My thyroid peroxidase level came back as a 33 highest number on the reference range before abnormal. all other tsh etc normal. can this cause insomnia?

Thyroid peroxidase: An elevated anti-TPO antibodies could indicate Hashimoto's thyroiditis. However, it is not clear that yours are actually elevated. If the TSH is normal, it is unlikely that this is affecting you; maybe these are perimenopausal sx. Even if the anti-TPO were elevated, that would indicate an autoimmune process is underway, but it may take years for it to cause actual hypothyroidism.