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Schiza S, Bouloukaki I, Kaditis A, Lombardi C, Bonsignore MR. Vitamin D deficiency: A forgotten aspect in sleep disorders? A critical update. Sleep Med 2024; 121:77-84. [PMID: 38941960 DOI: 10.1016/j.sleep.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/28/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
Over the past few years, there has been a surge in interest regarding the connection between sleep duration and quality, sleep disorders, mainly Obstructive sleep apnoea (OSA) and Vitamin D. There is growing evidence to support a new role of Vitamin D in the maintenance and regulation of optimal sleep. Furthermore, a notable link has been identified between OSA and a decrease in serum Vitamin D levels, which appears to intensify as the severity of sleep apnea worsens. Vitamin D status could also potentially serve as a mediator or provide an explanation for the association between OSA and cardiometabolic morbidity, but the current state of research in this area is inadequate. Studies have indicated that the supplementation of Vitamin D can optimize sleep quality, presenting more proof of the connection between insufficient vitamin D levels and sleep disorders. However, it is unclear whether low serum Vitamin D levels are a contributing factor to OSA development or if OSA predisposes individuals to Vitamin D deficiency. As a result, various studies have endeavored to examine the complex relationship between OSA and Vitamin D deficiency. In children and adolescents, while data is limited, there seems also to be a link between sleep disorders and Vitamin D levels. Therefore, the objective of this review is to provide a comprehensive overview of the current evidence on the association between Vitamin D and sleep disorders in both adults and children.
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Affiliation(s)
- Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece.
| | - Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Athanasios Kaditis
- Division of Pediatric Pulmonology and Cystic Fibrosis Center, Department of Child Health, University of Missouri School of Medicine, MUHC Children's Hospital, Columbia, MO, USA; Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Carolina Lombardi
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, St. Luke Hospital, Milan, Italy
| | - Maria R Bonsignore
- Division of Respiratory Medicine, PROMISE Dept, University of Palermo, Palermo, Italy; IBIM CNR, Palermo, Italy
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Jiang J, Tan H, Xia Z, Li J, Zhou S, Huang T. Serum vitamin D concentrations and sleep disorders: insights from NHANES 2011-2016 and Mendelian Randomization analysis. Sleep Breath 2024:10.1007/s11325-024-03031-2. [PMID: 38739211 DOI: 10.1007/s11325-024-03031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/15/2024] [Accepted: 03/29/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This investigation seeks to examine the association between serum vitamin D concentrations and the prevalence of sleep disorders, additionally elucidating the causal relationship via Mendelian Randomization (MR) analysis. MATERIALS AND METHODS This research employed data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016, focusing on adults aged 20-50Â years reporting sleep disorders. The research encompassed 4913 American adults. Weighted multivariable logistic regression models and cubic spline analyses were utilized to evaluate the association between serum vitamin D concentrations and the incidence of sleep disorders. Additionally, a two-sample Mendelian Randomization analysis was performed to evaluate the potential causal link between serum vitamin D concentrations and the risk of sleep disorders. RESULTS Within the 2011-2016 NHANES cohort of the U.S. population, a notable inverse association was detected between serum vitamin D concentrations and sleep disorders (ÎČâ=ââ-â3.81, 95% CI:â-â6.10 toâ-â1.52, pâ=â0.003). After multivariate adjustments, a higher incidence of sleep disorders was associated with lower vitamin D Concentrations (OR 1.52, 95% CI 1.10-2.10, trend pâ=â0.014). Restricted cubic spline regression analysis indicated a linear association between serum vitamin D concentrations and sleep disorders(non-linearity pâ>â0.05). Lastly, the two-sample MR analysis yielded evidence supporting a potential causal connection between serum vitamin D concentrations and sleep disorders, with each unit increase in genetically predicted serum vitamin D reducing the odds ratio to 0.78 (95% CI 0.61-0.99, pâ=â0.044). CONCLUSIONS These results imply that lower vitamin D concentrations in the population might correlate with a heightened risk of sleep disorders, suggesting the importance of considering vitamin D supplementation when treating sleep disorders.
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Affiliation(s)
- Junjie Jiang
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China
| | - Hanyu Tan
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China
| | - Zhongfang Xia
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China
| | - Jun Li
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China
| | - Shuang Zhou
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China
| | - Tao Huang
- Department of Otolaryngology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei Province, People's Republic of China.
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Karnopp TE, da Silva Freitas V, Di Domenico AL, Chapacais GF, Dos Santos NG, Freitas EC, Gasparin AA, Monticielo OA. What is known about the effects of vitamin D in neuropsychiatric lupus? Adv Rheumatol 2024; 64:2. [PMID: 38167239 DOI: 10.1186/s42358-023-00344-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.
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Affiliation(s)
- ThaĂs Evelyn Karnopp
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil.
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
| | - Vinicius da Silva Freitas
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Andressa Leite Di Domenico
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Gustavo Flores Chapacais
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - NatĂĄlia Garcia Dos Santos
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, Porto Alegre, RS, Brazil
| | - Eduarda Correa Freitas
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Andrese Aline Gasparin
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Odirlei André Monticielo
- Laboratory of Autoimmune Diseases, Division of Rheumatology, Hospital de ClĂnicas de Porto Alegre, Centro de Pesquisas Experimentais, Universidade Federal Do Rio Grande Do Sul, Rua Ramiro Barcelos, 2350, Sala 12109, Porto Alegre, 90035â003, Brazil
- Division of Rheumatology, Department of Internal Medicine, Hospital de ClĂnicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
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Ceolin G, Antunes LDC, Moretti M, Rieger DK, Moreira JD. Vitamin D and depression in older adults: lessons learned from observational and clinical studies. Nutr Res Rev 2023; 36:259-280. [PMID: 35022097 DOI: 10.1017/s0954422422000026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Depression is a mental disorder triggered by the interaction of social, psychological and biological factors that have an important impact on an individual's life. Despite being a well-studied disease with several established forms of treatment, its prevalence is increasing, especially among older adults. New forms of treatment and prevention are encouraged, and some researchers have been discussing the effects of vitamin D (VitD) on depression; however, the exact mechanism by which VitD exerts its effects is not yet conclusive. In this study, we aimed to discuss the possible mechanisms underlying the association between VitD and depression in older adults. Therefore, we conducted a systematic search of databases for indexed articles published until 30 April 2021. The primary focus was on both observational studies documenting the association between VitD and depression/depressive symptoms, and clinical trials documenting the effects of VitD supplementation on depression/depressive symptoms, especially in older adults. Based on pre-clinical, clinical and observational studies, it is suggested that the maintenance of adequate VitD concentrations is an important issue, especially in older adults, which are a risk population for both VitD deficiency and depression. Nevertheless, it is necessary to carry out more studies using longitudinal approaches in low- and middle-income countries to develop a strong source of evidence to formulate guidelines and interventions.
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Affiliation(s)
- Gilciane Ceolin
- Postgraduate Program in Nutrition, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
| | - Luciana da Conceição Antunes
- Department of Nutrition, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
| | - Morgana Moretti
- Postgraduate Program in Biochemistry, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
| | - DĂ©bora Kurrle Rieger
- Department of Nutrition, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
| | - JĂșlia Dubois Moreira
- Department of Nutrition, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
- Translational Nutritional Neuroscience working Group, Universidade Federal de Santa Catarina, FlorianĂłpolis, Santa Catarina, Brazil
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Ciobanu AM, Petrescu C, Anghele C, Manea MC, Ciobanu CA, Petrescu DM, Antonia MO, Riga S. Severe Vitamin D Deficiency-A Possible Cause of Resistance to Treatment in Psychiatric Pathology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2056. [PMID: 38138159 PMCID: PMC10744484 DOI: 10.3390/medicina59122056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023]
Abstract
In the last few years, vitamin D functions have been studied progressively, and along with their main role in regulating calcium homeostasis, the potential function in the nervous system and the link between different psychiatric disorders and vitamin D deficiency have been revealed. The discovery of vitamin D receptors in multiple brain structures, like the hippocampus, led to the hypothesis that vitamin D deficiency could be responsible for treatment resistance in psychiatric diseases. The aim of this study was to analyze the current knowledge in the literature regarding vitamin D deficiency among individuals afflicted with psychiatric disorders and assess the potential therapeutic benefits of vitamin D supplementation. A systematic search was conducted on the PubMed database for articles published in the last five years (2016-2022) in English, focusing on human subjects. Results show that vitamin D deficiency has implications for numerous psychiatric disorders, affecting mood and behavior through its influence on neurotransmitter release, neurotrophic factors, and neuroprotection. It also plays a role in modulating inflammation, which is often elevated in psychiatric disorders. In conclusion, vitamin D deficiency is prevalent and has far-reaching implications for mental health. This review underscores the importance of exploring the therapeutic potential of vitamin D supplementation in individuals with psychiatric disorders and highlights the need for further research in this complex field.
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Affiliation(s)
- Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, âCarol Davilaâ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, âCarol Davilaâ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Cristina Anghele
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, âCarol Davilaâ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Mihnea Costin Manea
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, âCarol Davilaâ University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (C.P.); (C.A.); (M.C.M.)
- Department of Psychiatry, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | | | - Diana Mihaela Petrescu
- Department of Neurology, âCarol Davilaâ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mihalache Oana Antonia
- Neurology Clinic, âFundeniâ Clinical Institute, 022328 Bucharest, Romania
- Department of Stress Research and Prophylaxis, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, âProf. Dr. Alexandru Obregiaâ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
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6
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Shuai J, Gao M, Zou Q, He Y. Association between vitamin D, depression, and sleep health in the National Health and Nutrition Examination Surveys: a mediation analysis. Nutr Neurosci 2023:1-8. [PMID: 37962262 DOI: 10.1080/1028415x.2023.2279363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVE This study aimed to assess the association between vitamin D and sleep health and to investigate whether depression could mediate this relationship. METHODS A cross-sectional analysis was performed using the 2005-2014 US National Health and Nutrition Examination Survey (NHANES) data. The logistic regression models were conducted to evaluate association of serum vitamin D concentrations with sleep health and depression. Mediation analyses were conducted to investigate the mediated effects of depression on the association of vitamin D with sleep health. RESULTS In multivariate logistic models, vitamin D was found to be negatively associated with an increased risk of poor sleep health, with an odds ratio (OR) of vitamin D deficiency versus sufficiency was 1.256 (95% CIâ=â1.084-1.455). Additionally, univariate logistic models showed that vitamin D was also negatively associated with depression risk (vitamin D deficiency vs. sufficiency: ORâ=â1.699, 95% CIâ=â(1.373-2.103). Further mediation analyses showed that the association of vitamin D with sleep health was mediated by depression, with the mediating effects of depression accounted for 44.56% of the total effects. CONCLUSION Vitamin D affects sleep health directly and indirectly through depression. The results suggest that interventions increasing intake of vitamin D should be prioritized to promote sleep health of persons with or at risk of depression.
