Sleep disorders, vitamin D and skin pigmentation

This article discusses the link between vitamin D deficiency and the increase of the occurrence of sleep disorders.

Vitamin D Deficiency and Daytime Sleepiness: Skin Pigmentation Is a Complicated Factor

Posted: 01/30/2013 12:11 pm

Vitamin D has received a great deal of attention recently. Vitamin D has long been recognized as primarily a regulator of calcium and phosphorus, helping to protect bone density. In recent years, however, our understanding of the functions of vitamin D in the body has expanded. Vitamin D is now understood to play an important role in metabolic and immune system functions. Vitamin D deficiency has been linked to a number of illnesses and chronic conditions, including high blood pressure, diabetes, metabolic syndrome, pulmonary disease, and chronic pain.

We've seen evidence that vitamin D deficiency is associated with sleep problems, particularly with daytime sleepiness. A new study examined the link between daytime sleepiness and vitamin D, and also considered one of the major risk factors of vitamin D deficiency: skin pigmentation.

Researchers at Louisiana State University investigated the relationship between vitamin D and daytime sleepiness with two specific goals in mind. First, they wanted to determine whether a correlation exists between vitamin D levels in the body and excessive daytime sleepiness. Second, they sought to evaluate the role that race might play in the relationship between daytime sleepiness and vitamin D.

In earlier work, researchers at LSU had observed that more than half of the patients who came to their sleep clinic with sleep problems and with chronic pain were also deficient in vitamin D. They noticed this cluster of symptoms appeared to occur more often in patients who were African-American.

Vitamin D is actually a fat-soluble hormone that the body can receive in food and also through supplements. But the primary -- and most effective -- way the body accumulates vitamin D is during exposure to sunlight. Exposure to sunlight prompts our skin to self-manufacture vitamin D. Increased skin pigmentation lowers the rate of manufacture of vitamin D. Therefore, greater levels of skin pigmentation are considered a risk factor for vitamin D deficiency.

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The results of the study support a strong correlation between excessive daytime sleepiness and vitamin D. They also indicate that race is a factor in the relationship between vitamin D and daytime sleepiness. But the results were in some ways surprising and indicate a complicated relationship, particularly where race is concerned.

Here's an overview of the most important findings:

• Sixty-five percent of the study population was found to have a vitamin D deficiency.
• The patients with greater skin pigmentation had higher average levels of daytime sleepiness and lower average levels of vitamin D, compared to those with less skin pigmentation
• African-American patients made up 35 percent of the study population, but 55 percent of the group that was deficient in vitamin D
• Only 6 percent of the group without a vitamin D deficiency were African-American
• Among those with deficiencies of vitamin D -- under 20 mg/mL as measured by a blood test -- there was no correlation between vitamin D levels and daytime sleepiness. This is the opposite of what was expected based on prior research.
• An exception to this was found among African-American patients in the study group. Among those African-American patients with vitamin D deficiency, there was a direct correlation between levels of vitamin D and daytime sleepiness. Among these patients, higher vitamin D levels were associated with higher levels of daytime sleepiness -- the exact opposite of what was expected.

It is this last finding that is unexpected, and surprised researchers themselves, who expected to see lower levels of vitamin D associated with higher levels of daytime sleepiness.

Why might this have been the case?    Full article HERE

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Vitamin D deficiency linked with cognitive impairment in adults

This study shows that Vitamin D deficiency, or hypovitaminosis D, is linked with cognitive impairment in adults affecting their memory.

Hypovitaminosis D is associated with global cognitive impairment in adults. It remains unclear which domain–specific cognitive functions are affected with hypovitaminosis D. Lower serum 25OHD concentrations predict executive dysfunctions, especially on mental shifting, information updating and processing speed. The association with episodic memory remains uncertain.

Abstract

Background: Hypovitaminosis D is associated with global cognitive impairment in adults. It remains unclear which domain-specific cognitive functions are affected with hypovitaminosis D. Objective. To systematically review and quantitatively synthesize the association of serum 25-hydroxyvitamin D (25OHD) concentrations with episodic memory and executive functions in adults. Methods: A Medline and PsycINFO^®libraries search was conducted on May 2012, with no limit of date, using the Medical Subject Headings (MeSH) terms “Vitamin D” OR “Hydroxycholecalciferols” combined with the MeSH terms “Memory” OR “Memory Disorders” OR “Executive Function” OR “Attention” OR “Cognition” OR “Cognition disorders” OR “Dementia” OR “Alzheimer disease” OR “Neuropsychological Tests”. Fixed-effects meta-analysis was performed from 12 eligible studies using an inverse-variance method. Results: Of the 285 selected studies, 14 observational studies (including 3 prospective cohort studies) and 3 interventional studies met the selection criteria. All were of good quality. The number of participants ranged from 44–5,692 community-dwellers (0–100% women). In the pooled analysis, although episodic memory disorders showed only modest association with lower 25OHD concentrations (summary effect size of the difference (ES) = −0.09 [95%CI:−0.16;−0.03]), associations of greater magnitude were found with executive dysfunctions (processing speed: mean difference of Trail Making Test (TMT)-A score = 4.0 [95%CI:1.20;6.83]; mental shifting: mean difference of TMT-B score = 12.47 [95%CI:6.78;18.16]; information updating tests: ES = −0.31 [95%CI:−0.5;−0.09]). The pooled risk of incident decline of TMT-B score was OR = 1.25 [95%CI:1.05;1.48] in case of initial lower 25OHD concentrations. Vitamin D repletion resulted in improved executive functions (ES = −0.50 [95%CI:−0.69;−0.32] for before-and-after comparison), but exhibited no difference with control groups (ES = 0.14 [95%CI:−0.04;0.32] for between-group comparison after intervention). Conclusion: Lower serum 25OHD concentrations predict executive dysfunctions, especially on mental shifting, information updating and processing speed. The association with episodic memory remains uncertain.

