Sleep, Pain and Vitamin D

Low level of vitamin D is connected to painful conditions such as fibromyalgia, and rheumatic diseases[i]. Infectious, autoimmune and neurological diseases, as well as neuromuscular disorders, which can lead to increased pain sensitivity are also linked to insufficient Vitamin D status[ii]. Low levels of vitamins D is also associated with poor sleep quality.

Sleep is a complex interactive state full of restorative and intense metabolic activity.  Chronic sleep and circadian rhythm disruption, regardless of shift work, electromagnetic smog, blue light, or other zeitgeber zappers, is linked to gastrointestinal diseases such as IBS and colorectal cancer. In fact, an imbalanced microbiome can impair sleep.

Additionally, use of CPAP machines in both obese and non-obese people with sleep apnea not only improved their quality of sleep, but also increased their levels of absorption of vitamin D[iii], which possibly suggests sleep deprivation depletes vitamin D levels. Furthermore, chronic lack of sleep among both men and women 30 to 87 years of age, is related to increased pain sensitivity[iv].  

The microbiome bacteria normally make small quantities of toxins called lipopolysaccharides and cellular chemicals called cytokines that induce your dream state (REM) sleep. An imbalanced microbiome can promote larger quantities of these toxins and chemical messengers, which disrupts sleep, not to mention that the excess toxins can lead to inflammation and pain in the head, muscles, or joints. Pain keeps you up at night.

We use Vitamin D to restore the gap junction function of the gut. Gap junctions, the space between the cells lining the gastrointestinal tract, need vitamin D to pull them back together again. If not, the risk for “leaky gut” or infiltration of gastrointestinal products into the blood stream, becomes an issue.  

Over 70% of the immune system is in the gut. Immune action from the active form of vitamin D goes beyond gap junction work. Vitamin D is involved in several pathways including those that decrease inflammatory actions and pain sensitization[v].

The simple conclusion you might jump to is to supplement with Vitamin D. Some review of the scientific literature suggests this may do more harm than good. Vitamin D supplementation has the potential to induce a secondary B5 (pantothenic) acid deficiency. According to neuroscientist, SC Gominak, a B complex vitamin may be required to help off-set this short change in B’s when supplementing with D as well as help restore a healthy microbiome diversity[vi].

Clinically speaking, a probiotic, healthy vitamin D level, B-Complex and other natural anti-inflammatories such as fish oil and curcumin, could all help the gut be healthy, sleep to improve, and in all, reduce the level of inflammatory pain experienced in a wide variety of conditions. How do you know what is right for you?

Naturopathic medicine is individualized care, and no two people are alike. A comprehensive review of your health condition, sleep hygiene, nutrient status and existing medications is an important part of your sleep and pain management.

Contact Dr. Laura today for a free 15min consult to find out how she might work with you.

[i] de Oliveira DL, Hirotsu C, Tufik S, Andersen ML. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017 Jul;234(1):R23-R36. doi: 10.1530/JOE-16-0514. Epub 2017 May 23. PMID: 28536294.

[ii] Dhesi JK, Bearne LM, Moniz C, Hurley MV, Jackson SH, Swift CG & Allain TJ 2002 Neuromuscular and psychomotor function in elderly subjects who fall and the relationship with vitamin D status. Journal of Bone and Mineral Research 17 891–897. (doi:10.1359/jbmr.2002.17.5.891)

[iii] Liguori C, Romigi A, Izzi F, Mercuri NB, Cordella A, Tarquini E, Giambrone MP, Marciani MG & Placidi F 2015 Continuous positive airway pressure treatment increases serum vitamin D levels in male patients with obstructive sleep apnea. Journal of Clinical Sleep Medicine 11 603–607. (doi:10.5664/jcsm.4766)

[iv] Sivertsen B, Lallukka T, Petrie KJ, Steingrímsdóttir OA, Stubhaug A & Nielsen CS 2015 Sleep and pain sensitivity in adults. Pain 156 1433–1439. (doi:10.1097/j.pain.0000000000000131)

[v] Garcion E, Wion-Barbot N, Montero-Menei CN, Berger F & Wion D 2002 New clues about vitamin D functions in the nervous system. Trends in Endocrinology and Metabolism 13 100–105. (doi:10.1016/S1043- 2760(01)00547-1)

[vi] Gominak SC. Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity. Med Hypotheses. 2016 Sep;94:103-7. doi: 10.1016/j.mehy.2016.07.007. Epub 2016 Jul 14. PMID: 27515213.