Sleep disorders in systemic lupus erythematosus. Does vitamin D play a role?

Gholamrezaei, Ali; Bonakdar, Zahra Sayed; Mirbagher, Leila; Hosseini, Naeimeh

doi:10.1177/0961203314532563

Cited by 19 publications

(17 citation statements)

References 13 publications

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“…To the best of our knowledge, this is the first study to analyze the association between serum levels of vitamin D and sleep quality in HD patients. We found that low serum levels of vitamin D were significantly associated with sleep disturbance in HD patients, which is similar to the findings of previous studies in elderly adults and patients with SLE [ 12 , 13 , 14 ]. Our finding might have important implications in providing novel proposals for the prevention and treatment of sleep disturbance in HD patients.…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore, increasing clinical studies have shown that low serum levels of vitamin D are associated with poorer sleep, including low sleep efficiency and short sleep duration, in non-HD subjects, suggesting a potential role for vitamin D in maintaining healthy sleep [ 12 , 13 ]. Similarly, a significantly correlation between vitamin D levels and sleep quality has been found in patients with systemic lupus erythematosus (SLE) [ 14 ]. Recent uncontrolled clinical trials of vitamin D supplements in patients with sleep problems have reported improved sleep quality with higher levels of supplemental vitamin D [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients

et al. 2017

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Sleep disturbance is a frequent and serious complication of hemodialysis (HD). Low serum vitamin D levels have been associated with sleep quality in non-HD subjects. Our aim was to examine the possible association between serum vitamin D levels and the presence of sleep disturbance in HD patients. We recruited 141 HD patients at the HD center of the First Affiliated Hospital of Jiaxing University during 2014–2015. Serum levels of 25-hydroxyvitamin D (25(OH)D) were determined by the competitive protein-binding assay. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Demographic, clinical and laboratory data were recorded. Meanwhile, 117 healthy control subjects were also recruited and underwent measurement of 25(OH)D. Eighty-eight patients (62.4%) had sleep disturbance (PSQI scores ≥ 5). Patients with sleep disturbance showed lower levels of 25(OH)D as compared to those without sleep disturbance (85.6 ± 37.4 vs. 39.1 ± 29.1 nmol/L, p < 0.001). In multivariate analyses, serum levels of 25(OH)D (≤48.0 nmol/L) were independently associated with sleep disturbance in HD patients (OR 9.897, 95% CI 3.356–29.187, p < 0.001) after adjustment for possible variables. Our study demonstrates that low serum levels of vitamin D are independently associated with sleep disturbance in HD patients, but the finding needs to be confirmed in future experimental and clinical studies.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients

et al. 2017

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“…6 Furthermore, it also associated with the quality of sleep. 12 On the contrary, vitamin D intake has been suspected as a risk factor for development of systemic lupus erythematosus in women, however, this has been disproved by Costenbader et al 13 In the Kingdom of Bahrain, a population-based study has confirmed a high prevalence of VDD in healthy subjects, especially in females, and that showed a seasonal variation. 14 Nevertheless, vitamin D status in Bahraini patients with SLE has not been investigated before.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Vitamin D deficiency in Adult Patients with Systemic Lupus Erythematosus in kingdom of Bahrain

