Micronutrient levels and deficiencies may contribute to sleep duration, extreme daytime sleepiness, and other impairments that impact our overall health and wellbeing.
Feeling groggy or tired all the time? Your micronutrient intake could be a factor
Rootine TeamOct 22, 2021

Feeling groggy or tired all the time? Your micronutrient intake could be a factor

Getting a good night’s rest is essential for your physical and mental wellbeing. Studies suggest as much as 40 percent of the population experiences some sort of sleep disturbance or impairment and one in four Americans develop insomnia each year. [1] This lack of sleep may lead to problems such as cognitive decline or physical implications like obesity, respiratory problems, and cardiovascular disease.[2][3]

It is well-established that lack of proper sleep results in health issues, but studies are also showing that the inverse relationship can also be true – our health impacts the quality, duration, and restfulness of our sleep. On a cellular level, micronutrient levels and deficiencies may contribute to sleep duration, extreme daytime sleepiness, and other impairments that impact our overall health and wellbeing. [4]

The science of sleep

Everyone has an internal body clock, your circadian rhythm, and a sleep-wake homeostasis which dictates when you are awake or ready for sleep. This clock is affected by a variety of internal and external cues, including light levels, sleep schedules, and stimulants such as caffeine.

Like with everything, your circadian clock is unique to you and can change throughout your life, especially with age. [5] As you are sleeping, you cycle through rapid eye movement (REM) and non-REM sleep, with each cycle starting over every 80-100 minutes. The cycle repeats several times each night.

Many chemicals and hormones play important roles in sleep. Neurotransmitters important to the sleep cycle include GABA, acetylcholine, orexin, and serotonin, while hormones such as melatonin help regulate sleep and wakefulness.[6]

While the relationship between micronutrients and sleep has not been extensively research, this is an increasingly studied area of interest as we learn more about internal functions of the body and how they affect our sleep cycles.

Micronutrients and Sleep

As we examine the relationship between a few micronutrients and sleep, it is important to remember that everyone is unique in their supplemental needs and dose quantities. Because there are so many different lifestyle, genetic, and biological factors to consider for each individual, it is important to note that rather than looking at general recommended doses, “optimal intake rather than high or low intake of micronutrients is needed to maintain normal sleep patterns.”[7] Sleep effect may also change depending on the interaction among micronutrients, so it is important to consider how these micronutrients function together in the body.

Iron

Iron deficiency can contribute to behavioral and developmental symptoms by affecting serotonin, noradrenaline and dopamine, myelination, and metabolic activity in neurons.[8] Iron is essential to many enzymes involved in neurotransmitter synthesis, such as serotonin and norepinephrine and DA.[9] Iron also plays a key role in the metabolism of monoamines in the brain. A lack of iron can result in impaired monoamine oxidase activity, leading to apathy, drowsiness, and lack of attention.[10]

A deficiency in iron can result in iron-deficiency anemia (IDA), which in turn can contribute to fatigue and sleep disorders. One of these, restless legs syndrome (RLS), causes abnormal sensations in the legs and may result in difficulty falling and staying asleep.[11]

In a study on patients with IDA, the Pittsburg sleep quality index was used to find that IDA affects sleep quality by showing statistically significant differences in patients vs. controls. “The total sleep quality score was 6.71±3.02 in patients and 4.11±1.64 in controls,” with a “global sum of 6 or greater” indicating poor sleepers and worse sleep quality.[12]

Studies have shown that iron supplementation was found to have a positive effect on sleep disorders and should be considered in patients struggling with sleep impairments.[13]

Zinc

Zinc can also play a role in regulating sleep and sleep quality. Not only is zinc involved in enzymatic activity and cell signaling, but it is also involved in neuronal activity in the brain. Decreased levels of zinc have been correlated with short sleep duration and some research suggests zinc supplementation could be linked to better sleep quality.[14] [15] A recent study on zinc as a sleep modulator hypothesizes that zinc may also play an important role in the central nervous system by reaching a compartment in the CNS and activating a signaling pathway responsible in the promotion of sleep.[16]

Magnesium

Magnesium is an essential element that helps regulate the body’s stress levels and can help improve sleep quality with supplementation depending on age, biological sex, and other factors.

Magnesium plays a key role in ion transport and electrical conductivity, which facilitate functioning of the N-methyl-D-aspartic acid (NMDA) receptor, an important sleep regulator.[17] Magnesium may also be involved in melatonin synthesis “as a cofactor for serotonin N-acetyltransferase (arylalkylamone-N-acetyltransferase; AANAT), which facilitates the conversion of serotonin to N-acetylserotonin, the rate limiting step in melatonin synthesis.”[18]

Magnesium deficiency may be a factor in chronic insomnia. A study on the effect of magnesium supplementation on primary insomnia in elderly subjects found that magnesium supplementation appeared “to improve subjective measures of insomnia such as ISI score, sleep efficiency, sleep time and sleep onset latency, early morning awakening, and likewise, insomnia objective measures such as concentration of serum renin, melatonin, and serum cortisol, in elderly people.”[19]

