Exploring possible links between platelet counts and poor sleep

Sleep and I have never had an easy relationship. For as long as I can remember, I’ve struggled to switch my brain off at night.

Even as a child, falling asleep didn’t always come naturally to me, so while other children would have a bedtime story and drift off, for me, it meant repeating that routine over and over until eventually I caved.

I’ve tried lots of different things over the years to improve my sleep quality, from herbal remedies to white noise, and now, at 34, I religiously have to read a book to drift off.

I’ve learned to accept that it’s just the way I am. I’m a naturally bad sleeper. However, recently I’ve started to delve into this topic further and ask, could my relationship with sleep have anything to do with my immune thrombocytopenia (ITP)? And, more specifically, my platelet count?

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I was diagnosed with ITP when I was 8, so some of my earliest memories of struggling with sleep overlap with the years when my platelet count was the most unpredictable.

When we talk about ITP, the conversation understandably tends to revolve around bleeding and bruising. Those certainly dominated my childhood. But as I’ve grown older, I’ve become increasingly interested in the parts of living with ITP that aren’t necessarily visible and that have taken me time and research to come to grips with.

Fatigue is one of them. Could sleep be another?

What does the research say?

Interestingly, researchers are beginning to ask similar questions.

A study published in 2025 examined platelet count and sleep quality in people with ITP. Researchers studied 87 people with ITP alongside 71 healthy controls and found that those with ITP experienced significantly poorer sleep quality.

This included taking longer to fall asleep, poorer sleep efficiency, and greater daytime functional problems.

Perhaps most interestingly, platelet counts were associated with sleep quality, with lower platelet levels linked to poorer sleep. Among participants whose platelet counts were below 50×10⁹/L, 68% had what researchers classified as severe sleep disturbance.

The researchers also explored a possible connection involving serotonin and melatonin — two substances involved in regulating mood and our sleep-wake cycle — and suggested that changes associated with thrombocytopenia could play a role.

There are limitations, of course. This is emerging research, involving a relatively small number of people, and an association between platelet count and sleep doesn’t necessarily mean one directly causes the other.

Looking back at childhood differently

When I think about my childhood with ITP now, I wonder how many things we accepted because the focus was understandably on keeping me physically safe, and not “bleeding out.”

Was I tired because I hadn’t slept properly? Was I struggling to sleep because I was anxious about hospital appointments and blood tests? Was my body itself contributing to it? Or was it a mixture of everything?

I’ll probably never know the true answer to any of these questions, as I can’t travel back in time. I can answer those questions for others who may have a child going through it and reassure them.

My platelet levels have been stable for many years now, yet sleep is something I still struggle with. That alone tells me there’s unlikely to be one simple explanation for my insomnia.

But after living with ITP for most of my life, I find it fascinating that science is beginning to explore symptoms and experiences that patients may have quietly lived with for years. Perhaps sleep should become part of that conversation, too.

Because when somebody with ITP says they’re exhausted, maybe the next question shouldn’t simply be, “What’s your platelet count?” Perhaps we should also be asking: “How are you sleeping?”

Note: Bleeding Disorders News is strictly a news and information website about the syndrome. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Bleeding Disorders News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to bleeding disorders.