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Affiliation(s)
- Jingliang Shuai
- Department of Epidemiology and Health Statistics, School of Public Health, Xiangya School of Public Health, Central South University, Changsha, People's Republic of China
| | - Mengqi Gao
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Qi Zou
- Medical Department, The First Hospital of Nanchang, Nanchang, People's Republic of China
| | - Youming He
- Department of Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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Jung J, Kang J, Kim T. Attenuation of homeostatic sleep response and rest-activity circadian rhythm in vitamin D deficient mice. Chronobiol Int 2023; 40:1097-1110. [PMID: 37661839 DOI: 10.1080/07420528.2023.2253299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
The link between vitamin D deficiency (VDD) and sleep disturbances has long been suggested. However, the direct causality between VDD, sleep disturbances, and circadian rhythm remains unclear. We aimed to characterize sleep-wake behavior and circadian rhythms in an animal model of VDD. VDD was induced by feeding vitamin D-deficient chow, and we analyzed sleep and circadian rhythm parameters. During light period, VDD mice exhibited reduced wake with more frequent wake bouts and increased NREM sleep time. However, during dark period, the wake EEG power spectrum peaked at theta band frequency, and slow-wave energy was suppressed in mice with VDD. Rest-activity analyses revealed increased circadian period, lower wheel counts, and more frequent and short activity bouts during VDD. Combining sleep and circadian data, we found significantly suppressed activities during the hours with a wake duration shorter than 30âminutes. Moreover, mice in VDD state exhibited a negative correlation between wake theta power and hourly wheel-running counts during dark period. Our data point to a direct link between VDD and disturbances in sleep and rest-activity circadian rhythm, featuring frequent wake bouts during the sleeping phase, reduced sleep pressure build-up in dark period, and reduced activity levels due to increased susceptibility to sleepiness.
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Affiliation(s)
- Jieun Jung
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Jiseung Kang
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
| | - Tae Kim
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, Republic of Korea
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Chang Q, Zhu Y, Zhou G, Liang H, Li D, Cheng J, Pan P, Zhang Y. Vitamin D status, sleep patterns, genetic susceptibility, and the risk of incident adult-onset asthma: a large prospective cohort study. Front Nutr 2023; 10:1222499. [PMID: 37457981 PMCID: PMC10349527 DOI: 10.3389/fnut.2023.1222499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Vitamin D has been known to be associated with asthma, particularly in children, while the evidence among adults is limited and inconclusive. This study aimed to investigate the association between serum, vitamin D concentrations, and the incidence of adult-onset asthma and also the modified effect caused by sleep patterns and genetic risks. Methods A prospective cohort study with 307,872 participants aged between 37 and 73 years was conducted based on the UK Biobank, with a median follow-up of 12 years. The Cox proportional hazard model was applied to evaluate the association between vitamin D status and incident adult-onset asthma, and the modified effect was investigated by conducting stratified analysis according to sleep pattern score and genetic risk score, and subgroup analyses were performed by sex, age, BMI, and smoking status as well. Results Individuals with optimal vitamin D concentration were associated with 11.1% reduced risk of incident asthma compared to those participants with deficient vitamin D (HR = 0.889; 95% CI: 0.820-0.964; p = 0.005). Moreover, stratification analysis demonstrated that the protective effect of vitamin D on asthma risk was modified by sleep patterns or genetic susceptibility, with the strongest protective effect being observed in the subpopulation with a moderate sleep pattern (HR = 0.883; 95% CI: 0.797-0.977; p = 0.016) and a moderate genetic risk (HR = 0.817; 95% CI: 0.711-0.938; p = 0.004). In subgroup analyses, the protective effect of optimal vitamin D levels was only significant among men, individuals younger than 60 years of age, overweight individuals, and current or previous smokers. Conclusion Increased serum vitamin D levels were associated with a lower risk of incident adult-onset asthma, and this association was modified by sleep patterns and genetic predisposition to some extent.
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Affiliation(s)
- Qinyu Chang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Yiqun Zhu
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Guowei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huaying Liang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Dianwu Li
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
| | - Jun Cheng
- Department of Spine Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Pinhua Pan
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Zhang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Pourrostami K, Heshmat R, Derakhshanian H, Ejtahed HS, Shafiee G, Safari O, Abkhoo AR, Mohammadian-Khonsari N, Mahdavi-Gorabi A, Ebrahimi M, Qorbani M, Kelishadi R. The association between vitamin D status and sleep duration in school-aged children; the CASPIAN-V study. J Diabetes Metab Disord 2023; 22:341-346. [PMID: 37255800 PMCID: PMC10225404 DOI: 10.1007/s40200-022-01146-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/11/2022] [Accepted: 10/10/2022] [Indexed: 06/01/2023]
Abstract
Background Considering the high prevalence of both vitamin D deficiency (VDD) and sleep impairment in children and adolescents, this study was conducted to determine the association between VDD and sleep duration in the Iranian pediatric population. Methods This multicentric national study was conducted in 2019 on 2564 frozen sera obtained from 7 to 18- year students who were studied in the fifth survey of a national school-based surveillance program conducted in 30 provinces of Iran. Sleep duration was assessed using a questionnaire based on the World Health Organization-Global School-based Student Health Survey protocol. Short sleep duration was defined as sleep duration less than 8Â h/day VDD Vitamin Dâ<â20 ng/dL, and vitamin D insufficiency as 20-30 ng/dL.An adjusted logistic regression model was applied to evaluate the associations of vitamin D status with sleep duration. Results The Mean (SD) of students' age was 12.1(3.0) years; overall 10.6%of participants had VDD and 23% of participants had short sleep duration. in the adjusted logistic model, students with a low level of vitamin D (insufficient and deficient) had a higher odds of short sleep duration in comparison to those with normal vitamin D level (OR: 1.29, 95%CI: 1.02-1.62). Conclusion The current study showed that low Vitamin D levels (insufficient and deficient)were significantly associated with short sleep duration in school-aged children. Further studies are recommended to determine the efficacy of vitamin D replacement in improving sleep duration and quality.
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Affiliation(s)
- Kumars Pourrostami
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences Iran, Tehran, Iran
| | - Hoda Derakhshanian
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences Iran, Tehran, Iran
| | - Omid Safari
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Amin Reza Abkhoo
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences Iran, Tehran, Iran
| | | | - Armita Mahdavi-Gorabi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mehdi Ebrahimi
- Department of Internal Medicine, Faculty of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences Iran, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Vitamin D in Neurological Diseases. Int J Mol Sci 2022; 24:ijms24010087. [PMID: 36613531 PMCID: PMC9820561 DOI: 10.3390/ijms24010087] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D may have multiple effects on the nervous system and its deficiency can represent a possible risk factor for the development of many neurological diseases. Recent studies are also trying to clarify the different effects of vitamin D supplementation over the course of progressive neurological diseases. In this narrative review, we summarise vitamin D chemistry, metabolism, mechanisms of action, and the recommended daily intake. The role of vitamin D on gene transcription and the immune response is also reviewed. Finally, we discuss the scientific evidence that links low 25-hydroxyvitamin D concentrations to the onset and progression of severe neurological diseases, such as multiple sclerosis, Parkinson's disease, Alzheimer's disease, migraine, diabetic neuropathy and amyotrophic lateral sclerosis. Completed and ongoing clinical trials on vitamin D supplementation in neurological diseases are listed.
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11
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Yin WJ, Yu LJ, Wang P, Tao RX, Jiang XM, Zhang Y, Zhu DM, Zhu P. Sleep patterns modify the association of 25(OH)D with poor cardiovascular health in pregnant women. Front Nutr 2022; 9:1013960. [PMID: 36451743 PMCID: PMC9702519 DOI: 10.3389/fnut.2022.1013960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The relationship between vitamin D status and gestational cardiovascular health (CVH) is inconsistent in previous studies. Emerging evidence shows that sleep behaviors are related to vitamin D metabolism. However, no studies evaluate the interaction of vitamin D and sleep behaviors on gestational CVH. OBJECTIVE We aimed to estimate the relationship between 25-hydroxyvitamin D [25(OH)D] concentrations and gestational CVH, and whether the relationship was modified by sleep behaviors. METHODS The data of this study was from a multicenter birth cohort study. A total of 9,209 pregnant women at 16-23 weeks of gestation were included. 25(OH)D concentrations were measured from collected blood. Sleep patterns consisted of major sleep behaviors including duration, chronotype, insomnia, snoring, and excessive daytime sleepiness. Data on poor CVH was based on four "clinical" CVH metrics, including body mass index, blood pressure, total cholesterol, and glucose levels. RESULTS The proportion of women with poor CVH was 25.0%. The relative risk (RR) (95%CI) of poor CVH was 0.67 (0.58-0.76) in women with 25(OH)D â„ 50 nmol/L after multivariate adjustments. Lower 25(OH)D concentrations were significantly associated with poor CVH. Such association was also evident in subgroups analysis. We found a significant interaction of 25(OH)D (P for interaction = 0.01) with sleep patterns on the risk of poor CVH. A negative dose-response relation was observed between 25(OH)D concentrations and poor CVH risk in healthy or intermediate sleep, not poor sleep. 25(OH)D concentrations were lower and the risk of poor CVH was higher in pregnant women with poor sleep patterns (P < 0.05). CONCLUSION Our study suggests that sleep patterns modify the association of 25(OH)D concentrations with the CVH among pregnant women.
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Affiliation(s)
- Wan-jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Li-jun Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-xue Tao
- Department of Obstetrics and Gynecology, Hefei First Peopleâs Hospital, Hefei, China
| | - Xiao-min Jiang
- Department of Obstetrics and Gynecology, Anhui Province Maternity and Child Health Hospital, Hefei, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dao-min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth Peopleâs Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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12
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Li MT, Robinson CL, Ruan QZ, Surapaneni S, Southerland W. The Influence of Sleep Disturbance on Chronic Pain. Curr Pain Headache Rep 2022; 26:795-804. [PMID: 36190680 DOI: 10.1007/s11916-022-01074-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to present an overview of common sleep disturbance pathologies and their impact on chronic pain, while examining various factors that are implicit in the relationship between sleep disturbance and chronic pain, including neurobiochemistry, anatomy, and systemic mediators, and reviewing recent and landmark literature. RECENT FINDINGS Earlier literature reviews and studies have introduced the bidirectional relationship between sleep disturbance and chronic pain; that is, impaired sleep may worsen chronic pain, and chronic pain causes sleep disturbance. However, more recent reviews and studies seem to show a more associative, rather than causative relationship. There have been recent studies that attempt to determine mechanisms that link sleep disturbance and chronic pain; the results of these studies were more varied, ultimately concluding that there may be a separate, yet-to-be discovered mechanism that shows the causative relationship between sleep disturbance and pain. There are several neurotransmitters that are involved in the mediation of chronic pain and sleep disturbance as separate entities, and some studies have shown that there may be mechanisms that govern both chronic pain and sleep disturbance as a single unit. Other neuroendocrine substances also serve to mediate chronic pain and sleep disturbance. All these substances are found to be associated with various sleep disorders and are also associated with chronic pain symptoms as well. Inflammation plays a role in chronic pain and sleep disturbance, with an increase in inflammatory substances and mediators associated with an increase or worsening in chronic pain symptoms and sleep disorders. The HPA axis plays a role in chronic pain and sleep disorders, influencing pain and sleep pathways through stress response, inflammation, and maintenance of homeostasis. There are several variables that influence both chronic pain and sleep disturbance, and more research into these variables may further our understanding into the complex pathways governing the influence of sleep disturbance on pain, and ultimately to improve treatment for this issue.
