Vitamins and sleep: an exploratory study

Gut Microbiota Dysbiosis and Sleep Disorders: Culprit in Cardiovascular Diseases

Background: Over the past decade, the gut microbiome (GM) has progressively demonstrated to have a central role in human metabolism, immunity, and cardiometabolic risk. Likewise, sleep disorders showed an impact on individual health and cardiometabolic risk. Recent studies seem to suggest multi-directional relations among GM, diet, sleep, and cardiometabolic risk, though specific interactions are not fully elucidated. We conducted a systematic review to synthesize the currently available evidence on the potential interactions between sleep and GM and their possible implications on cardiometabolic risk. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses, including articles from January 2016 until November 2022. Narrative syntheses were employed to describe the results. Results: A total of 8 studies were selected according to these criteria. Our findings indicated that the sleep disorder and/or the acute circadian rhythm disturbance caused by sleep-wake shifts affected the human GM, mainly throughout microbial functionality. Conclusions: Sleep disorders should be viewed as cardiovascular risk factors and targeted for preventive intervention. More research and well-designed studies are needed to completely assess the role of sleep deprivation in the multi-directional relationship between GM and cardiometabolic risk.

Understanding the Impact of Vitamin B Supplements on a Saudi Population

Introduction B vitamins help generate energy within cells. A significant portion of populations in developed countries suffer a deficiency in one or more B vitamins. This study assesses the use of vitamin B supplements and their effects. Methodology This cross-sectional study was conducted using public participants in Saudi Arabia. Participants from all over Saudi Arabia were recruited through self-conducted surveys to study the effects of using vitamin B supplements on appetite, BMI, energy, and sleep, and to identify any side effects in participants. Inclusion criteria included age (18 years or older) and use of vitamin B supplements. Children, pregnant women, adults who had never used vitamin B, and those not willing to participate in the study were excluded. Results In total, 1,521 adults were recruited. Most of the participants were young Saudi Females. While taking vitamin B supplements, a minority of participants complained of mild gastrointestinal upset, but a significant proportion experienced no side effects. In this study, a significant proportion of participants experienced an increase in appetite, which was associated with a significant increase in BMI after taking vitamin B supplements. This study also explored increases in energy, which were significant and associated with significant increases in sleeping time. Male participants in the present study noticed a significant increase in erectile dysfunction (ED). Conclusions This study found significant effects of vitamin B supplements on BMI, appetite, energy, and sleep, as well as an increase in ED in male participants. More studies are needed to further explore these findings.

Effects of Additional Granola in Children's Breakfast on Nutritional Balance, Sleep and Defecation: An Open-Label Randomized Cross-Over Trial

The contribution of breakfast to daily nutrient intake is low, particularly among children, at only about 20%, and it is difficult to determine whether children are receiving adequate nutrients at breakfast. Although alterations in breakfast content are considered to affect lifestyle habits such as sleep and defecation, there have been few intervention studies in children. The relationship between nutritional balance, dietary intake, and lifestyle habits in children remains unclear. We conducted an intervention study on elementary school children's breakfasts and observed the effects of improving the nutritional balance of breakfast on sleep parameters and defecation status. An intervention study was conducted with 26 elementary school students in Tokyo. The study design was an open-label randomized cross-over trial. Subjects consumed their usual breakfast during the control period and a granola snack containing soy protein in addition to their usual breakfast during the intervention period. Questionnaires regarding breakfast, sleep, and bowel movements were administered during each period. Based on the answers to these questionnaires, we compared the nutritional sufficiency of macronutrients, vitamins, and minerals (29 in total), as well as changes in sleep parameters and defecation status. The additional consumption of granola snacks increased the breakfast intake of 15 nutrients. The changes were particularly significant for iron, vitamin B1, vitamin D, and dietary fiber. During the intervention, sleep duration was decreased and wake-up time became earlier. In terms of defecation, the intervention did not change stool characteristics, but the frequency of defecations per week increased on average by 1.2 per week. These results suggest that the nutritional balance and the amount of breakfast are linked to sleep and defecation and that improving breakfast content can lead to lifestyle improvements in children.

