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Vitamin D and sleep in children
Baha Al-Shawwa1,2, Zarmina Ehsan1,2, David G Ingram1,2
1Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.
Insights
Vitamin D deficiency in children is linked to shorter sleep duration and efficiency. This deficiency also correlates with later bedtimes, suggesting a connection between vitamin D levels and children's sleep patterns.
Area of Science:
- Pediatric Sleep Medicine
- Endocrinology
- Nutritional Science
Background:
- Vitamin D's role in adult sleep is established, with deficiency linked to sleep disorders.
- The association between vitamin D status and sleep architecture in children is less understood.
- Pediatric sleep disturbances warrant investigation into potential contributing factors like vitamin D deficiency.
Purpose of the Study:
- To investigate the relationship between vitamin D status and sleep architecture in children referred to a sleep clinic.
- To determine if vitamin D deficiency is associated with specific sleep parameters in pediatric patients.
- To explore potential links between vitamin D, sleep patterns, and circadian rhythms in children.
Main Methods:
- Retrospective-cohort study involving children undergoing polysomnography.
- Inclusion criteria: overnight polysomnogram and 25-hydroxy vitamin D level within 120 days.
- Exclusion criteria: obstructive sleep apnea (OSA) or central sleep apnea.
Main Results:
- 51% of 39 pediatric patients exhibited vitamin D deficiency (<30 ng/mL).
- Children with vitamin D deficiency had significantly less total sleep time and poorer sleep efficiency.
- Vitamin D deficiency was associated with later weekday and weekend bedtimes.
Conclusions:
- Vitamin D deficiency in children is associated with objectively measured reduced sleep duration and efficiency.
- The findings suggest a potential link between vitamin D deficiency and delayed sleep onset in pediatric populations.
- Further prospective research is needed to clarify the causal relationship between vitamin D status and sleep disturbances in children.
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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