Vitamin B12

While the relationship between vitamin B12 and sleep is not yet completely confirmed, several studies have seen a positive association between B12 levels and treatment of circadian rhythm sleep disorders, with an increase in vitamin B12 levels leading to improvement of sleep-wake rhythms.[20] [21]

Vitamin B12 deficiency is involved in the pathophysiology of depression, which can be associated with insomnia.[22] One study has linked vitamin B12 deficiency as a rare cause of excessive daytime sleepiness.[23] Deficiency is common among older people, or those who have trouble absorbing the nutrient. Other symptoms of deficiency include fatigue and weakness.[24]

Vitamin B6

Vitamin B6 supplementations have been linked to dream recall and lucid dreaming.[25] One study investigating the effect of vitamin B6 on dreaming found that “Vitamin B-6 may act by increasing cortical arousal during periods of rapid eve movement (REM) sleep.”[26] It hypothesizes that vitamin B6’s action as a cofactor in the conversion of L-Tryptophan to 5-Hydroxytryptophan (5-HTP) and 5-HTP to serotonin may increase serotonin levels, which initially suppress REM sleep and later results in an REM rebound effect toward the morning hours.

Vitamin D

Studies suggest that vitamin D deficiency may be associated with a higher risk of sleep disorders including poor sleep quality, short sleep duration, and fatigue.[27] [28]

This may be linked to vitamin D receptors in areas of the brain that are important to sleep regulation, such as the hypothalamus, prefrontal cortex, midbrain central gray, substantia nigra, and raphe nuclei. [29]

Vitamin D supplementations have been linked to improving sleep quality, duration, and latency in several studies of those with sleep disorders.[30] [31]

Calcium

As an important part of helping the brain use tryptophan to make melatonin, calcium can also induce sleepiness and a deficiency may lead to short sleep. Calcium supplements may help with difficulty falling asleep and non-restorative sleep.[32]

Research also suggests that poor sleep may be a risk factor for bone loss, as chronic sleep deprivation decreases bone mineral density and impacts bone metabolism. [33]

Selenium

Selenium, as a powerful antioxidant, may reduce the oxidative stress in patients with sleep apnea. [34] Research has found that less selenium, among other nutrient variables, is associated with greater difficulty falling asleep. [35] Supplementation may reduce symptoms associated with obstructive sleep apnea.

Rootine

The way you recharge is crucial to feeling energized and performing at your best throughout the day. We know a one-size-fits-all approach doesn’t work for a lot of things – including your nutrition. Rootine considers all factors when preparing your personalized micronutrient pack, including your lifestyle, DNA, and blood data as well as how micronutrients interact with each other.

Learn more and become a Rootine member today.

[1] Penn Medicine News. 1 in 4 Americans Develop Insomnia Each Year. The University of Pennsylvania. Available from:

https://www.pennmedicine.org/news/news-releases/2018/june/1-in-4-americans-develop-insomnia-each-year

[2]Hossain JL, Shapiro CM. The prevalence, cost implications, and management of sleep disorders: an overview. Sleep Breath. 2002 Jun;6(2):85-102. doi: 10.1007/s11325-002-0085-1. PMID: 12075483.

[3] National Heart, Lung, and Blood Institute. How Sleep Works. National Institutes of Health. Available from: https://www.nhlbi.nih.gov/health-topics/how-sleep-works

[4]Ji X, Grandner MA, Liu J. The relationship between micronutrient status and sleep patterns: a systematic review. Public Health Nutr. 2017 Mar;20(4):687-701. doi: 10.1017/S1368980016002603. Epub 2016 Oct 5.

[5]See [3].

[6] Suni, E, DeBanto, J. How Sleep Works. Sleep Foundation. Available from: https://www.sleepfoundation.org/how-sleep-works

[7] See [4].

[8]Murat S, Ali U, Serdal K, Süleyman D, İlknur P, Mehmet S, Bahattin A, Tunahan U. Assessment of subjective sleep quality in iron deficiency anaemia. Afr Health Sci. 2015 Jun;15(2):621-7. doi: 10.4314/ahs.v15i2.40.

[9]Beard J. Iron Deficiency Alters Brain Development and Functioning, The Journal of Nutrition, Volume 133, Issue 5, May 2003, Pages 1468S–1472S, https://doi.org/10.1093/jn/133.5.1468S

[10]See [8].

[11] Neurology and Neurosurgery. What is Restless Legs Syndrome (RLS)? Johns Hopkins Medicine. Available from: https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/

[12]See [8].

[13] Leung, W, Singh, I, McWilliams, S, Stockler, S, Ipiroglu, OS. Iron deficiency and sleep – A scoping review. Sleep Medicine Reviews. 2020 June Volume 51. https://doi.org/10.1016/j.smrv.2020.101274

[14]Grandner MA, Jackson N, Gerstner JR, Knutson KL. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite. 2013 May;64:71-80. doi: 10.1016/j.appet.2013.01.004. Epub 2013 Jan 20.