Methods

• A Medline and PsycINFO libraries search was conducted on May 2012, with no limit of date, using the Medical Subject Headings (MeSH) terms “Vitamin D” OR “Hydroxycholecalciferols” combined with the MeSH terms “Memory” OR “Memory Disorders” OR “Executive Function” OR “Attention” OR “Cognition” OR “Cognition disorders” OR “Dementia” OR “Alzheimer disease” OR “Neuropsychological Tests”.
• Fixed–effects meta–analysis was performed from 12 eligible studies using an inverse–variance method.

Results

• Of the 285 selected studies, 14 observational studies (including 3 prospective cohort studies) and 3 interventional studies met the selection criteria.
• All were of good quality. The number of participants ranged from 44–5,692 community–dwellers (0–100% women).
• In the pooled analysis, although episodic memory disorders showed only modest association with lower 25OHD concentrations (summary effect size of the difference (ES) = –0.09), associations of greater magnitude were found with executive dysfunctions (processing speed: mean difference of Trail Making Test (TMT)–A score = 4.0 [95%CI:1.20;6.83]; mental shifting: mean difference of TMT–B score = 12.47 [95%CI:6.78;18.16]; information updating tests: ES = –0.31).
• The pooled risk of incident decline of TMT–B score was OR = 1.25 [95%CI:1.05;1.48] in case of initial lower 25OHD concentrations.
• Vitamin D repletion resulted in improved executive functions, but exhibited no difference with control groups (ES = 0.14 [95%CI:–0.04;0.32] for between–group comparison after intervention).

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Vitamin D recommended for children with epilepsy

This article reviews research leading to the recommendation that children with epilepsy take low-dose Vitamin D supplements to help with their bone health.

The review was done by doctors at Leicester Royal Infirmary’s Department of Paediatric Neurology. Their work shows that bone health in young people with epilepsy may be a bigger problem than was previously thought. These young people may be two or three times more likely to break bones than others their age.

Previous research has shown that epilepsy can affect bone health in some groups. Some anti-epileptic medicines can affect bone metabolism. This is a process that gradually replaces old bone tissue with new tissue – important in healing fractures, for instance. The medicines can prevent the body doing this as effectively as it should.

These medicines can also negatively affect bone density – so that a person’s bones contain less minerals than they should. This makes them easier to break. Previous research has shown increased risks of poor bone-health in older people or menopausal women, for example. However, literature has suggested that young people with epilepsy are not at increased risk of broken bones.

The review from Leicester Royal Infirmary disagrees. While the previous research says that young people are not at a higher risk, the review points out that these older studies only looked at very small numbers of people. They also failed to take into account other factors that could affect bone health in youngsters with epilepsy. These include things like other conditions, how mobile the young person is, what their diet is like and whether they are obese.

The Leicester team say that further research in this area is urgently needed. Still, they say that in the absence of reliable scientific evidence, young people with epilepsy should be prescribed a low-dose vitamin D supplement. This should lower the possible risk of fractures.

In the article was published in The Journal of Paediatric Neurosciences. In it, authors state: “Low-dose vitamin D supplementation… is now recommended for healthy children and it is biologically feasible that children with epilepsy may be at higher risk of clinically significant deficiency. It is important that neurologists ensure that low-dose vitamin D supplementation should be prescribed… in children with epilepsy.”

Read more here

Link Found Between Daytime Sleepiness and Vitamin D

A study shows a link between daytime sleepiness and vitamin D intake. Additionally, race plays a factor.

A new study suggests that there is a significant correlation between excessive daytime sleepiness and vitamin D, and race plays an important factor.

Results show that in patients with normal vitamin D levels, progressively higher levels of daytime sleepiness were correlated inversely with progressively lower levels of vitamin D. Among patients with vitamin D deficiency, sleepiness and vitamin D levels were associated only among black patients. Surprisingly, this correlation was observed in a direct relationship, with higher vitamin D levels associated with a higher level of sleepiness among black patients.

