sleep disturbances in anemia patients. It’s interesting to note that women are at higher risk of developing both iron deficiency anemia and RLS. 

Restless leg syndrome is a condition characterized by tingling in the legs and irresistible urge to move your legs to relieve this discomfort. These sensations are more prevalent at night, when your body is at rest, making it difficult to fall and stay asleep. According to Sleep Review Magazine, the MEIS1 gene has recently been linked to both RLS and iron deficiency anemia. 

Anemia as a Precursor for Insomnia 

Another Chinese medical study suggested that individuals with anemia exhibit a higher prevalence of insomnia. In fact, patients with a prior anemia diagnosis were over 30% more likely to develop insomnia over a six year period than those with healthy iron levels. The study also showed that both severe and moderate anemia can increase your risk of developing insomnia symptoms. While women are at greater risk of developing both anemia and RLS, anemic men are actually more likely to suffer from insomnia than women with the same diagnosis. 

Preventing and Treating Iron Deficiency Anemia and Insomnia

Studies suggest that treating iron deficiency anemia may help ease insomnia symptoms. A mix of dietary and lifestyle changes can boost your iron levels and improve sleep.

Adopt a Healthy Diet

Eating the right foods will not only ensure you get enough iron in your diet but also maintain a healthy weight and achieve quality sleep. Incorporate iron-rich foods into your diet like red meat, eggs, leafy greens, and certain shellfish. Healthy foods rich in iron don’t just ward off anemia symptoms. They can also promote quality sleep and prevent gastrointestinal issues like acid reflux, nausea, and bloating. Foods rich in vitamin C like melons, citrus fruits, broccoli, and tomatoes can enhance how well your body absorbs iron.

Try eating a light, healthy meal at least 3 hours before you go to sleep to avoid both hunger pains and discomfort that might make it difficult to fall asleep or cause you to wake frequently.

Avoid Caffeinated Beverages

When it comes to treating both iron deficiency anemia and insomnia, what you drink is as important as what you eat. Caffeinated beverages like tea and coffee can significantly interrupt your sleep – especially when you consume them too close to bedtime or too late in the afternoon. In addition to making you too alert to fall asleep or causing you to wake frequently, caffeinated beverages also make it more difficult for your body to absorb iron. Replace these drinks with healthier alternatives like water, orange juice, and vegetable juice.

Be Aware of the Symptoms

The symptoms of both iron deficiency anemia and insomnia are very similar. Being aware of the symptoms is the first step toward preventing iron deficiency anemia and losing sleep over it. If you find yourself waking up in the morning feeling fatigued, unfocused, and groggy, it may be a sign that you’re not sleeping well at night. These are also common warning signs of an iron deficiency. Early detection is key so you can make positive changes like improving your diet and diagnosing any underlying medical conditions that may be causing both your anemia and insomnia.

Other Tips for Improving Sleep Quality

By improving sleep quality you can help ease some of the adverse side effects of insomnia including excess fatigue. When you achieve restful, restorative sleep, your body is better prepared to tackle other medical conditions including anemia thanks to a boosted immune system.

Adopt a Consistent Sleep Schedule

By going to bed and waking up at the same time every day, you promote a healthy circadian rhythm or sleep-wake cycle. Following a consistent schedule can help you feel more alert during the day and tired at night, preparing you for quality sleep. Support a healthy routine by starting your day with a healthy, iron-enriched meal and exercise. Follow through with a healthy lunch and dinner and limited caffeinated beverages throughout the day.

Practice Good Sleep Hygiene

Your sleep hygiene describes your sleep habits and environment. By improving your sleep hygiene practices, you can also improve your overall health and wellbeing in the face of an anemia diagnosis.

Try performing routine, relaxing behaviors before bed including meditation and mindfulness exercises, listening to relaxing music, taking a soothing bath, or drinking chamomile tea. All of these behaviors are not only calming and may induce sleep but they act as triggers to your brain and body that it’s time to prepare for bed.

Creating a sleep environment that promotes sleep is also important. This includes reducing outside disturbances like light and sound, avoiding watching television or using your cell phone in bed, and investing in quality bedding.

Fight the Fatigue of Iron Deficiency Anemia and Insomnia

Both iron deficiency anemia and insomnia can cause a host of unwanted side effects including fogginess, dizziness, cognitive impairment, fatigue, and weakness. By diagnosing and addressing your iron deficiency and adopting healthy sleep hygiene habits, you can wake to feel rested, rejuvenated, and alert.

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