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Affiliation(s)
- Michael T Li
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Christopher Louis Robinson
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Qing Zhao Ruan
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sindhuja Surapaneni
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Warren Southerland
- Department of Anesthesia, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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13
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Silvestri R, Ipsiroglu OS. Behavioral sleep medicine-The need for harmonization of clinical best practice outcome measures in children and adolescents with intellectual or developmental disabilities and restless sleep. Front Psychiatry 2022; 13:1003019. [PMID: 36226108 PMCID: PMC9548631 DOI: 10.3389/fpsyt.2022.1003019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
In behavioral medicine, sleep disorders, insomnia in particular, may be considered comorbidities and precipitating factors to intellectual or developmental disabilities (IDD). Nevertheless, sleep alterations have often been neglected in favor of daytime features and symptoms, albeit simple behavioral nighttime observations may disclose hypermotor features that characterize restless sleep. The root of most hypermotor restlessness is linked to central iron deficiency. The latter is often exacerbated by vitamin D deficiency (VDD), which interferes with both dopaminergic and serotonergic mechanisms. In this way, an imbalance affecting daytime behavior and mood is created. Several sleep-related motor disorders such as bruxism, periodic and aperiodic leg movements, Restless Legs Syndrome (RLS), and Restless Sleep Disorder (RSD) are commonly seen in Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). However, they are rarely diagnosed and often overlooked in affected children and adolescents. As a result, not only are these disorders not adequately addressed therapeutically, but their symptoms may be worsened by the side-effects of drugs used to contain disruptive daytime behavior, such as antipsychotics and antidepressants. In children with IDDs, obesity, inactivity and metabolic effects of antipsychotics often lead to Sleep Disordered Breathing (SDB), which is currently understood as an inflammatory state leading to "hyperactive" lethargy and further alterations of the hypoxic chain and vitamin D levels. Endorsing simple routine blood tests, including inflammatory markers such as C-reactive protein, ferritin, transferrin, and vitamin D levels, may favorably complement caregiver observations and ambulatory sleep recordings, leading to a sleep disorder diagnosis and consequent therapy. In fact, the treatment of SDB, RLS, and RSD has been copiously demonstrated to favorably impact vigilance, behavior, social competence, and academic skills in healthy and, to a greater extent, in IDD children. Thus, consulting and deliberating the root causes of functional and categorical diagnoses within a clinical framework may engender a more precise diagnosis and further benefit pediatric daytime and nighttime management of hyperactive behaviors.
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Affiliation(s)
- Rosalia Silvestri
- Department of Clinical and Experimental Medicine, Sleep Medicine Center, University of Messina, Azienda Ospedaliera Universitaria âGaetano Martinoâ, Messina, Italy
| | - Osman S. Ipsiroglu
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- H-Behaviours Research Lab, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
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14
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Larsen A, Hopstock L, Jorde R, Grimnes G. Associations of serum 25-hydroxyvitamin D and subjective sleep measures in an Arctic population: Insights from the population-based TromsĂž Study. Sleep Med X 2022; 4:100056. [PMID: 36274862 PMCID: PMC9579360 DOI: 10.1016/j.sleepx.2022.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/21/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the relation between serum 25-hydroxyvitamin D (s-25(OH)D) and subjective sleep measures in an Arctic population (69°N). Methods Cross-sectional data was collected from 21,083 individuals (aged â„40 years) participating in the population based TromsĂž Study: TromsĂž7 (2015â2016). The present study included 20,438 participants, after having excluded respondents missing data on s-25(OH)D (n = 161) and/or subjective sleep measures (including sleep duration, insomnia, and daytime sleepiness)(n = 490). Based on s-25(OH)D (assessed using LC-MS/MS), participants were grouped as deficient (<30 nmol/L), insufficient (30â49.9 nmol/L), sufficient (50â75 nmol/L), or high (>75 nmol/L). Sleep duration was grouped as inadequate (ISD) if < 7 or â„9 h. Linear and logistic regression were used to calculate unstandardized ÎČ-values and odds ratios [95% confidence intervals]. The analyses were adjusted for season, age, BMI, lifestyle factors and relevant comorbidities. Results In both men and women, s-25(OH)D was positively associated with sleep duration, and compared to the sufficient s-25(OH)D group, the insufficient s-25(OH)D group reported significantly shorter sleep duration in both sexes. There was an increased odds of ISD in both men and women but adjusted for confounding factors this was only significant in women (1.16 [1.03, 1.32], p = .017). In men, there were no significant associations between s-25(OH)D and the remaining sleep measures. Women in the high s-25(OH)D group had lower ESS-scores (â0.28 [-0.47, â0.08], p = .006), but higher odds of insomnia (1.16 [1.01, 1.33], p = .036) compared to women in the sufficient group. Conclusions In this Arctic population, a tenuous association was found between s-25(OH)D and subjective sleep measures, predominantly in women. 25(OH)D was associated with self-reported sleep measures in this Arctic population. 25(OH)D was positively associated with self-reported sleep duration in both sexes. Women with sufficient 25(OH)D had lower odds of insomnia. RCTs are needed to determine the role of vitamin D in sleep health.
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Affiliation(s)
- A.U. Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 TromsĂž, Norway
- Corresponding author.
| | - L.A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, TromsĂž, Norway
| | - R. Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 TromsĂž, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 TromsĂž, Norway
| | - G. Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 TromsĂž, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 TromsĂž, Norway
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15
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Tang HY, Ko WS, Yan YH, Yu SC, Chiou YL. Relationship between serum 25 hydroxyvitamin D (25(OH)D) levels and mental health in shift female nurses. Sci Rep 2022; 12:14583. [PMID: 36028631 PMCID: PMC9418151 DOI: 10.1038/s41598-022-18721-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
The nurses work long hours and in various shifts, and often accompanied by depression, fatigue, and sleep disorders. Many studies have found that 25 hydroxyvitamin D (25(OH)D) is related to mental health. We aimed to investigate the relationship between depression, sleep problems, fatigue, and serum 25(OH)D levels in shift nurses. We recruited 34Â day-shift, 30 evening-shift and 31 night-shift nurses. The Beck Depression Inventory II (BDI-II), Numerical Rating Scale and General Sleep Disturbance Scale to evaluate the levels of depression, sleep problems, fatigue. Blood samples (20Â ml) were collected under a fasting state to determine basic biochemistry and inflammatory parameters. In central of Taiwan, approximately 96.1% of shift nurses had deficient (<â20Â ng/ml) (45 females and 1 male) and inadequate (20-29Â ng/ml) (39 females and 2 male) 25(OH)D levels. Approximately 84.2% of shift nurses experienced fatigue. In sleep disturbance, night-shift nurses experienced significantly more severe sleep disturbance than day-shift and evening-shift nurses. However, no significant correlation was observed between 25(OH)D levels and mental health when the 25(OH)D level was categorized. 25(OH)D deficiency, sleep disturbance, depression, and fatigue were common in shift female nurses, but it was not possible to demonstrate the impact of 25(OH)D deficiency on the mental health of shift nurses in Taiwan.
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Affiliation(s)
- Hsin-Ya Tang
- Department of Nutrition, Master of Biomedical Nutrition Program, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, 433304, Taichung, Taiwan, Republic of China
| | - Wang-Sheng Ko
- Department of Internal Medicine, Kuang-Tien General Hospital, Taichung, Taiwan
| | - Yuan-Horng Yan
- Department of Medicine Research, Kuang-Tien General Hospital, Taichung, Taiwan
| | - Su-Chen Yu
- Department of Nursing, Kuang-Tien General Hospital, Taichung, Taiwan.
| | - Ya-Ling Chiou
- Department of Nutrition, Master of Biomedical Nutrition Program, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, 433304, Taichung, Taiwan, Republic of China.
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16
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Martelli M, Salvio G, Santarelli L, Bracci M. Shift Work and Serum Vitamin D Levels: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158919. [PMID: 35897284 PMCID: PMC9332580 DOI: 10.3390/ijerph19158919] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
Vitamin D deficiency and insufficiency are highly prevalent conditions worldwide due to several factors, including poor sun exposure. Shift workers may be exposed to the risk of hypovitaminosis D due to fewer opportunities for sunlight exposure compared to day workers. A systematic review of the PubMed, SCOPUS, and EMBASE databases was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement to investigate the effect of shift work on vitamin D levels. Mean differences (MD) and 95% confidence intervals (CI) of serum 25-OH-D levels in shift workers and non-shift workers were calculated. A total of 13 cross-sectional studies were included in the meta-analysis. We found significantly lower levels of serum 25-OH-D in shift workers compared with non-shift workers (MD: â1.85, 95% CI [â2.49 to â1.21]). Heterogeneity among included studies was high (I2 = 89%, p < 0.0001), and neither subgroup analysis nor meta-regression were able to identify specific sources of the heterogeneity that may be related to the different characteristics of shift work among studies. The monitoring of serum vitamin D levels and prompt correction of any deficiencies should be considered in shift workers. Notably, since a large part of the observations are derived from Koreans, larger epidemiological studies are needed in other populations.
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Affiliation(s)
- Margherita Martelli
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Gianmaria Salvio
- Endocrinology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Lory Santarelli
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
- Correspondence: (L.S.); (M.B.)
| | - Massimo Bracci
- Occupational Health, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
- Correspondence: (L.S.); (M.B.)
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17
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Bouloukaki I, Markakis M, Pateli R, Lyronis I, Schiza S, Tsiligianni I. Vitamin D levels in primary care patients: correlations with clinical, seasonal, and quality-of-life parameters. Fam Pract 2022; 39:678-684. [PMID: 35325110 DOI: 10.1093/fampra/cmac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of vitamin D deficiency varies across countries and few data exist in the adult population in Greece. OBJECTIVES To assess vitamin D levels in unselected patients from primary care and to investigate possible correlations with clinical, seasonal, and quality-of-life parameters. METHODS In this cross-sectional study, 389 consecutive patients were included. They were grouped according to vitamin D status as vitamin D deficient (<20Â ng/mL) and vitamin D sufficient groups (â„20Â ng/mL). Demographic, Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), Beck Depression Inventory (BDI), and Fatigue Severity Scale (FSS) scores were measured and compared between groups. RESULTS Vitamin D deficiency (<20Â ng/mL) was observed in 50.4% of the cohort. Female gender (76% vs 66%, P = 0.026), obesity (42% vs 26%, P = 0.005), and hypertension (55% vs 43%, P = 0.023) were higher in the vitamin D deficiency group compared with the group without deficiency. After multiparametric adjustments (for age, gender, obesity, comorbidities, and seasonality), hypertension (odds ratio [OR] = 2.338, 95% confidence interval [CI] = 1.257-4.349, P = 0.007), excessive daytime sleepiness (ESS >10; OR = 3.345, 95% CI = 1.124-9.948, P = 0.029), depressive symptoms (BDI >10; OR = 3.769, 95% CI = 0.984-14.443, P = 0.04), and fatigue (FSS >36; OR = 7.157, 95% CI = 0.855-59.877, P = 0.04) showed significant independent associations with vitamin D deficiency in specific subgroups of patients. CONCLUSION A large proportion of patients in primary care had vitamin D deficiency, independently associated with hypertension, sleepiness, depressive symptoms, and fatigue. Further research is needed in order to determine the role of vitamin D in these patients.