"While we found a significant correlation between vitamin D and sleepiness, the relationship appears to be more complex than we had originally thought," said David McCarty, MD, the study's principal investigator. "It's important to now do a follow-up study and look deeper into this correlation."

The study, appearing online in the Dec. 15 issue of the Journal of Clinical Sleep Medicine, involved a consecutive series of 81 sleep clinic patients who complained of sleep problems and nonspecific pain. All patients eventually were diagnosed with a sleep disorder, which in the majority of cases was obstructive sleep apnea. Vitamin D level was measured by blood sampling, and sleepiness was determined using the Epworth Sleepiness Scale.

According to the authors, this is the first study to demonstrate a significant relationship between sleepiness and vitamin D. They noted that it is logical for race to affect this relationship because increased skin pigmentation is an established risk factor for low vitamin D.

The study was not designed to examine causality. However, the authors' previous and current research suggests that suboptimal levels of vitamin D may cause or contribute to excessive daytime sleepiness, either directly or by means of chronic pain.

Read more here

Vitamin D Deficiency Linked to Sleep Disorder Epidemic

A clinical trial shows that sufficient levels of vitamin D3 results in normal sleep regardless of the sleep disorder present.

Vitamin D is known as the "Sunshine Vitamin" because spending time outdoors in the sun is known to increase vitamin D in the body via the skin. Our ancestors spent a considerable amount of their time outdoors, but for the first time in history, large amounts of the world population spend most of their time inside their offices and homes. Researchers at the East Texas Medical Center and the University of North Carolina have discovered that vitamin D helps to regulate the sleep-wake cycle. They've found a definite link between vitamin D deficiency and the current global epidemic of sleep disorders.

Rapid eye movement sleep (REM) is one of the deepest levels of sleep. It is the level in which dreaming occurs, and its related to good memory and learning. A disruption of REM sleep or an absence of it, is one form of insomnia. Other sleep disorders include sleep apnea - which involves interrupted or obstructed breathing or snoring during the night; insomnia from hormone fluctuations such as with menstruation or menopause; restless leg syndrome; and periodic limb movement disorder, a condition where the person moves their limbs involuntarily during sleep.

The results of the clinical trial of vitamin D supplementation was published in a recent issue of the journal "Medical Hypothesis". The researchers followed 1500 patients over a 2 year period. A consistent level of vitamin D3 was maintained in their blood over many months. This produced normal sleep in most of the participants, regardless of their type of sleep disorder, which suggests that many types of insomnia may share the same cause. During the research, the authors discovered the presence of high concentrations of vitamin D "receiving sites" or "receptors" in those areas of the brain that are related to the onset and maintenance of sleep.

Calcium is also directly related to our cycles of sleep. In one study, published in the European Neurology Journal, researchers found that calcium levels in the body are higher during the rapid eye movement (REM) phase. This study concluded that disturbances in sleep, especially the absence of REM deep sleep or disturbed REM sleep, are related to a calcium deficiency. Restoration to the normal course of sleep was achieved following the normalization of the blood calcium level. As a note, calcium works best when its balanced with magnesium in a two to one ratio (with twice as much calcium as magnesium).

Natural insomnia remedies containing vitamin D and calcium can be helpful with both falling asleep and staying asleep during the night. One remedy that's designed for many forms of insomnia is Sleep Minerals II fromwww.NutritionBreakthroughs.com. This sleep aid contains highly absorbable forms of vitamin D3, calcium, and magnesium, the best ingredients for sleeplessness and insomnia, as well as for heart health, restless legs syndrome, bone strength, menopause insomnia and teenage insomnia. The formula is delivered in a softgel form with healthy carrier oils, making it more rapidly absorbable than tablets or capsules and providing a deeper, longer-lasting sleep.

Doctor P. P. of Houston, Texas says: "I had developed sleeping problems and took two different sleep medications over the course of several weeks. When I discontinued them, the insomnia came back even worse. I literally got about 20 hours of sleep in 6 weeks time. Sleep Minerals II was just what I needed. I've been taking it for a couple weeks and getting many hours of sleep a night. As a doctor I would definitely avoid prescribing sleeping drugs — I would recommend Sleep Minerals II."

Anita L. of New Caney, Texas says: "I was having hot flashes every 30 minutes to an hour through the night and was so miserable. After about two weeks of taking the Sleep Minerals, I noticed an incredible difference with my sleep. I have much less interruption from flashes, I'm sleeping much better, and I'm a lot more comfortable."

The authors of the vitamin D study noted that sleeping disorders have played a role in the development of medical conditions such as hypertension, heart disease, stroke, diabetes, depression, and chronic pain -- all of which have become widespread similarly to insomnia. The authors suggest further research be done on the management of vitamin D levels in a variety of medical conditions related to sleep.

Read more here