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Dr. Michael J. Breus

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Vitamin D for Sleep?

Posted: 01/22/2011 11:41 am

Once again I love it when a mystery is revealed, or at least partially explained.

I was reading a case study in the Journal of Clinical Sleep Medicine and it helped confirm a hypothesis I have had for a while about the importance of vitamins to your sleep.

Look at the busy B's: Did you know that vitamin B can help regulate the use of tryptophan?

  • B3: has been shown to increase REM sleep, help with depression in some cases and a decrease in nighttime awakenings.
  • B6: is essential in the production of serotonin, the "calming" hormone that helps calm the body before falling asleep.
  • Folic Acid: Deficiency in folic acid deficient can be found in those with insomnia.
  • Important Minerals: Calcium and Magnesium, taken in a 2:1 ratio, can be helpful for sleep.
  • Calcium: is a natural relaxant which has a calming effect on the nervous system. 500 mg daily can be helpful (soda can actually strip away calcium).
  • Magnesium: is a mineral that appears to help assist chronic sleep problems as well. It should be taken 250 mg daily with 500 mg of calcium.


But a recent case study has shown that for a patient with severe sleepiness and a vitamin D deficiency, a vitamin D supplementation improved daytime sleepiness dramatically:

The patient was a 28-year-old female. She was suffering for about four months with excessive sleepiness. Her symptoms started slowly and continued to progress. She kept a standard bedtime between 10 and 11 pm, and she reported falling asleep within minutes. She would wake at 7:30 a.m. and reported that she did not think that she was sleeping poorly. She would get her kids ready for school and then be back in bed by eight am until noon. She would then nap from four pm to seven pm. She reported about 14 hours of sleep per day.

Her sleep study showed no signs of sleep apnea or other sleep disorder. During her clinic visit she showed no signs of narcolepsy, depression or anxiety. Her next day nap study was unremarkable. She reported muscle fatigue and pain, as well as headaches, her lab work showed a thyroid in the low, but normal range and she had low levels of vitamin D.

She was started on a vitamin D supplementation at 50,000 units once per week (IV) and within two weeks she started to see a decrease in her sleepiness and fatigue.

Vitamin D is actually considered a fat soluble hormone that can be received in foods (dietary sources and fish) or is self-manufactured by the skin after exposure to UVB light. A vitamin D deficiency has been noticed as a global issue and recently found in underserved populations, patients in northern latitudes, people with darker skin tones, the elderly, obese and pregnant or lactating women. Also very common in areas with a high degree of sunshine (this seems counterintuitive, but think about all that sunblock!). Recent studies have linked vitamin D deficiency to metabolic syndrome, muscle pain and even type 2 diabetes.

So why do we think it helped her sleepiness? It is really hard to say, but I have seen this in some of my patients. It could be linked to a decrease in sleep disturbing pain. Or vitamin D may be something that will help decrease a person's drive for sleep. Only more research in this exciting new area can tell us.

Check with your doctor about vitamin supplementation. We all work hard, and eating right isn't always easy. And even when we do, we may not get what we need from the food we eat. Our bodies actually make vitamin D, but we have to get enough sunlight to make that happen effectively.

Have you started taking vitamin D and noticed an increase in your daytime energy? What about vitamin B? Share your stories -- would love to hear your experiences with keeping healthy and getting better sleep.

Sweet Dreams,
Michael J. Breus, Ph.D.
The Sleep Doctorâ„¢

Everything you do, you do better with a good night's sleep.â„¢ www.thesleepdoctor.com, twitter@thesleepdoctor, Facebook: The Sleep Doctor.

 
 
 

Follow Dr. Michael J. Breus on Twitter: www.twitter.com/thesleepdoctor

Once again I love it when a mystery is revealed, or at least partially explained. I was reading a case study in the Journal of Clinical Sleep Medicine and it helped confirm a hypothesis I have had f...
Once again I love it when a mystery is revealed, or at least partially explained. I was reading a case study in the Journal of Clinical Sleep Medicine and it helped confirm a hypothesis I have had f...
 
 
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12:04 PM on 01/26/2011
Don't tell the farmacist's
The fear vitamin D as hell
OverseasVet
stuck in a 3rd world country called texas
01:38 AM on 01/25/2011
According to the Institute of Medicine of the National Academies, "It reviewed a range of health outcomes, including but not limited to cancer, cardiovascular disease and hypertension, diabetes and metabolic syndrome, falls, immune response, neuropsychological functioning, physical performance, preeclampsia, and reproductive outcomes. This thorough review found that information about the health benefits beyond bone health—benefits often reported in the media—were from studies that provided often mixed and inconclusive results and could not be considered reliable. However, a strong body of evidence from rigorous testing substantiates the importance of vitamin D and calcium in promoting bone growth and maintenance." It also concluded that most North Americans have adequate blood levels of vitamin D and do not need supplimentation.
http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Report-Brief.aspx
04:33 PM on 01/24/2011
Is anyone else concerned about the author's signature and trademark?