[15]Gholipour Baradari A, Alipour A, Mahdavi A, Sharifi H, Nouraei SM, Emami Zeydi A. The Effect of Zinc Supplementation on Sleep Quality of ICU Nurses: A Double Blinded Randomized Controlled Trial. Workplace Health Saf. 2018 Apr;66(4):191-200. doi: 10.1177/2165079917734880. Epub 2017 Dec 14.

[16]Cherasse Y, Urade Y. Dietary Zinc Acts as a Sleep Modulator. Int J Mol Sci. 2017 Nov 5;18(11):2334. doi: 10.3390/ijms18112334.

[17]Ikonte CJ, Mun JG, Reider CA, Grant RW, Mitmesser SH. Micronutrient Inadequacy in Short Sleep: Analysis of the NHANES 2005-2016. Nutrients. 2019 Oct 1;11(10):2335. doi: 10.3390/nu11102335.

[18]Id.

[19]Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec;17(12):1161-9. PMID: 23853635; PMCID: PMC3703169.

[20]Okawa M, Mishima K, Nanami T, Shimizu T, Iijima S, Hishikawa Y, Takahashi K. Vitamin B12 treatment for sleep-wake rhythm disorders. Sleep. 1990 Feb;13(1):15-23. doi: 10.1093/sleep/13.1.15. PMID: 2305167.

[21]Ohta T, Ando K, Iwata T, Ozaki N, Kayukawa Y, Terashima M, Okada T, Kasahara Y. Treatment of persistent sleep-wake schedule disorders in adolescents with methylcobalamin (vitamin B12). Sleep. 1991 Oct;14(5):414-8. PMID: 1759094.

[22]Djokic G, Vojvodić P, Korcok D, Agic A, Rankovic A, Djordjevic V, Vojvodic A, Vlaskovic-Jovicevic T, Peric-Hajzler Z, Matovic D, Vojvodic J, Sijan G, Wollina U, Tirant M, Thuong NV, Fioranelli M, Lotti T. The Effects of Magnesium - Melatonin - Vit B Complex Supplementation in Treatment of Insomnia. Open Access Maced J Med Sci. 2019 Aug 30;7(18):3101-3105. doi: 10.3889/oamjms.2019.771. PMID: 31850132; PMCID: PMC6910806.

[23]Khawaja I, Yingling K, Bukamur H, Abusnina W. Vitamin B12 Deficiency: A Rare Cause of Excessive Daytime Sleepiness. J Clin Sleep Med. 2019 Sep 15;15(9):1365-1367. doi: 10.5664/jcsm.7936. PMID: 31538608; PMCID: PMC6760402.

[24] Harvard Health Blog. Vitamin B12 deficiency can be sneaky, harmful. Harvard Health Publishing, Harvard Medical School. Available from: https://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780

[25]Aspy DJ, Madden NA, Delfabbro P. Effects of Vitamin B6 (Pyridoxine) and a B Complex Preparation on Dreaming and Sleep. Percept Mot Skills. 2018 Jun;125(3):451-462. doi: 10.1177/0031512518770326. Epub 2018 Apr 17. PMID: 29665762.

[26]Ebben M, Lequerica A, Spielman A. Effects of pyridoxine on dreaming: a preliminary study. Percept Mot Skills. 2002 Feb;94(1):135-40. doi: 10.2466/pms.2002.94.1.135. PMID: 11883552.

[27]Gao Q, Kou T, Zhuang B, Ren Y, Dong X, Wang Q. The Association between Vitamin D Deficiency and Sleep Disorders: A Systematic Review and Meta-Analysis. Nutrients. 2018 Oct 1;10(10):1395. doi: 10.3390/nu10101395. PMID: 30275418; PMCID: PMC6213953.

[28]See [17].

[29] See [27].

[30]Huang W, Shah S, Long Q, Crankshaw AK, Tangpricha V. Improvement of pain, sleep, and quality of life in chronic pain patients with vitamin D supplementation. Clin J Pain. 2013 Apr;29(4):341-7. doi: 10.1097/AJP.0b013e318255655d. PMID: 22699141.

[31]Majid MS, Ahmad HS, Bizhan H, Hosein HZM, Mohammad A. The effect of vitamin D supplement on the score and quality of sleep in 20-50 year-old people with sleep disorders compared with control group. Nutr Neurosci. 2018 Sep;21(7):511-519. doi: 10.1080/1028415X.2017.1317395. Epub 2017 May 5. PMID: 28475473.

[32]Grandner MA, Jackson N, Gerstner JR, Knutson KL. Sleep symptoms associated with intake of specific dietary nutrients. J Sleep Res. 2014 Feb;23(1):22-34. doi: 10.1111/jsr.12084. Epub 2013 Sep 2. PMID: 23992533; PMCID: PMC3866235.

[33] See [17].

[34]Albuquerque RG, Hirotsu C, Tufik S, Andersen ML. Why Should We Care About Selenium in Obstructive Sleep Apnea? J Clin Sleep Med. 2017 Jul 15;13(7):931-932. doi: 10.5664/jcsm.6674. PMID: 28502283; PMCID: PMC5482587.

[35] See [32].



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