Effect of Vitamin E Supplementation on Chronic Insomnia Disorder in Postmenopausal Women: A Prospective, Double-Blinded Randomized Controlled Trial

Chronic insomnia disorder is one of the most common problems in postmenopausal women, exacerbated by underdiagnosis and improper treatment. This double-blinded, randomized, placebo-controlled trial was conducted to evaluate the potential of vitamin E to treat chronic insomnia as an alternative to sedative drugs and hormonal therapy. The study enrolled 160 postmenopausal women with chronic insomnia disorder, divided randomly into two groups. The vitamin E group received 400 units of mixed tocopherol daily, while the placebo group received an identical oral capsule. The primary outcome of this study was sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI), a self-evaluated and standardized questionnaire. The secondary outcome was the percentage of participants using sedative drugs. There were no significant differences in baseline characteristics between the study groups. However, the median PSQI score at baseline was slightly higher in the vitamin E group compared with the placebo (13 (6, 20) vs. 11 (6, 20); p-value 0.019). After one month of intervention, the PSQI score was significantly lower (indicating better sleep quality) in the vitamin E group compared with the placebo (6 (1, 18) vs. 9 (1, 19); p-value 0.012). Moreover, the improvement score was significantly higher in the vitamin E group compared with the placebo (5 (-6, 14) vs. 1 (-5,13); p-value < 0.001). In addition, there was a significant reduction in the percentage of patients using sedative drugs in the vitamin E group (15%; p-value 0.009), while this reduction was not statistically significant in the placebo group (7.5%; p-value 0.077). This study demonstrates vitamin E's potential as an excellent alternative treatment for chronic insomnia disorder that improves sleep quality and reduces sedative drug use.

Mental Health Symptom Reduction Using Digital Therapeutics Care Informed by Genomic SNPs and Gut Microbiome Signatures

Neuropsychiatric diseases and obesity are major components of morbidity and health care costs, with genetic, lifestyle, and gut microbiome factors linked to their etiology. Dietary and weight-loss interventions can help improve mental health, but there is conflicting evidence regarding their efficacy; and moreover, there is substantial interindividual heterogeneity that needs to be understood. We aimed to identify genetic and gut microbiome factors that explain interindividual differences in mental health improvement after a dietary and lifestyle intervention for weight loss. We recruited 369 individuals participating in Digbi Health’s personalized digital therapeutics care program and evaluated the association of 23 genetic scores, the abundance of 178 gut microbial genera, and 42 bacterial pathways with mental health. We studied the presence/absence of anxiety or depression, or sleep problems at baseline and improvement on anxiety, depression, and insomnia after losing at least 2% body weight. Participants lost on average 5.4% body weight and >95% reported improving mental health symptom intensity. There were statistically significant correlations between: (a) genetic scores with anxiety or depression at baseline, gut microbial functions with sleep problems at baseline, and (b) genetic scores and gut microbial taxa and functions with anxiety, depression, and insomnia improvement. Our results are concordant with previous findings, including the association between anxiety or depression at baseline with genetic scores for alcohol use disorder and major depressive disorder. As well, our results uncovered new associations in line with previous epidemiological literature. As evident from previous literature, we also observed associations of gut microbial signatures with mental health including short-chain fatty acids and bacterial neurotoxic metabolites specifically with depression. Our results also show that microbiome and genetic factors explain self-reported mental health status and improvement better than demographic variables independently. The genetic and microbiome factors identified in this study provide the basis for designing and personalizing dietary interventions to improve mental health.

The Association of Self-Reported Iron and Vitamin D Levels on Sleep Quality and Pain Perception in a Subset of Saudi Population

Background and Aims

There has been a rising concern regarding the relationship of iron levels, vitamin D, and consumption of multivitamins on pain perception and sleep quality. The purpose of this study is to shed light on these connections in hopes of enhancing quality of sleep.

Methods

A cross-sectional analysis was used, and data collection was based on close-ended online questionnaire created on Survey Monkey. The survey included an operator designed questionnaire, questions from both the Brief Pain Inventory and Sleep Quality questionnaires. The targeted population was participants who were medically fit, non-pregnant Saudi citizens aged between 25 and 55 years.

Results

Prior to the COVID-19 crisis, data were collected during the months of February and March 2020, with a grand total of 3127 participants, out of which 2774 responses were included. The outcome of the research revealed that diminished levels of vitamin D, and iron had a negative impact on sleep quality. In turn, poor sleep quality had a significant pain response.

Conclusion

This study reveals the detrimental role of vitamins on sleep, and their concurrent domino effect on pain.