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Affiliation(s)
- Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece.,Primary Care Health Center of Kastelli, Heraklion, Crete, Greece.,Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Manolis Markakis
- Primary Care Health Center of Kastelli, Heraklion, Crete, Greece
| | - Rodanthi Pateli
- Primary Care Health Center of Kastelli, Heraklion, Crete, Greece
| | - Ioannis Lyronis
- Primary Care Health Center of Kastelli, Heraklion, Crete, Greece
| | - Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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18
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Al-Musharaf S. Changes in Sleep Patterns during Pregnancy and Predictive Factors: A Longitudinal Study in Saudi Women. Nutrients 2022; 14:nu14132633. [PMID: 35807814 PMCID: PMC9268456 DOI: 10.3390/nu14132633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess sleep patterns during the three trimesters of pregnancy and whether vitamin D concentrations, along with other risk factors, are associated with these alterations. In a longitudinal study, 140 pregnant women (age 18 to 39 years) were followed throughout their first, second, and third trimesters. Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) at each trimester, along with an assessment of biochemical parameters, including serum vitamin D levels. The information that was collected included anthropometric data, socio-economic status, dietary intake, and physical activity. The PSQI was higher in mid and late pregnancy than in early pregnancy (both p = 0.001), and the sleep duration was also higher in late versus early pregnancy. Linear regression analyses revealed independent predictors of deteriorating sleep quality from early to late pregnancy, including low income (B ± SE â0.60 ± 0.26, p = 0.03) and low serum vitamin D levels in the second trimester (B ± SE â0.20 ± 0.01, p = 0.04). Energy intake and sitting in the second half of pregnancy were positively associated with changes in the PSQI score from the second to third trimesters (B ± SE 0.15 ± 0.07, p = 0.048) and (B ± SE 0.01 ± 0.00, p = 0.044), respectively. Low socio-economic status, low serum vitamin D levels, greater energy intake, and sitting time were associated with worsening patterns of sleep quality from early to late pregnancy.
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Affiliation(s)
- Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
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19
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Irfan SA, Ali AA, Shabbir N, Altaf H, Ahmed A, Thamara Kunnath J, Divya Boorle NVL, Miguel AK, Loh CC, Gandrakota N, Ali Baig MM. Effects of Vitamin D on Systemic Lupus Erythematosus Disease Activity and Autoimmunity: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e25896. [PMID: 35844337 PMCID: PMC9278795 DOI: 10.7759/cureus.25896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
This study aims to assess the role of vitamin D on systemic lupus erythematosus (SLE) patients and its effects on systemic lupus erythematosus disease activity index (SLEDAI), anti-double-stranded DNA (anti-dsDNA), C3, C4, and fatigue in patients with SLE. A systemic search was conducted using three electronic databases, i.e., PubMed/Medline, Cochrane Library, and Google Scholar. Review Manager 5.4.1 (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) was employed for statistical analysis. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the result was reported in the standard mean difference (SMD) with its corresponding 95% confidence interval. Six randomized controlled trials were selected. Five outcomes were assessed (SLEDAI, anti-dsDNA, C3, C4, and fatigue) to evaluate the role of vitamin D in SLE patients. A significant decrease in SLEDAI (SMD = -0.85 (-1.12, -0.58); p < 0.00001; I2 = 42%) and a non-significant decrease in anti-dsDNA (SMD = -0.09 (-0.03, 0.12); p = 0.42; I2 = 0%) was noted. A significant increase in levels of C3 (SMD = 0.30 (0.09, 0.51); p = 0.006; I2 = 0%) and fatigue (SMD = -1.27 (-2.38, -0.16); p = 0.02; I2 = 56%) was noted when vitamin D was used. Insignificant difference was observed in C4 (SMD = 0.20 (-0.02, 0.41); p = 0.07; I2 = 0%). Vitamin D in SLE patients showed a significant decrease in SLEDAI scores and a significant increase in C3 levels. The effect of vitamin D on fatigue was inconclusive. No significant difference in anti-dsDNA and C4 levels was noted.
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20
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Mirzaei-Azandaryani Z, Abdolalipour S, Mirghafourvand M. The effect of vitamin D on sleep quality: A systematic review and meta-analysis. Nutr Health 2022; 28:515-526. [PMID: 35578558 DOI: 10.1177/02601060221082367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Poor sleep quality is a common problem in the general population that affects the quality of life of individuals. Aim: This systematic review aimed to determine the effect of vitamin D on sleep quality (primary outcome) and side effects (secondary outcome). Methods: A systematic search was performed using Cochrane Library, PubMed, Embase, Web of Sciences, Scopus, Google Scholar, SID, and Magiran databases with no limit at the time of publication. Cochrane collaboration instrument was used to evaluate the quality of the included studies. RevMan software was used for meta-analysis. Mean Difference was calculated due to the same sleep quality measurement tools in all studies. Heterogeneity of studies was assessed using I-squared (I2). Due to high heterogeneity (I2â>â75%), Random Effect was used instead of Fixed Effect. Results: Out of a total of 1637 titles and abstracts found, after removing duplicate items (23 items), 1596 items were removed due to irrelevance and lack of inclusion criteria. 18 articles were fully studied due to insufficient abstract information and finally, 5 articles were entered into systematic review and meta-analysis. The results of the meta-analysis showed that the use of vitamin D supplementation significantly improves sleep quality (MD: -1.32; 95%CI: -2.55 to -0.09; Pâ=â0.04). Conclusions: Also, according to the findings of this study, receiving vitamin D supplementation did not cause any side effects. According to the results of this review study, sleep quality in people receiving vitamin D significantly improved compared to the control group.
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Affiliation(s)
- Zahra Mirzaei-Azandaryani
- Department of Midwifery, Students Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somyieh Abdolalipour
- Department of Midwifery, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Faculty of Nursing and Midwifery, Social determinants of Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
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de Menezes JĂșnior LAA, Fajardo VC, de Freitas SN, Machado-Coelho GLL, de Oliveira FLP, do Nascimento Neto RM, Meireles AL. Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea. Sleep Breath 2022; 27:727-735. [DOI: 10.1007/s11325-022-02603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/04/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
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Vitamin D and Parkinson's Disease. Nutrients 2022; 14:nu14061220. [PMID: 35334877 PMCID: PMC8953648 DOI: 10.3390/nu14061220] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin D is a fat-soluble secosteroid, traditionally considered a key regulator of bone metabolism, calcium and phosphorous homeostasis. Its action is made possible through the binding to the vitamin D receptor (VDR), after which it directly and indirectly modulates the expression of thousands of genes. Vitamin D is important for brain development, mature brain activity and associated with many neurological diseases, including Parkinsonâs disease (PD). High frequency of vitamin D deficiency in patients with Parkinsonâs disease compared to control population was noted nearly twenty years ago. This finding is of interest given vitamin Dâs neuroprotective effect, exerted by the action of neurotrophic factors, regulation of nerve growth or through protection against cytotoxicity. Vitamin D deficiency seems to be related to disease severity and disease progression, evaluated by Unified Parkinsonâs Disease Rating Scale (UPDRS) and Hoehn and Yahr (H&Y) scale, but not with age of PD onset and duration of disease. Additionally, fall risk has been associated with lower vitamin D levels in PD. However, while the association between vitamin D and motor-symptoms seems to be possible, results of studies investigating the association with non-motor symptoms are conflicting. In addition, very little evidence exists regarding the possibility to use vitamin D supplementation to reduce clinical manifestations and disability in patients with PD. However, considering the positive balance between potential benefits against its limited risks, vitamin D supplementation for PD patients will probably be considered in the near future, if further confirmed in clinical studies.
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Heybeli C, Soysal P, Oktan MA, Smith L, Ăelik A, Kazancioglu R. Associations between nutritional factors and excessive daytime sleepiness in older patients with chronic kidney disease. Aging Clin Exp Res 2022; 34:573-581. [PMID: 34448151 DOI: 10.1007/s40520-021-01966-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/17/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Excessive daytime sleepiness (EDS) is prevalent in not only older adults, but also patients with chronic kidney disease (CKD), and is associated with higher risks of morbidity and mortality. AIMS The aim of the present study is to determine associations between EDS and nutritional status and serum nutrient levels in older patients with CKD. METHODS This cross-sectional study included 367 patients (agedââ„â65 years) with CKD (eGFRâ<â60 ml/min/1.73 m2 and/orâ>â30 mg/day of albuminuria forâ>â3 months). EDS was recorded using the Epworth Sleepiness Scale (a score ofââ„â11). Malnutrition was diagnosed according to the Mini Nutritional Assessment (MNA) tool (a score ofâ<â17). RESULTS The mean age was 81â±â7 years, and 248 (67%) were female. EDS was seen in 99 (26.9%) patients. Those with EDS had significantly lower MNA scores and more frequent malnutrition than those without EDS (pâ<â0.05). In multivariable analysis adjusted for age, sex, cerebrovascular disease, dementia, number of drugs, and number of urinations at night, and the Charlson Comorbidity Index the relationship between malnutrition and EDS persisted (OR 2.58, 95% CI 1.38-4.83, pâ=â0.003). There was no significant difference between the presence of EDS and serum levels or deficiencies of vitamin D, vitamin B12, and folate (pâ>â0.05). CONCLUSIONS EDS is associated with malnutrition in older patients with CKD. Therefore, EDS and nutritional status should be evaluated together in clinical practice. However, future studies are needed to determine the direction of the association between malnutrition and EDS and to evaluate if dietary intervention can improve EDS.
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Affiliation(s)
- Cihan Heybeli
- Division of Nephrology, BaĆkent University Faculty of Medicine, Ä°zmir ZĂŒbeyde Hanım Application and Research Centre, Ä°zmir, Turkey.
| | - Pinar Soysal
- Division of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Asi Oktan
- Division of Nephrology, BaĆkent University Faculty of Medicine, Ä°zmir ZĂŒbeyde Hanım Application and Research Centre, Ä°zmir, Turkey
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK
| | - Ali Ăelik
- Division of Nephrology, BaĆkent University Faculty of Medicine, Ä°zmir ZĂŒbeyde Hanım Application and Research Centre, Ä°zmir, Turkey
| | - Rumeyza Kazancioglu
- Division of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Hamit G, Ayca O, Omer B, Nevra O, Aynur O. Association of circadian locomotor output cycles kaput rs1801260 and hypocretin receptor 1 rs2271933 polymorphisms in patients with chronic migraine and sleep disorder. NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_195_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Bahrami A, Rezaeitalab F, Farahmand SK, Mazloum Khorasani Z, Arabi SM, Bahrami-Taghanaki H, Ferns GA, Ghayour-Mobarhan M. High-dose Vitamin D Supplementation and Improvement in Cognitive Abilities, Insomnia, and Daytime Sleepiness in Adolescent Girls. Basic Clin Neurosci 2021; 12:339-348. [PMID: 34917293 PMCID: PMC8666927 DOI: 10.32598/bcn.2021.1910.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/10/2019] [Accepted: 09/02/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Vitamin D may affect the modulation of signaling pathways in the central nervous system. We aimed to evaluate the effect of high-dose vitamin D supplementation on neuropsychological functions in female adolescents. Methods: We studied the effects of 9 weeks of vitamin D supplementation (50000 IU vitamin D3 [cholecalciferol]/week) on cognitive abilities and sleep disorders in 940 adolescent girls. Results: Oral vitamin D supplementation improved cognitive abilities, including memory, inhibitory control, selective attention, decision making, planning, sustained attention, and cognitive flexibility in healthy adolescent girls (P<0.001). The prevalence of subjects with insomnia after intervention fell from 15.0% to 11.3%. Similar results were also found for the prevalence of sleepiness (15.6% reduced to 14.7%), or cases with both insomnia and sleepiness (8.0% reduced to 6.1%; P<0.05). Conclusion: High dose of vitamin D can improve cognitive abilities and alleviate insomnia and daytime sleepiness in adolescent girls. Further investigations are required on different population groups (age and gender) to determine the sustainability of these effects. The value of vitamin D therapy in other neurological disorders would also be of research interest.