> Sweet Dreams,
> Michael J. Breus, Ph.D.
> The Sleep Doctorâ„¢

My "scam-dar" goes off whenever a non-MD provides medical advice (sometimes with lawyer crafted disclaimers) while holding themselves out as a "doctor." A PhD does entitle one to the "doctor" honorific -- but in this case it appears to used as a way to add unwarranted credibility to medical issues.

I am not adverse to people writing or even advocating homeopathic or alternative treatments. But unless they actual have relevant medical degrees, using the doctor title can be seriously misleading (imo).

Vitamins and supplements can have serious medical effects (not always good) and can significantly impact prescribed medications. I would consult a licensed physician before taking the advice of a non-md Phd who is pushing his latest book.
01:38 AM on 01/24/2011
That's quite interesting.

My uncle takes some pills for sleep, dont know which.

Thanks for sharing.

http://www.healthyskinguide.net
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Fred Butters
12:39 AM on 01/24/2011
I started taking a Magnesium supplement at night (400mg Magnesium Glycinate). I sleep really deeply now, and I've had the most vivid dreams every single night. It doesn't make me sleepy at all, but when I fall asleep, I stay asleep until the morning.

I also take 6,000units of vitamin D3 every morning if I'm not going to be in the sun that day.
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jgarma
01:25 AM on 01/24/2011
Yes, my mother takes a powdered magnesium called "Calm" each night and touts its effectiveness.

Other sleep-enhancers are melatonin (also a fine antioxidant and a fav of mine), Vespro GHS, and ZMA (also said to aide muscle growth. More about these here:
http://www.garmaonhealth.com/2009/08/restful-rejuvenating-sleep/

Also, the famed Dr. Oz has some insights in this HuffPost article;
http://www.huffingtonpost.com/dr-mehmet-oz/dr-ozs-big-sleep-tips-vid_b_422243.html
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MsIrisMG
Why not me?
12:37 AM on 01/24/2011
I wish Michael could have found this solution instead of resorting to anaesthetic. Even if he opted food & juicing rather than supplements, it might have helped with his insomnia.
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No death panels
There's no man with a trumpet. Only me.
11:00 PM on 01/23/2011
This is the link to the study: http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=27996

Keep in mind IT IS JUST A CASE REPORT PEOPLE! No reason to go out and O.D. on vit D.
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elicourey
It takes a nation of millions to hold me back!
10:18 AM on 01/23/2011
Drink coffee :-)
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Carcinogen
Objectivism isn't a philosophy, it's a cult
10:34 AM on 01/23/2011
Sans creamer and sugar.
10:01 AM on 01/23/2011
I feel compelled to chime in with my own story...too many sad stories of chronic sleeplessness- and recommendations to take more pills! I know what that's about because I had horrendous restlessness and night sweats (from menopause) and I used to pound Tylenol pm.... well all that changed when my sister gave me a pair of Goodnighties Recovery Sleepwear -- there is something in the fabric that calms you down and it also regulates your body temperature! from even the first night, I began to heal my battered body. It was nice...now I'm not a Tiger Mom who is ready to 'eat her own' ! :) I have sassy teens ... so I'm sure there are a few mom's out there that get that! LOL :)
09:31 AM on 01/23/2011
Sunblock usually only blocks UV-B, which is the sun you need to get vitamin D. UV-A is what causes melanomas. Sunblock does not block this unless it is a sunblock that blocks UV-A-- but it must be specific for UV-A. So, sunblock keeps people vitamin D deficient, and allows the skin cancer rays to get through anyway-- It is better not to use sunblock.

I'm in a northern latitude and have been taking 4000 iu of D per day. I used to sleep 12 or so hours a day, and now can get by on 7 or 8. I wake up refreshed and do not feel tired all day. My mood is much better as well. Winter depression is gone, and much less anxiety. I initially began to take it to try to get my blood pressure stabilized, and other health things like immune system bolstering and protecting against certain cancers. I thing Vit-D deficiency should be the first test any doctor gives.
01:51 AM on 01/23/2011
I have been utterly exhausted for the last four-five days or so. I don't think I am sleeping well, and it's almost impossible to get up. I am in a haze. The simplest functioning is quite difficult. It feels like my mind is constantly shutting itself off, but I am not tired in a restful way. I'll lie down to rest, but just lie there tired. I feel too tired to sleep now.