Prevalence, Risk Factors, and Clinical Correlates of Insomnia in China College Student During the COVID-19

Objective: The 2019 novel coronavirus disease (COVID-19) broke out in Hubei Province and spread rapidly to the whole country, causing huge public health problems. College students are a special group, and there is no survey on insomnia among college students. The purpose of this study was to investigate the incidence and related factors of insomnia in college students during the period of COVID-19. Method: A total of 1,086 college students conducted a cross-sectional study through the questionnaire star platform. The survey time was from February 15 to February 22, 2020. The collected information included demographic informatics and mental health scale, Athens Insomnia Scale (AIS) to assess sleep quality, Self-Reporting Questionnaire-20 (SRQ-20) to assess general psychological symptoms, Chinese perceived stress scale (CPSS) to assess stress. We used logistic regression to analyze the correlation between related factors and insomnia symptoms. Results: The prevalence of insomnia, general psychological symptoms and stress were 16.67, 5.8, and 40.70%, respectively. Multivariate logistic regression analysis showed that gender (OR = 1.55, p = 0.044, 95% CI = 1.00-2.41), general psychological symptoms (OR = 1.49, p < 0.01, 95% CI = 1.40-1.60) and living in an isolation unit (OR = 2.21, p = 0.014, 95% CI = 1.17-4.16) were risk factors for insomnia of college students. Conclusion: Our results show that the insomnia is very common among college students during the outbreak of covid-19, and the related factors include gender, general psychological symptoms and isolation environment. It is necessary to intervene the insomnia of college students and warrants attention for mental well-being of college students.

The Role of Vitamin C in Two Distinct Physiological States: Physical Activity and Sleep

This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, and knowing that both states share a connection with oxidative stress, we discuss the existing body of evidence to answer the question of whether vitamin C supplementation can be beneficial in the context of sleep health and key aspects of physical activity, such as performance, metabolic changes, and antioxidant function. We analyze the effect of ascorbic acid on the main sleep components, sleep duration and quality, focusing on the most common disorders: insomnia, obstructive sleep apnea, and restless legs syndrome. Deeper understanding of those interactions has implications for both public health and clinical practice.

A critical review of self-care for sleep disturbances: prevalence, profile, motivation, perceived effectiveness and medical provider communication

Objective

This study aims to undertake the first critical review of self-care use among adults with sleep disturbances by focusing on the prevalence of self-care—the self-determined and self-administered use of products or practices—by adults with sleep disturbances.

Methods

A comprehensive search of 2006–2016 international literature in CINAHL, AMED, Medline and EMBASE databases was conducted. The search was confined to empirical research findings regarding sleep disturbances - as indicated by a validated sleep scale/index or clinician diagnosis.

Results

Of the 21 articles included in this review, only three reported on sleep disturbances other than insomnia disorder (ID) or insomnia symptoms (IS). Overall, a high prevalence of self-care use is reported among adults with sleep disturbances, particularly for ID and IS. Self-care products and practices are more likely to be used by adults with sleep disturbances, than those without sleep disturbances. Commonly used self-care products and practices include OTC hypnotics, antihistamines, diphenhydramine products, diet, exercise, painkillers, herbal medicines, vitamins, minerals and dietary supplements, yoga, tai chi, Qigong, meditation, exercise and relaxation.

Conclusions

Many adults with sleep disturbances–particularly ID or IS–frequently use self-care products and practices. Self-care products are also used concomitantly with conventional prescription medications without disclosure to medical professionals. The current literature is of varied methodological caliber, frequently relies on small sample sizes and low-quality data collection therefore further rigorous health services research is required. There is an especial paucity of data regarding self-care for sleep disturbances such as restless legs syndrome and obstructive sleep apnea. Healthcare providers may find it beneficial to actively ask patients about their use of self-care for sleep disturbances to help avoid harmful drug-drug or drug-herb interactions.

The Effects of Magnesium - Melatonin - Vit B Complex Supplementation in Treatment of Insomnia