Hassan¹

2017

MOJWH

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Introduction: Vitamin D deficiency (VDD) has been implicated as an important factor in the development or aggravation of systemic lupus erythematosus (SLE). Patients with SLE are especially prone to the development of VDD due to the nature of their illness and avoidance of sun exposure. However, the prevalence of VD status in Bahraini patients with SLE has not been studied before. Our aim is to study the prevalence of VDD in Bahraini cohort with SLE. Material and methods: Fifty-eight Bahraini patients with SLE were included retrospectively in this study. The mean age of the patients, was 39.78years (16.0-61.0, STD 12.98). Most of the patients were females 50/58. The patients were followed at the rheumatology department at "Salmanyia medical complex" in Bahrain. Controls were fifty-eight age-matched healthy Bahraini subjects. Serum levels of 25 (OH) vitamin D3 were estimated using chemilumenescence immunoassay. Chi Square and T-Test were used for analysis a p value of≤0.05 was considered significant. Results: There was statistically significant difference (p≤0.05) in the mean serum levels of vitamin D between patients (30.67nmol/l) and controls (39.95nmom/L). There was a statistically significant difference in Phos, PTH and ALP between patients and control group with a p≤0.001 for each. In the SLE patients there were 49.1% deficient, 45.1% insufficient and 3.8% were Optimal. In the controls; 27% was deficient, 52% insufficient and 21% optimal. Conclusion: There was high prevalence of VDD in Bahraini patients with SLE. Both patients and controls had low vitamin D levels, however the patients had statistically significant lower vitamin D serum levels compared to the controls. Our study also highlights the need for studying the effects of correcting hypovitaminosis on the clinical disease activity in Bahraini SLE patients.

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“…In an observational study of 60 patients who took vitamin D 3 , an inverse relationship between the 25-(OH) 3 level and fatigue score was identified [101]. Apart from fatigue, the vitamin D level was found to be related to sleep quality in the patients with SLE [102]. With the use of the Pittsburgh Sleep Quality Index, a retrospective study of 60 SLE patients revealed a significant relationship between a low serum vitamin D level and poor sleep quality [102].…”

Section: Vitamin D and Its Major Extra-musculoskeletal Impactsmentioning

confidence: 99%

“…Apart from fatigue, the vitamin D level was found to be related to sleep quality in the patients with SLE [102]. With the use of the Pittsburgh Sleep Quality Index, a retrospective study of 60 SLE patients revealed a significant relationship between a low serum vitamin D level and poor sleep quality [102]. …”

Section: Vitamin D and Its Major Extra-musculoskeletal Impactsmentioning

confidence: 99%

The Impact of Vitamin D on the Immunopathophysiology, Disease Activity, and Extra-Musculoskeletal Manifestations of Systemic Lupus Erythematosus

Mak

2018

IJMS

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Over the past two decades it has been increasingly recognized that vitamin D, aside from its crucial involvement in calcium and phosphate homeostasis and the dynamics of the musculoskeletal system, exerts its influential impact on the immune system. The mechanistic roles that vitamin D plays regarding immune activation for combating infection, as well as pathologically and mediating autoimmune conditions, have been progressively unraveled. In vitro and in vivo models have demonstrated that the action of vitamin D on various immunocytes is not unidirectional. Rather, how vitamin D affects immunocyte functions depends on the context of the immune response, in the way that its suppressive or stimulatory action offers physiologically appropriate and immunologically advantageous outcomes. In this review, the relationship between various aspects of vitamin D, starting from its adequacy in circulation to its immunological functions, as well as its autoimmune conditions, in particular systemic lupus erythematosus (SLE), a prototype autoimmune condition characterized by immune-complex mediated inflammation, will be discussed. Concurring with other groups of investigators, our group found that vitamin D deficiency is highly prevalent in patients with SLE. Furthermore, the circulating vitamin D levels appear to be correlated with a higher disease activity of SLE as well as extra-musculoskeletal complications of SLE such as fatigue, cardiovascular risk, and cognitive impairment.

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Sleep disorders in systemic lupus erythematosus. Does vitamin D play a role?

Abstract: We found a role for vitamin D in sleep quality of SLE patients. Further studies are warranted to confirm these results and to find possible mechanisms of action.

Cited by 19 publications

References 13 publications

Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients

Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients

Prevalence of Vitamin D deficiency in Adult Patients with Systemic Lupus Erythematosus in kingdom of Bahrain

The Impact of Vitamin D on the Immunopathophysiology, Disease Activity, and Extra-Musculoskeletal Manifestations of Systemic Lupus Erythematosus

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