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Affiliation(s)
- Afsane Bahrami
- Cellular and Molecular Research Center, School of Medicine, Birjand University of Medical Sciences, Bijand, Iran
| | - Fariborz Rezaeitalab
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Kazem Farahmand
- Department of Traditional Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mazloum Khorasani
- Endocrine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mostafa Arabi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Bahrami-Taghanaki
- Chinese and Complementary Medicine Research Center, School of Traditional and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, School of Brighton & Sussex Medical, University of Brighton and the University of Sussex, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- Metabolic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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26
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Al-Khudhairy MW, AlOtaibi A, AbdulRahman L, Al-Garni M, Yaslam R, Fatani R. The Association of Self-Reported Iron and Vitamin D Levels on Sleep Quality and Pain Perception in a Subset of Saudi Population. Risk Manag Healthc Policy 2021; 14:4853-4865. [PMID: 34880694 PMCID: PMC8647758 DOI: 10.2147/rmhp.s318698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- May Wathiq Al-Khudhairy
- Oral Biology, Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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Larsen AU, Hopstock LA, Jorde R, Grimnes G. No improvement of sleep from vitamin D supplementation: insights from a randomized controlled trial. Sleep Med X 2021; 3:100040. [PMID: 34881361 PMCID: PMC8567000 DOI: 10.1016/j.sleepx.2021.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Vitamin D has been linked to sleep health in observational studies. Data from randomized controlled trials (RCTs) with vitamin D is scarce. Methods This study presents the results of a secondary analysis of 189 vitamin D insufficient participants (47.1% women) in a previously performed RCT, of which 92 were randomized to vitamin D (100,000 IU (2500 Όg) as a bolus dose followed by 20,000 IU (500 Όg) per week), and 97 to placebo. At baseline and after 4 months at the end of the study serum 25-hydroxyvitamin D (s-25(OH)D) was measured, and the study questionnaire assessing sleep duration, daytime sleepiness, and symptoms of insomnia, was completed. Results At baseline, mean s-25(OH)D was 35.0 ± 11.8 and 35.5 ± 13.3 nmol/L in the vitamin D and placebo groups, respectively. After four months, we found no statistically significant differences between the intervention groups in any of the assessed sleep outcomes, neither when stratified by sex, nor when performed in subgroups based on baseline or end of study s-25(OH)D level or presence of sleep complaints at baseline. Conclusions We were not able to demonstrate a significant effect of vitamin D supplementation on sleep in this vitamin D insufficient population. RCT investigating vitamin D for 4 months in participants with low vitamin D status. Vitamin D did not improve sleep duration, excessive daytime sleepiness or insomnia. The role of vitamin D in sleep health remains controversial.
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Affiliation(s)
- A U Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, TromsĂž, Norway
| | - L A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, TromsĂž, Norway
| | - R Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, TromsĂž, Norway
| | - G Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, TromsĂž, Norway.,Division of Internal Medicine, University Hospital of North Norway, TromsĂž, Norway
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de Oliveira DL, Dokkedal-Silva V, Fernandes GL, Kim LJ, Tufik S, Andersen ML. Sleep duration as an independent factor associated with vitamin D levels in the EPISONO cohort. J Clin Sleep Med 2021; 17:2439-2449. [PMID: 34170232 DOI: 10.5664/jcsm.9452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea and short sleep duration have been separately associated with inadequate serum 25-hydroxyvitamin D [25(OH)D] levels. However, whether these 2 factors may concurrently influence 25(OH)D in the general population is unknown. We hypothesized that both obstructive sleep apnea and short sleep duration would be independently associated with lower concentrations of 25(OH)D in a sex-dependent manner. METHODS In this cross-sectional study, 712 individuals, part of the prospective EPISONO cohort (Brazil), underwent polysomnography, answered sleep questionnaires, and had their blood collected for serum 25(OH)D quantification. RESULTS Individuals with a sleep duration of < 6 hours had 2-fold increased odds of 25(OH)D < 20 ng/mL compared with those who reported 6 or more hours of sleep, even after adjusting for confounding factors. Subset sex analysis revealed that men with a sleep duration of < 6 hours had 4-fold increased odds of 25(OH)D < 20 ng/mL. In women, short sleep duration was not associated with lower 25(OH)D levels. The presence of obstructive sleep apnea (as classified according to the individual's apnea-hypopnea index) was not independently related to 25(OH)D concentrations in men or women. Sleep parameters, including sleep latency and sleep efficiency, had no association with 25(OH)D < 20 ng/mL. CONCLUSIONS Short sleep, but not apnea-hypopnea index, was an independent factor associated with low 25(OH)D serum levels in men, but not in women. Apnea-hypopnea index scores were not associated with 25(OH)D levels in either sex. These results raise the possibility of investigating sex-specific characteristics, such as gonadal hormone regulation, and re-evaluating obstructive events by classifying them in mild, moderate, and severe obstructive sleep apnea. CITATION de Oliveira DL, Dokkedal-Silva V, Fernandes GL, Kim LJ, Tufik S, Andersen ML. Sleep duration as an independent factor associated with vitamin D levels in the EPISONO cohort. J Clin Sleep Med. 2021;17(12):2439-2449.
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Affiliation(s)
- Daniela Leite de Oliveira
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
| | - VinĂcius Dokkedal-Silva
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
| | - Guilherme Luiz Fernandes
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
| | - Lenise Jihe Kim
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
| | - Monica Levy Andersen
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil *Contributed equally
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Investigating Vitamin D and Sleep Quality. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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El-Baz FM, Abdelsayed MGR, Abdel-Hafeez AS, Abdelmageed RI. Decreased vitamin D levels in children with primary mono-symptomatic nocturnal enuresis. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2021. [DOI: 10.1186/s43042-021-00191-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nocturnal enuresis (NE) is a common voiding problem in pediatric populations. Relatively, few studies have investigated the 25-Hydroxyvitamin D and NE associations in children, which may open up a new research area on the effect of vitamin D as nutritional therapy in the treatment of NE. The aim of this study was to determine the level of 25-hydroxyl vitamin D among children and adolescents with nocturnal enuresis in comparison to non-enuretic Egyptian children.
Results
Fifty children (24 females, 26 males) who presented with primary mono-symptomatic nocturnal enuresis (PMNE) and 50 healthy children (23 females, 27 males) were recruited in this study. A structured questionnaire focusing on demographic, socioeconomic, and frequency of bed-wetting were collected, and vitamin D serum levels were assessed in all children. In the NE group, the mean value of serum vitamin D levels was lower than the control (19.0â±â6.5 versus 23.89â±â4.19; Pâ<â0.0001). Serum 25-hydroxyvitamin D levels were abnormal (<â20 ng/mL) in 46% of children with NE and 16% of controls (Pâ<â0.001). The higher bed-wetting frequencies were associated with lower levels of 25(OH) D (Every night: 7.0â±â1.4, 3â5 time/week: 11.2â±â1.7, 1â3 times/week: 17.6â±â3.7,â<â2times/week: 22.4â±â2.9, Once/6 month: 24.1â±â4.3 (ng/ml), Pâ<â0.001).
Conclusion
A difference in serum 25-hydroxyvitamin D levels was found between the two study groups. There is a need for more studies to explain vitamin D deficiency in larger series so that this test can be used in regular enuretic child investigations.
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Koc Okudur S, Soysal P. Excessive Daytime Sleepiness is Associated With Malnutrition, Dysphagia, and Vitamin D Deficiency in Older Adults. J Am Med Dir Assoc 2021; 22:2134-2139. [PMID: 34181909 DOI: 10.1016/j.jamda.2021.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Both excessive daytime sleepiness (EDS) and nutritional deficiencies are common and can cause similar negative consequences, such as falls, and cognitive impairment in older adults, but there is no study investigating the relationship between the two. The aim of this study is to investigate the relationship between malnutrition/micronutrient deficiency and EDS in patients with and without dementia. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS A total of 800 outpatients (243 of whom had dementia), aged â„65 years, were included. METHODS All patients underwent comprehensive geriatric assessment. Mini Nutritional Assessment (MNA) scores >23.5, 17-23.5, or <17 were categorized as well-nourished, malnutrition risk, and malnutrition, respectively. Eating Assessment Tool score of â„3 was accepted as dysphagia. Serum vitamin B12, vitamin D, and folate deficiencies were also evaluated. The Epworth Sleepiness Scale score of â„11 points indicated EDS. RESULTS The mean age was 79.1±7.5 years. The prevalence of EDS was 22.75%. In patients with dementia, those with EDS had significantly lower MNA scores and more frequent dysphagia (P < .05). In patients without dementia, those with EDS have lower MNA scores than those without EDS; malnutrition, dysphagia, and vitamin D deficiency were higher (P < .05). In multivariable analysis adjusted for age, gender, living status, ischemic heart disease, cerebrovascular events, polypharmacy, dementia, and insomnia, the association between EDS and malnutrition [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.37-2.20], dysphagia (OR 2.01, 95% CI 1.33-2.88), and vitamin D deficiency (OR 2.0, 95% CI 1.12-3.55) persisted. CONCLUSIONS AND IMPLICATIONS There is a significant relationship between EDS and malnutrition risk, dysphagia, and vitamin D deficiency in older adults. Therefore, when examining an older patient with EDS, dysphagia, malnutrition, and vitamin D levels should be evaluated, or EDS should be investigated in an older patient with malnutrition, dysphagia, and vitamin D deficiency. Thus, it will be possible to manage all these conditions more effectively.
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Affiliation(s)
- Saadet Koc Okudur
- Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
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Lee HJ, Choi H, Yoon IY. Impacts of serum vitamin D levels on sleep and daytime sleepiness according to working conditions. J Clin Sleep Med 2021; 16:1045-1054. [PMID: 32108568 DOI: 10.5664/jcsm.8390] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES Low serum vitamin D levels are known to be associated with working conditions and poor sleep, but precedent studies on this issue were limited by the absence of objective sleep measurements or clear distinction between daytime and night shift work. Hence, we aimed to examine serum vitamin D levels and sleep in daytime and night-shift workers using actigraphy. METHODS A total of 412 night-shift and 432 daytime workers at Seoul National University Bundang Hospital was recruited. All participants completed questionnaires regarding demographic and clinical characteristics. They underwent blood tests for serum vitamin D levels. Objective sleep data were obtained from 150 night-shift workers and 203 daytime workers using actigraphy. RESULTS There was no significant difference in serum vitamin D levels between night-shift and daytime workers after controlling for possible confounders. In daytime workers, vitamin D deficiency was closely related to shorter duration of total sleep time (odds ratio [OR]: 3.07, 95% confidence interval [CI]: 1.51-6.26, P = .002) and higher risk of excessive daytime sleepiness (OR: 2.20, 95% CI: 1.30-3.74, P = .003). Deficient vitamin D was also associated with life quality impairment regarding psychological health (OR: 1.83, 95% CI: 1.07-3.29, P = .028) and social relationship (OR: 1.78, 95% CI: 1.10-2.88, P = .020). However, in night-shift workers, no significant association was observed between serum vitamin D level and sleep parameters, depressive/anxiety symptoms, or quality of life. CONCLUSIONS The modest adverse impact of poor vitamin D status on sleep could be attenuated by substantial shift work-related sleep disturbances in night-shift workers. Further studies might be needed to clarify the beneficial effect of vitamin D supplementation for improving sleep and daytime sleepiness in workers with various working conditions.