Insomnia means difficulty in falling asleep and/or stays asleep. Insomnia commonly leads to daytime sleepiness, lethargy, and a general feeling of being unwell. The most common treatment of insomnia includes GABAA receptor positive allosteric modulators or Melatonin agonists. Our study aimed to evaluate the efficacy of Magnesium- melatonin-vitamin B complex supplement in the treatment of insomnia. The study included 60 patients diagnosed with insomnia. The patients were randomly divided into study group (N = 30), and control group (N = 30), and study group was treated with Magnesium-melatonin-vitamin B complex (one dose contains 175 mg liposomal magnesium oxide, 10 mg Vit B6, 16 μg vit B12, melatonin 1 mg, Extrafolate-S 600 μg) once a day 1 hour before sleep, during the 3 months. The severity of insomnia symptoms was measured by self-reported Athens insomnia scale (AIS), with a cut-off score by Soldatos (AIS score ≥ 6). Mean AIS score at zero points was 14.93 ± 3.778 in the study group and 14.37 ± 4.081 in the control group (p = 0.476), indicating the compatibility of the groups, and both scores correspond to mild to moderate insomnia. Mean AIS score after 3 months of the Magnesium- melatonin- vitamin B complex supplementation was 10.50 ± 4.21 corresponding to mild insomnia, while median AIS score in the control group was 15.13 ± 3.76 which is referred to moderate insomnia, and difference among groups was significant (p = 0.000). Our founding’s indicating that 3 months of the Magnesium- melatonin-vitamin B complex supplementation has a beneficial effect in the treatment of insomnia regardless of cause.

Gut Microbiota as an Objective Measurement for Auxiliary Diagnosis of Insomnia Disorder

Insomnia is a type of sleep disorder which is associated with various diseases’ development and progression, such as obesity, type II diabetes and cardiovascular diseases. Recent investigation of the gut-brain axis enhances our understanding of the role of the gut microbiota in brain-related diseases. However, whether the gut microbiota is associated with insomnia remains unknown. In the present investigation, leveraging the 16S rDNA amplicon sequencing of V3-V4 region and the novel bioinformatic analysis, it was demonstrated that between insomnia and healthy populations, the composition, diversity and metabolic function of the gut microbiota are significantly changed. Other than these, redundancy analysis, co-occurrence analysis and PICRUSt underpin the gut taxa composition, signaling pathways, and metabolic functions perturbed by insomnia disorder. Moreover, random forest together with cross-validation identified two signature bacteria, which could be used to distinguish the insomnia patients from the healthy population. Furthermore, based on the relative abundance and clinical sleep parameter, we constructed a prediction model utilizing artificial neural network (ANN) for auxiliary diagnosis of insomnia disorder. Overall, the aforementioned study provides a comprehensive understanding of the link between the gut microbiota and insomnia disorder.

Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep

Anecdotal evidence indicates that supplementation with vitamin B6 (pyridoxine) before bed can enhance dream vividness and recall. In a single pilot study, Ebben, Lequerica, and Spielman (2002) found that vitamin B6 had a dose-dependent effect of increasing scores on a composite measure of dream vividness, bizarreness, emotionality, and color. The present research replicated this study using a larger and more diverse sample of 100 participants from across Australia. We conducted a randomized, double-blind, placebo-controlled investigation of the effects on dreaming and sleep of ingesting 240 mg vitamin B6 (pyridoxine hydrochloride) before bed for five consecutive days. We also included an exploratory condition involving a B complex preparation containing a range of B vitamins. We found that vitamin B6 significantly increased the amount of dream content participants recalled but did not significantly affect dream vividness, bizarreness, or color, nor did it significantly affect other sleep-related variables. In contrast, participants in the B complex group showed significantly lower self-rated sleep quality and significantly higher tiredness on waking. We discuss the potential for using vitamin B6 in research on lucid dreaming.

The Utilization of Health Services and Self-Care by Older Women With Sleeping Problems: Results From a Nationally Representative Sample of 9,110 Women

OBJECTIVE

This research aims to investigate the health service use-including complementary and alternative medicine (CAM)-and self-care by women aged 62 to 67 with sleeping problems.

METHOD

In total, 9,110 participants (99.6%) responded to questions about sleeping problems, health service utilization and self-care (e.g., herbal medicines and vitamins), demographics, and chronic illnesses.

RESULTS

In all, 48.2% ( n = 4,394) women indicated that they had a sleeping problem. Women with sleeping problems consulted a general practitioner (GP) more frequently (odds ratio [OR] = 1.72; 95% confidence interval [CI] = [1.36, 2.17]; p < .005) and were more likely to be using herbal medicines (OR = 1.24; 95% CI = [1.13, 1.36]; p < .005) than women without sleeping problems.

DISCUSSION

Health professionals, particularly GPs, may need to actively inquire with older patients in their care with sleeping problems about the use of herbal medicines, to ensure their sleeping problems are being directly and effectively treated, particularly in light of increased risks associated with sleeping problems for this age cohort.