Anyhow, I do take fish oil and 3,000 IU of D3 every day. And it did help with bone pain I had when I first started it. I don't know what is wrong with me now. It very well could be something psychological, but I am in such a haze I can't even figure out what emotionally is wrong, if anything. Being in therapy and having somatic problems, I am trained to think *everything* is actually something else that is emotional in nature.

I think I will probably go to a doc in the box place tomorrow to get checked out. I know they can retest my D levels there. I haven't had them checked since I found out I had very low levels (I think it was 13 something). My doctor told me just to take 2,000 IU a day, but I increased it after reading various articles to 3,000. I'm guessing when I get my blood checked it'll probably still be low. Any other tests anyone can think I should ask for?
09:22 AM on 01/23/2011
I am a physician - the key test is Vitamin D 25 OH. If your level was in the 13 range, then you need at least 50,000 IU per week for 3 months. I typically retest after 3 months and, if normal, recommend daily 1000 IU supplements thereafter. Individual practice may vary, but this is my recommendation - some physicians will transition to a 50,000 IU every other week, thereafter.

For what it's worth, I have never seen dramatic changes in my patients with Vit D therapy, though I regularly check and replace it (there are theoretical implications with autoimmunity and cancer)
02:52 AM on 01/24/2011
Confusingly, Vitamin D levels are sometimes reported in two different ways. The one I have seen, ng/ml, has a target range IIRC of 30-100, so 13 is pretty low. After taking 5000 IU/day for 3 months I reached 42 ng/ml, and 66 ng/ml by summer's end. I can only assume I was deficient before I began. The supplement appears to have a tremendous effect on my bipolar disorder - life-changing really. Because bipolar and multiple sclerosis, two of the illnesses thought most likely to benefit from Vitamin D supplementation, are so poorly understood it may be sometime before it is possible to identify the markers that indicate who will benefit, if at all.

Anecdotes are not worth much, true, but the clinical evidence is mounting quickly that Vitamin D is importnt far beyond preventing rickets and the RDA of 400 IU is ridiculously low. The fact that Vitamin D deficiency - and the risk of MS - increase with latitude and darker skin - is suggestive. I remain a cautiously optimistic skeptic, but am encouraging others strongly to consider supplements.
10:12 AM on 01/23/2011
I just posted... mainly because I can totally relate to your utter exhaustion story--you need to try 'Goodnighties' sleepwear- no kidding! I was a skeptic when my sister kept raving about this fabric for her fibromyalgia-it helped her finally get some sleep to manage her pain cycles better! She gave me a pair for Christmas and I am now like a different person. It's so nice to feel better. chronic exhaustion is horrendous and it ruins your immune system (and you disposition!) LOL :) LR
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jgarma
01:20 AM on 01/23/2011
I'm really chuckling after reading how Vitamin D helps with sleep. I recently summarized a long video presentations one of the world's experts on Vitamin D, Dr. Micheal Holick, where I listed "30 Reasons to Take Vitamin D".

And despite that long list, sleep wasn't on it!

Vitamin D really is turning out to be some kinda miracle supplement, so if you wish to delve into the benefits, check out this post featuring the work and conclusions of Dr Holick:
http://www.garmaonhealth.com/2010/12/30-reasons-vitamin-d/
03:58 AM on 01/23/2011
There is nothing miraculous about vitamin d supplements, it is simply that a shortage of vitamin d is very bad for you. You have to think about it the correct way round. So once you have enough vitamin d adding more will not achieve anything. The arguments at the moment are about how much is enough.

However, as a shortage of vitamin d can lead to bone pain and bone pain may keep you awake.....
09:40 AM on 01/23/2011
Sleep is linked to the regulation of serotonin and melatonin and other hormones regulating the sleep/wake cycle. On a list of the benefits of vit. D It would probably not be listed as "sleep."

Most people above a certain latitude are very deficient.
12:07 AM on 01/23/2011
Really, B3 increases REM sleep? Well, that explains it > The other night I dreamed I ate a giant marshmellow, and when I awakened the next morning my giant marshmellow was gone...
02:11 AM on 01/23/2011
Were you missing a pillow?
12:41 AM on 01/25/2011
No, both pillows were there in the morning, but the upper left side of my mattress was missing...
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Fred Butters
11:12 PM on 01/22/2011
Wearing sunscreen - even an 8 SPF - prevents 95% of vitamin D synthesis. Get some sun and when your body tells you it's had enough, sit in the shade.
http://www.proteinpower.com/drmike/supplements/heliophobe-madness/
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DrImranKhan
Neurologist
11:06 PM on 01/22/2011
Impressive article, to make vitamin -D we need to spend more time under the Sun. At lunch breaks its is better to sit under the Sun. Make vitamin -D and get rid of weakness and tiredness.