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Affiliation(s)
- Hyuk Joo Lee
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hayun Choi
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Korea
| | - In-Young Yoon
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Abstract
STUDY OBJECTIVES The impact of vitamin D on human health including sleep has been well described in adults. Its deficiency has been associated with multiple sleep disorders such as decrease in sleep duration, worsening of sleep quality, and even OSA. Such correlation is less evident in the pediatric population. In the current study, we examined the relationship between sleep architecture and vitamin D status in children referred to a sleep clinic. METHODS This was a retrospective-cohort study in a tertiary care children's hospital over a 1-year period. Children who underwent an in-laboratory overnight-polysomnogram and had a 25-hydroxy vitamin D level obtained within 120 days of the sleep study were included. Patients with OSA or central sleep apnea were excluded. Data from polysomnograms and Pediatric Sleep Questionnaires were collected and analyzed. RESULTS A total of 39 patients (mean age, 6.6 years; 46% female) were included in the study. Twenty (51%) patients had vitamin D deficiency (25-hydroxy vitamin D level < 30 ng/mL). Children with vitamin D deficiency had less total sleep time (470.3 minutes ± 35.6 vs 420.3 minutes ± 61.7; P = .004) and poorer sleep efficiency (91.9% ± 5.6% vs 84.5% ± 9.5%; P = .015) compared with children with sufficient vitamin D. In addition, children with vitamin D deficiency had later weekday bedtimes (21:02 Pm ± 1:01 vs 20:19 Pm ± 0:55; P = .037) and later weekend bedtimes (21:42 Pm ± 0:59 vs 20:47 Pm ± 1:08; P = .016) than children with sufficient vitamin D, with a tendency for later wake time that did not reach statistical significance. The remainder of the polysomnogram findings and Pediatric Sleep Questionnaire data were not different between the 2 groups. CONCLUSIONS Vitamin D deficiency in children was associated with objectively measured decreased sleep duration and poorer sleep efficiency. Furthermore, vitamin D deficiency was associated with delayed bedtimes, suggesting that vitamin D and circadian rhythm could be related. Future prospective studies in children would be helpful to learn if vitamin D deficiency leads to sleep disturbance or vice versa.
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Affiliation(s)
- Baha Al-Shawwa
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Zarmina Ehsan
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - David G Ingram
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
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ILKHAN G, CELÄ°KHÄ°SAR H, KILAVUZ A. The evaluation of sleep quality, anxiety disorder and depression in older adults with Parkinson disease. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.848699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Vitti-Ruela BV, Dokkedal-Silva V, Hachul H, Tufik S, Andersen ML. Melatonin and vitamin D: complementary therapeutic strategies for breast cancer. Support Care Cancer 2021; 29:3433-3434. [PMID: 33677716 DOI: 10.1007/s00520-021-06115-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/26/2021] [Indexed: 12/12/2022]
Affiliation(s)
| | - VinĂcius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de SĂŁo Paulo (UNIFESP), Rua NapoleĂŁo de Barros, 925, SĂŁo Paulo, 04024-002, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de SĂŁo Paulo (UNIFESP), Rua NapoleĂŁo de Barros, 925, SĂŁo Paulo, 04024-002, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de SĂŁo Paulo (UNIFESP), Rua NapoleĂŁo de Barros, 925, SĂŁo Paulo, 04024-002, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de SĂŁo Paulo (UNIFESP), Rua NapoleĂŁo de Barros, 925, SĂŁo Paulo, 04024-002, Brazil.
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Alkhatatbeh MJ, Hmoud ZL, Abdul-Razzak KK, Alem EM. Self-reported sleep bruxism is associated with vitamin D deficiency and low dietary calcium intake: a case-control study. BMC Oral Health 2021; 21:21. [PMID: 33413308 PMCID: PMC7792220 DOI: 10.1186/s12903-020-01349-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 11/17/2020] [Indexed: 12/26/2022] Open
Abstract
Background Sleep bruxism may result in deleterious effects including loss of tooth enamel,
fracture of teeth or restorations, teeth hypersensitivity or pain, and headache. The aim was to study the link between sleep bruxism, low serum vitamin D, low consumption of dietary calcium, psychological symptoms, and frequent headache. Methods This case-controlled study included 50 individuals with sleep bruxism and 50 age and gender matched controls. 25-hydroxyvitamin D was measured in serum. Hospital Anxiety and Depression Scale was used to measure anxiety and depression. Data about dietary calcium and frequent headache were self-reported. Results Participants with sleep bruxism had lower 25-hydroxyvitamin D and higher scores of anxiety and depression compared to controls (pâ<â0.05). Vitamin D deficiency, abnormal scores of anxiety and depression, low calcium consumption (<â323âmg/day), and frequent headache were reported in higher % of individuals with sleep bruxism compared to controls (pâ<â0.05). Binary logistic regression showed that sleep bruxism was significantly associated with vitamin D deficiency (ORâ=â6.66, pâ=â0.02), low consumption of dietary calcium (ORâ=â5.94, pâ=â0.01), and frequent headache (ORâ=â9.24, pâ<â0.001). Multiple linear regression showed that anxiety was significantly associated with decreased 25-hydroxyvitamin D (pâ=â0.03), increased scores of depression (pâ<â0.001) and female sex (pâ=â0.01). Binary logistic regression also showed that frequent headache was significantly associated with sleep bruxism (ORâ=â5.51, pâ<â0.01). Conclusions Sleep bruxism was associated with vitamin D deficiency and low consumption of calcium and was also associated with increased scores of anxiety and depression. Further investigations should be performed to check if vitamin D and calcium supplementation could relieve sleep bruxism.
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Affiliation(s)
- Mohammad J Alkhatatbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Zainab L Hmoud
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Khalid K Abdul-Razzak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Esam M Alem
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan
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Romano F, Muscogiuri G, Di Benedetto E, Zhukouskaya VV, Barrea L, Savastano S, Colao A, Di Somma C. Vitamin D and Sleep Regulation: Is there a Role for Vitamin D? Curr Pharm Des 2020; 26:2492-2496. [PMID: 32156230 DOI: 10.2174/1381612826666200310145935] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Vitamin D exerts multiple pleiotropic effects beyond its role in calcium-phosphate metabolism. Growing evidence suggests an association between hypovitaminosis D and sleep disorders, thus increasing the interest in the role of this vitamin in the regulatory mechanisms of the sleep-wake cycle. OBJECTIVE The study aimed to explore and summarize the current knowledge about the role of vitamin D in sleep regulation and the impact of vitamin D deficiency on sleep disorders. METHODS The main regulatory mechanisms of vitamin D on sleep are explained in this study. The literature was scanned to identify clinical trials and correlation studies showing an association between vitamin D deficiency and sleep disorders. RESULTS Vitamin D receptors and the enzymes that control their activation and degradation are expressed in several areas of the brain involved in sleep regulation. Vitamin D is also involved in the pathways of production of Melatonin, the hormone involved in the regulation of human circadian rhythms and sleep. Furthermore, vitamin D can affect sleep indirectly through non-specific pain disorders, correlated with alterations in sleep quality, such as restless legs syndrome and obstructive sleep apnea syndrome. CONCLUSION Vitamin D has both a direct and an indirect role in the regulation of sleep. Although vitamin D deficiency has been associated to sleep disorders, there is still scant evidence to concretely support the role of vitamin D supplementation in the prevention or treatment of sleep disturbances; indeed, more intervention studies are needed to better clarify these aspects.
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Affiliation(s)
- Fiammetta Romano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Elea Di Benedetto
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Volha V Zhukouskaya
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
| | - Carolina Di Somma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universita degli Studi di Napoli Federico II, Italy
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Sung M, Rhie S, Kim JH, Lee SW, Ha EK, Jee HM, Yoo EG, Chae KY, Han MY. Assessment of vitamin D, exercise, and lipid profile associated with excessive daytime sleepiness in school children. Sleep Med 2020; 77:51-57. [PMID: 33310114 DOI: 10.1016/j.sleep.2020.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/25/2022]
Abstract
Previous research reported associations of excessive daytime sleepiness (EDS) with a low vitamin D level, obesity, and sexual maturity. The aim of this study was to identify the association and rank the importance of these with EDS. This study examined 618 children who were 10-12 year-old. The pediatric daytime sleepiness scale (PDSS) was used to evaluate EDS and sleep patterns. EDS was defined as a total PDSS score above 17. We ranked the importance of the relationship of these factors with EDS using random forest analysis. EDS (n = 111, 18%) was positively associated with more advanced pubertal stage in girls, chronic cough, urticaria, and allergic rhinitis. Multivariable analysis with adjustment for confounding indicated that children with low level of 25-hydroxyvitaminD3 (25(OH)D3 (<20 ng/mL) and high-density lipoprotein-cholesterol (HDL-C) (<40 mg/dL) levels had an increased risk of EDS (25(OH)D3:adjusted odds ratio [aOR] = 1.73; 95% confidence interval [CI]: 1.06 to 2.81; P = 0.028; HDL-C: aOR = 2.84; 95% CI: 1.05 to 7.68; P = 0.039). Random forest analysis indicated that 25(OH)D3 level, exercise, and body mass index (BMI) were over three. This study indicated high levels of 25-(OH)D3 and HDL-C and performing regular exercise decreased the risk of EDS.
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Affiliation(s)
- Myongsoon Sung
- Department of Pediatrics, Soon Chun Hyang University Gumi Hospital, Soon Chun Hyang, University College of Medicine, Gumi, South Korea
| | - Seonkyeong Rhie
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Ju Hee Kim
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hye Mi Jee
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Eun-Gyong Yoo
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Kyu Young Chae
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
| | - Man Yong Han
- Departments of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
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Ć iarnik P, JurĂk M, HardoĆovĂĄ M, KlobuÄnĂkovĂĄ K, Veverka J, Ć urda P, TurÄĂĄni P, KollĂĄr B. Excessive daytime sleepiness in sleep apnea: any role of testosterone or vitamin D? Physiol Res 2020; 69:907-917. [PMID: 32901503 DOI: 10.33549/physiolres.934507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Recent studies reported association of sleep-disordered breathing (SDB) with testosterone and vitamin D deficiency. Low testosterone and vitamin D levels have been linked to fatigue and excessive daytime sleepiness (EDS). However, the impact of testosterone and vitamin D deficiency on EDS in subjects with SDB remains unknown. The aim of this study was to explore the predictors of EDS in habitual snorers. Role of testosterone, and vitamin D was studied in detail. We also looked for associations between testosterone, vitamin D, and sleep-related indices. We prospectively enrolled 291 consecutive male patients with habitual snoring. Baseline clinical characteristics were recorded on admission. Standard overnight polysomnography was performed to detect SDB, and Epworth Sleepiness Scale (ESS) was used to assess EDS. Blood samples were obtained in a fasting condition in the morning after polysomnography to determine levels of testosterone and vitamin D. Respiratory disturbance index (RDI) (95 % CI: 1.004-1.024, p=0.005) and the use of antihistamines (95 % CI: 1.083-11.901, p=0.037) were the only independent variables significantly associated with EDS in binary logistic regression analysis. In linear multiple regression analysis, body mass index (BMI) (Beta=-0.282, p<0.001) and oxygen desaturation index (Beta=-0.150, p=0.043) were the only independent variables significantly associated with testosterone levels, and BMI (Beta=-0.142, p=0.016) was the only independent variable significantly associated with vitamin D. We failed to find any independent association of testosterone and vitamin D with subjectively rated EDS among habitual snorers. Our results suggest an independent association between the magnitude of nocturnal desaturation and testosterone levels.
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Affiliation(s)
- P Ć iarnik
- First Department of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic.