The relationship between micronutrient status and sleep patterns: a systematic review

OBJECTIVE

To review articles on the relationship of dietary and circulating micronutrients with sleep patterns, and to identify issues surrounding implications for future research and public health practice.

DESIGN

A systematic review was conducted. PubMed, Embase and Scopus were searched through January 2016.

SETTING

Both experimental and observational studies were included. However, studies that focused on secondary sleep impairment due to comorbidities were excluded.

SUBJECTS

Individuals in different age groups, from infants to older adults.

RESULTS

A total of twenty-six articles were selected. In the articles reviewed, researchers generally supported a potential role of micronutrients, particularly Fe and Mg, in the development of sleep stages among infants and in reversing age-related alterations in sleep architecture in older adults. Micronutrient status has also been linked to sleep duration, with sleep duration positively associated with Fe, Zn and Mg levels, and negatively associated with Cu, K and vitamin B12 levels. The mechanisms underlying these relationships include the impact of micronutrients on excitatory/inhibitory neurotransmitters and the expression of circadian genes.

CONCLUSIONS

Although the number of studies on the relationship between micronutrient status and sleep remains low, evidence has emerged that suggests a link between dietary/circulating micronutrients and sleep. Future research is needed to investigate the dose-dependent as well as the longitudinal relationships between micronutrient levels and human sleep across populations, test the interactions among micronutrients on sleep outcomes, and ultimately examine the clinical relevance of micronutrients on sleep health.

Serum nutritional biomarkers and their associations with sleep among US adults in recent national surveys

Background

The associations between nutritional biomarkers and measures of sleep quantity and quality remain unclear.

Methods

Cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) 2005–2006 were used. We selected 2,459 adults aged 20–85, with complete data on key variables. Five sleep measures were constructed as primary outcomes: (A) Sleep duration; (B) Sleep disorder; (C) Three factors obtained from factor analysis of 15 items and labeled as “Poor sleep-related daytime dysfunction” (Factor 1), “Sleepiness” (Factor 2) and “Sleep disturbance” (Factor 3). Main exposures were serum concentrations of key nutrients, namely retinol, retinyl esters, carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein+zeaxanthin, lycopene), folate, vitamin B-12, total homocysteine (tHcy), vitamin C, 25-hydroxyvitamin D (25(OH)D) and vitamin E. Main analyses consisted of multiple linear, logistic and multinomial logit models.

Results

Among key findings, independent inverse associations were found between serum vitamin B-12 and sleep duration, 25(OH)D and sleepiness (as well as insomnia), and between folate and sleep disturbance. Serum total carotenoids concentration was linked to higher odds of short sleep duration (i.e. 5–6 h per night) compared to normal sleep duration (7–8 h per night).

Conclusions

A few of the selected serum nutritional biomarkers were associated with sleep quantity and quality. Longitudinal studies are needed to ascertain temporality and assess putative causal relationships.

Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women's Health Study

BACKGROUND

Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women.

METHODS

Using information collected from 68,832 women who participated in the Shanghai Women's Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression.

RESULTS

The mean age of the study population was 59.6 years (SD=9.0; range: 44.6-79.9 years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6-8 h/day, 11.5% slept 5h or less, and 8.7% slept 9h or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around 7 h/day (6.5-7.4h/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status.

CONCLUSIONS

In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population.

Comparison of nutrient intake by sleep status in selected adults in Mysore, India

Insomnia has become a major public health issue in recent times. Although quality of sleep is affected by environmental, psychophysiological, and pharmacological factors, diet and nutrient intake also contribute to sleep problems. This study investigated the association between nutrient intake and co-morbid symptoms associated with sleep status among selected adults. Subjects in this study included 87 men and women aged 21-45 years. Presence of insomnia was assessed using the Insomnia Screening Questionnaire, and dietary intake was measured over three consecutive days by dietary survey. Descriptive analysis, ANOVA, and Chi-Square tests were performed to compute and interpret the data. Approximately 60% of the participants were insomniacs. People with insomnia consumed significantly lesser quantities of nutrients as compared to normal sleepers. Differences in intakes of energy, carbohydrates, folic acid, and B₁₂ were highly significant (P < 0.002). Further, intakes of protein, fat, and thiamine were significantly different (P < 0.021) between insomniacs and normal sleepers. The nutrient intake pattern of the insomniacs with co-morbid symptoms was quite different from that of the normal sleepers. Based on these results, it is probable that there is an association between nutrition deficiency, co-morbid symptoms, and sleep status. More studies are required to confirm these results.