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Rizza S, Pietroiusti A, Farcomeni A, Mina GG, Caruso M, Virgilio M, Magrini A, Federici M, Coppeta L. Monthly fluctuations in 25-hydroxy-vitamin D levels in day and rotating night shift hospital workers. J Endocrinol Invest 2020; 43:1655-1660. [PMID: 32342444 DOI: 10.1007/s40618-020-01265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/17/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Epidemiological studies have suggested that indoor hospital employees, either day or night shift workers, are at high risk of metabolic and cardiovascular diseases. Interestingly, previous reports have also described a higher prevalence of vitamin D (25OHD) deficiency among these workers. However, few studies have determined the monthly variations in 25OHD levels in indoor hospital employees. METHODS To address this lack of knowledge, in 2018, during the periodic health surveillance checks at the Service of Occupational Medicine, we measured 25OHD levels in a group of indoor hospital workers (88 rotating night shift workers vs 200 day workers). Each participant received a single annual health surveillance check. RESULTS The mean levels of 25OHD were consistently below the lower limit of the normal range in both groups throughout the year. Only in the summer, day workers but not rotating night shift workers (mean 25.9â±â11.3 ng/ml vs 23.1â±â9.1 ng/ml; pâ=â0.042) showed levels significantly higher than those in the other seasons. This difference remained statistically significant even after correction for study covariates [ÎČâ=â-  1.649 (CIâ- 0.283/- 3.482), pâ=â0.039]. A cosinor analysis confirmed that the difference in the 25OHD levels between groups was present later in the year. CONCLUSIONS We found that relatively young healthy hospital workers, especially those with rotating night shifts, in the absence of significant metabolic risk factors, have a high risk of 25OHD deficiency/insufficiency. Because 25OHD deficiency may lead to a progression to more severe conditions such as osteoporosis or bone fractures, our results should be verified in larger cohorts including different ancestries.
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Affiliation(s)
- S Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - A Pietroiusti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - A Farcomeni
- Department of Economics and Finance, University of Rome Tor Vergata, Rome, Italy
| | - G G Mina
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - M Caruso
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - M Virgilio
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - A Magrini
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - M Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - L Coppeta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Wang M, Zhou T, Li X, Ma H, Liang Z, Fonseca VA, Heianza Y, Qi L. Baseline Vitamin D Status, Sleep Patterns, and the Risk of Incident Type 2 Diabetes in Data From the UK Biobank Study. Diabetes Care 2020; 43:2776-2784. [PMID: 32847829 PMCID: PMC7576418 DOI: 10.2337/dc20-1109] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/24/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Circulating vitamin D concentrations have been associated with the risk of type 2 diabetes (T2D), but the results are inconsistent. Emerging evidence suggests that vitamin D metabolism is linked to sleep behaviors. We investigated the prospective association between serum 25-hydroxyvitamin D (25OHD) and the risk of incident T2D and whether such association was modified by sleep behaviors. RESEARCH DESIGN AND METHODS The study included 350,211 individuals free of diabetes in the UK Biobank. Serum 25OHD (nmol/L) concentrations were measured. Five sleep behaviors including sleep duration, insomnia, snoring, chronotype, and daytime sleepiness were included to generate overall sleep patterns, defined by healthy sleep scores. We also calculated genetic risk scores of sleep patterns. RESULTS During a median follow-up of 8.1 years, we documented 6,940 case subjects with incident T2D. We found that serum 25OHD was significantly associated with a lower risk of incident T2D, and the multivariate adjusted hazard ratio (HR) (95% CI) per 10 nmol/L increase was 0.88 (0.87-0.90). We found a significant interaction between 25OHD and overall sleep patterns on the risk of incident T2D (P for interaction = 0.002). The inverse association between high 25OHD and T2D was more prominent among participants with healthier sleep patterns. Among the individual sleep behaviors, daytime sleepiness showed the strongest interaction with 25OHD (P for interaction = 0.0006). The reduced HR of T2D associated with high 25OHD appeared to be more evident among participants with no frequent daytime sleepiness compared with those with excessive daytime sleepiness. The genetic variations of the sleep patterns did not modify the relation between 25OHD and T2D. CONCLUSIONS Our study indicates that higher serum 25OHD concentrations are associated with a lower risk of incident T2D, and such relations are modified by overall sleep patterns, with daytime sleepiness being the major contributor.
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Affiliation(s)
- Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Vivian A Fonseca
- Section of Endocrinology, Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Allahyari E, Hanachi P, Ariakia F, Kashfi TE, Ferns GA, Bahrami A, Mobarhan MG. The relationship between neuropsychological function and responsiveness to vitamin D supplementation using artificial neural networks. Nutr Health 2020; 26:285-294. [PMID: 32669041 DOI: 10.1177/0260106020937190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vitamin D has recently attracted interest for its pleiotropic effects. Vitamin D supplements are a potentially important public health intervention, but the response to supplementation varies between individuals. AIM We aimed to assess the association between several neuropsychological parameters and the magnitude of response to vitamin D supplementation using an artificial neural network method. METHODS Neuropsychological function was assessed in 619 participants using standard questionnaires. The study participants received vitamin D capsules containing 50,000 IU vitamin D per week over 9 weeks. To assess the relationship between responsiveness to vitamin D supplements and the impact on these neuropsychological parameters, the best-performing artificial neural network algorithms were selected from a combination of different transfer functions in hidden and output layers and variable numbers of hidden layers (between two and 50). The performance of the artificial neural network algorithm was assessed by receiver operating characteristic analysis and variables of importance were identified. RESULTS The artificial neural network algorithm with sigmoid transfer function in both hidden and output layers could predict responsiveness to vitamin D supplementation effectively. The sensitivity and specificity were between 0.60 and 0.70 and 0.66 and 0.70, respectively. Cognitive abilities (42.5%), basal vitamin D (21.3%), body mass index (9.5%), and daytime sleepiness (8%) are the most widely used variables to predict changes in serum vitamin D levels. CONCLUSIONS Cognitive abilities status and baseline 25-hydroxyvitamin D are important novel modifiers of the enhancement in circulating 25-hydroxyvitamin D after vitamin D supplementation.
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Affiliation(s)
- Elahe Allahyari
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research Center, 125609Birjand University of Medical Sciences, Birjand, Iran
| | - Parichehr Hanachi
- Department of Biology, Biochemistry Unit, 48408Al Zahra University, Tehran, IR Iran
| | - Fatemeh Ariakia
- Department of Biochemistry, School of Medical, Iran University of Medical Sciences, Tehran, Iran
| | - Toktam Emami Kashfi
- Department of Motor Behavior, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Gordon A Ferns
- 1949Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Afsane Bahrami
- Cellular and Molecular Research Center, 125609Birjand University of Medical Sciences, Birjand, Iran
| | - Majid Ghayour Mobarhan
- Metabolic Syndrome Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
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Bouloukaki I, Tsiligianni I, Mermigkis C, Bonsignore MR, Markakis M, Pataka A, Steiropoulos P, Ermidou C, Alexaki I, Tzanakis N, Schiza S. Vitamin D deficiency in patients evaluated for obstructive sleep apnea: is it associated with disease severity? Sleep Breath 2020; 25:1109-1117. [PMID: 32648186 DOI: 10.1007/s11325-020-02142-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/25/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The aim of the present study was to assess vitamin D levels in a large cohort of OSA patients and to investigate possible correlations with clinical and polysomnographic parameters. METHODS In this cross-sectional study, 685 consecutive patients underwent type 1 polysomnography (PSG) for OSA diagnosis. They were grouped according to apnea-hypopnea index (AHI) as mild, moderate, and severe. Patients with AHIâ<â5 served as controls. Demographic, PSG data, and serum levels of vitamin D were measured and compared between groups. RESULTS OSA was diagnosed in 617 of the patients (90%). Of those, 94 (15%) had mild OSA, 150 (24%) moderate OSA, and 373 (61%) severe OSA. The risk of vitamin D deficiency (<â20Â ng/mL) was observed in 38% of the cohort. OSA patients had lower vitamin D levels compared to controls (23Â ng/mL vs 26Â ng/mL, pâ=â0.006). The lowest levels of vitamin D [mean 21] (pâ<â0.001 among all groups) and the higher prevalence for vitamin D deficiency (45%) were observed in severe OSA patients. After multiparametric adjustments for age, gender, obesity, and comorbidities, severe OSA showed significant independent associations with the risk of vitamin D deficiency [OR (95% CI) 2.002 (1.049-3.819), pâ=â0.035]. CONCLUSIONS A large proportion of patients referred for OSA evaluation had vitamin D deficiency, which was independently associated with severe OSA. However, further research is needed in order to determine the role of vitamin D in OSA patients.
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Affiliation(s)
- Izolde Bouloukaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece. .,Primary Care Health Center of Kastelli, Heraklion, Crete, Greece.
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Charalampos Mermigkis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece
| | | | - Manolis Markakis
- Primary Care Health Center of Kastelli, Heraklion, Crete, Greece
| | - Athanasia Pataka
- Department of Respiratory Medicine, Respiratory Failure Unit, G. Papanikolaou Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paschalis Steiropoulos
- Sleep Unit, Department of Pneumonology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christina Ermidou
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece
| | - Ioanna Alexaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece
| | - Nikolaos Tzanakis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece
| | - Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, Voutes Campus, GR-71003, Heraklion, Crete, Greece
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Relationship between Sleep Duration, Sun Exposure, and Serum 25-Hydroxyvitamin D Status: A Cross-sectional Study. Sci Rep 2020; 10:4168. [PMID: 32144371 PMCID: PMC7060268 DOI: 10.1038/s41598-020-61061-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 02/20/2020] [Indexed: 11/08/2022] Open
Abstract
Normal-range sleep duration is an important factor for general health and metabolism, and insufficient or excessive sleep is associated with chronic metabolic disease. Among the many factors that affect sleep duration, sun exposure plays an important role in maintaining regular circadian rhythm and is also involved in the production and activation of 25-hydroxyvitamin D [25(OH)D], which regulates various functions in the body. However, 25(OH)D is available through food and various nutritional supplements without sun exposure, so it is important to find out the complex relationship among sun exposure, vitamin D status, and sleep duration. The relationship between sun exposure, vitamin D status, and sleep duration was analyzed in the nationwide survey and examination of 25,534 study populations, after adjusting for demographic characteristics, physical characteristics, lifestyle status, and socio-demographic variables. Vitamin D status alone did not show the relationship with sleep duration, although there were statistical relationships in the various factors including sun exposure with sleep duration. There was a statistical difference in 25(OH)D according to sleep duration, only in low sun exposure group. Subjects with low sun exposure and excessive sleep duration comparatively lower 25(OH)D than those with normal-range sleep, even after adjustment for potentially confounding factors. Individuals with limited exposure to sunlight should maintain adequate vitamin D status to have an appropriate sleep duration for health.
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Abstract
PURPOSE To examine if vitamin D deficiency was associated with poor sleep quality in a sample of African American and Hispanic pregnant women. We also examined if race moderates the relationship between serum 25(OH)D levels and sleep quality among participants in this sample. STUDY DESIGN AND METHODS Using a cross-sectional design, a sample of 115 African American and Hispanic pregnant women were enrolled from a federally qualified health center in the Midwest. Women completed questionnaires and had blood drawn for serum 25(OH)D levels between 24- and 32 weeks gestation. The questionnaires included demographic characteristics, the Pittsburgh Sleep Quality Index, and dietary vitamin D and calcium intake. RESULTS The overall regression model indicated that the predictors explained 17% of variance in sleep quality (F(5, 103) = 4.10, p = .002, R = 0.17). Serum 25(OH)D levels were significant predictors of sleep quality after controlling for covariates (i.e., race, maternal age, prepregnancy body mass index, gestational age at data collection). Race did not moderate the association between serum 25(OH)D levels and sleep quality among women in this sample. CLINICAL IMPLICATIONS Pregnant women should be screened for vitamin D deficiency. Women who have vitamin D deficiency should be provided vitamin D supplementation. Vitamin D supplementation may be a simple solution to enhance sleep quality at this critical time in a woman's life.
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Kim SY, Lee MH, Lim WJ, Kim SI, Lee YJ. Associations of 25-Hydroxyvitamin D Levels and Arthritis with Sleep Duration: The Korean National Health and Nutrition Examination Survey 2008-2014. Nat Sci Sleep 2020; 12:883-894. [PMID: 33177906 PMCID: PMC7650027 DOI: 10.2147/nss.s275464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/02/2020] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The mean sleep duration of Koreans is 7 hours 49 minutes, which is the lowest among Organization for Economic Cooperation and Development countries. Although vitamin D deficiency and arthritis are considered modifiable factors influencing restorative sleep, mean vitamin D levels are low (17.33 ng/mL) and arthritis is prevalent among Koreans. This study investigated whether vitamin D deficiency and arthritis increase the risk of short sleep duration. PATIENTS AND METHODS The current study used data from the Korean National Health and Nutrition Examination Survey (KNHANES) for 46,405 Korean adults. Vitamin D levels were measured using a radioimmunoassay kit. Sleep duration and arthritis history were assessed using a self-reported questionnaire. Sleep duration was categorized as optimal (7 to <9 hours/day), short (<7 hours/day), and long (â„9 hours/day). Vitamin D levels were grouped as vitamin D sufficiency (â„20 ng/mL), insufficiency (10-19.99 ng/mL), and deficiency (<10 ng/mL). Multiple imputation was used to compensate for missing data. Multinomial logistic regression was used to examine the associations of vitamin D and arthritis status with sleep duration. The regressions were adjusted for covariates, and each model was adjusted for vitamin D and arthritis. RESULTS Among these participants, 23,078 (49.73%) and 3518 (7.58%) had short and long sleep duration, respectively; 26,724 (57.59%) and 4349 (9.37%) exhibited vitamin D insufficiency and deficiency, respectively; and 4709 (10.15%) were arthritis patients. Compared with vitamin D sufficiency, vitamin D insufficiency and deficiency were associated with short sleep duration (vitamin D insufficiency group: OR = 1.07, 95% CI = 1.01-1.13; vitamin D deficiency group: OR = 1.13, 95% CI = 1.03-1.24). The presence of arthritis was associated with short sleep duration (OR = 1.14, 95% CI = 1.06-1.22) compared with its absence. The interaction between vitamin D deficiency and the presence of arthritis was significantly associated with short sleep duration. However, long sleep duration was not significantly associated with vitamin D levels or arthritis status. CONCLUSION Low vitamin D levels and the presence of arthritis were associated with an increased risk of short sleep duration. Additionally, there was a positive interaction effect between vitamin D deficiency and arthritis on short sleep duration.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Mi Hyun Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
| | - Weon-Jeong Lim
- Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Soo In Kim
- Department of Psychiatry, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
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Deng Y, Wang G, Ye X, Jiang Y, Lin Q, Dong S, Song Y, Zhu L, Meng M, Li W, Zhu Q, Sun W, Jiang F. The association between 25-hydroxyvitamin D levels and children's sleep-wake patterns: a prospective cohort study. Sleep Med 2019; 67:207-214. [PMID: 31952028 DOI: 10.1016/j.sleep.2019.11.1252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/16/2019] [Accepted: 11/20/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To explore the association between vitamin D in cord blood or in venous blood and children's sleep-wake patterns at two years of age. METHODS Data were from 209 children in a birth cohort, Shanghai Sleep Birth Cohort Study (SSBC). 25-Hydroxyvitamin D (25(OH)D) was assessed in cord blood and venous blood samples at two years of age by electrochemiluminescence immunoassay. Children's sleep-wake patterns were measured with the Brief Infant Sleep Questionnaire (BISQ) and Acti-Watch at two years of age. RESULTS The prevalence of vitamin D deficiency (defined as <50 nmol/L) was 50.4% in cord blood and 28% at two years of age. The cord blood 25(OH)D level was not significantly associated with children's sleep at two years of age. Children with 25(OH)D deficiency at two years old had shorter reported and actigraphic night sleep duration (NSD) and total sleep duration (TSD) than those with normal 25(OH)D concentration. 25(OH)D level at two years old was positively associated with night and total sleep duration (ÎČreported-NSD = 0.6, p = 0.011; ÎČreported-TSD = 0.6, p = 0.029; ÎČactigraphic-NSD = 0.82, p = 0.003; ÎČactigraphic-TSD = 0.78, p = 0.006), but was not associated with daytime sleep duration. There was no significant association between 25(OH)D level with night waking duration and midpoint of sleep either measured subjectively or objectively. CONCLUSION We found that not cord blood 25(OH)D level but two-year-old 25(OH)D level was associated with children's sleep-wake patterns at two years of age. These findings suggest more attention should be paid to the assessment of 25(OH)D levels in children with short sleep duration.
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Affiliation(s)
- Yujiao Deng
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiuxia Ye
- Neonatal Intensive Care Unit, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingmin Lin
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shumei Dong
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanjin Song
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lixia Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Meng
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Li
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanqi Sun
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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48
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Qvist N, Bergström I, Ă
kerstedt T, Persson J, Konradsen H, Forss A. From being restrained to recapturing vitality: non-western immigrant women's experiences of undergoing vitamin D treatment after childbirth. Int J Qual Stud Health Well-being 2019; 14:1632111. [PMID: 31232674 PMCID: PMC6598479 DOI: 10.1080/17482631.2019.1632111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 10/27/2022] Open
Abstract
Purpose: Vitamin D deficiency is a complex topic in human health and ill-health and has been studied in a variety of contexts and populations. Few studies examine Vitamin D deficiency among non-western immigrant women and even fewer examine women's perspective on daily life while living with low vitamin D levels after childbirth and undergoing vitamin D treatment. The aim was, therefore, to explore health and ill-health among non-western immigrant women living with low vitamin D levels after childbirth and reaching normalized levels after one year of vitamin D treatment. Method: An explorative qualitative study using qualitative content analysis. Six women aged 25 to 38 years, diagnosed with low 25-hydroxyvitamin D levels during pregnancy, were recruited after having undergone vitamin D treatment. Results: The women told about living a restrained life which gradually transformed into an experience of recaptured vitality. They also experienced a need for continuity in medication, as an interruption of treatment meant returning symptoms. Conclusion: In this study, non-western immigrant women described benefits in everyday life, increased strength, relieved pain and improved sleep quality. The findings can provide valuable knowledge for healthcare providers meeting women with physical weakness, musculoskeletal pain and/or poor sleep quality after childbirth. Further studies using a longitudinal design and larger samples are warranted.
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Affiliation(s)
- Ninni Qvist
- Osteoporosis Center, Inflammation & Infection Theme, Karolinska University Hospital Huddinge, Sweden
| | - Ingrid Bergström
- Osteoporosis Center, Inflammation & Infection Theme, Karolinska University Hospital Huddinge, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Sweden
| | - Torbjörn Ă
kerstedt
- Stress Research Institute, Stockholm University, Sweden
- Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jan Persson
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Sweden
- Behavioral Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | - Anette Forss
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Department of Philosophy, Stony Brook University, New York, USA
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Tobore TO. Towards a comprehensive etiopathogenetic and pathophysiological theory of multiple sclerosis. Int J Neurosci 2019; 130:279-300. [PMID: 31588832 DOI: 10.1080/00207454.2019.1677648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Multiple sclerosis (MS) is a neurodegenerative disease caused by dysfunction of the immune system that affects the central nervous system (CNS). It is characterized by demyelination, chronic inflammation, neuronal and oligodendrocyte loss and reactive astrogliosis. It can result in physical disability and acute neurological and cognitive problems. Despite the gains in knowledge of immunology, cell biology, and genetics in the last five decades, the ultimate etiology or specific elements that trigger MS remain unknown. The objective of this review is to propose a theoretical basis for MS etiopathogenesis.Methods: Search was done by accessing PubMed/Medline, EBSCO, and PsycINFO databases. The search string used was "(multiple sclerosis* OR EAE) AND (pathophysiology* OR etiopathogenesis)". The electronic databases were searched for titles or abstracts containing these terms in all published articles between January 1, 1960, and June 30, 2019. The search was filtered down to 362 articles which were included in this review.Results: A framework to better understand the etiopathogenesis and pathophysiology of MS can be derived from four essential factors; mitochondria dysfunction (MtD) & oxidative stress (OS), vitamin D (VD), sex hormones and thyroid hormones. These factors play a direct role in MS etiopathogenesis and have a modulatory effect on many other factors involved in the disease.Conclusions: For better MS prevention and treatment outcomes, efforts should be geared towards treating thyroid problems, sex hormone alterations, VD deficiency, sleep problems and melatonin alterations. MS patients should be encouraged to engage in activities that boost total antioxidant capacity (TAC) including diet and regular exercise and discouraged from activities that promote OS including smoking and alcohol consumption.
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50
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Zhang H, Zhang J, Mao C, Li K, Wang F, Chen J, Liu C. Relationship between 25-Hydroxyvitamin D, bone density, and Parkinson's disease symptoms. Acta Neurol Scand 2019; 140:274-280. [PMID: 31389003 DOI: 10.1111/ane.13141] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Vitamin D deficiency is widespread in patients with Parkinson's disease (PD). Our aim was to determine whether serum vitamin D levels correlated with bone mineral density (BMD) and non-motor symptoms in patients with PD. MATERIALS & METHODS A consecutive series of 182 patients with PD and 185 healthy controls were included. Serum 25-hydroxyvitamin D (25[OH]D) levels were measured by immunoassay, while BMD of the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. Associations between serum vitamin D levels and clinical data were evaluated using partial correlation analysis. RESULTS Patients with PD had significantly lower serum 25(OH)D levels relative to healthy controls (49.75 ± 14.11 vs 43.40 ± 16.51, P < 0.001). Furthermore, PD patients with lower vitamin D levels had a significantly higher frequency of falls (P = 0.033) and insomnia (P = 0.015). They also had significantly higher scores for the Pittsburgh Sleep Quality Index (PSQI; P = 0.014), depression (P = 0.020), and anxiety (P = 0.009). Finally, patients with PD also had a significantly lower mean BMD of the lumbar spine (P = 0.011) and femoral neck (P < 0.001). After adjusting for age, sex, and body mass index, vitamin D levels significantly correlated with falls, insomnia, and scores for the PSQI, depression, and anxiety. CONCLUSIONS In patients with PD, vitamin D levels significantly correlated with falls and some non-motor symptoms. However, no associations were found between BMD and the serum 25(OH)D levels in patients with PD. Thus, vitamin D supplementation is a potential therapeutic for non-motor PD symptoms.
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Affiliation(s)
- HuiâJun Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
| | - JinâRu Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
| | - ChengâJie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
| | - Kai Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
| | - Fen Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience Soochow University Suzhou China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
| | - ChunâFeng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease The Second Affiliated Hospital of Soochow University Suzhou China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience Soochow University Suzhou China
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