Abstract
Objective: The aim of this study is to show the use and efficacy of vitamin D supplementation in treatment course of chronic insomnia with melatonin.
Background: Numerous articles and clinical studies appear to prove the connections between vitamin D deficiency and different neurological pathologies like MS, chronic fatigue syndrome, neuropathic pain and sleep disorders. In sleep regulation Vitamin D acts through central receptors found in the anterior and posterior hypothalamus, substantia nigra, midbrain central grey nucleus and nucleus reticularis pontis.
Design/Methods: 10 women of 60–65 year old for whom insomnia was the initial complaint for consultation were selected. All of them mentioned the presence of chronic fatigue, multiple nighttime awakenings and excessive daytime sleepiness. In anamnesis no other pathology was found except general musculoskeletal pain. Neurological examination was normal. Vitamin D levels and thyroid hormones were tested in blood which showed normal thyroid function and vitamin D deficiency ranging from 8–16 ng/ml (normal range between 30–50 ng/ml). A treatment course of 3 weeks with low dose melatonin was started.( 0.5 mg/day) combined with a single administration of oral vitamin D 50.000 UI/week and 1000 UI/day.
Results: Symptoms were improved starting from the first week and there was no need of increasing the dosage or adding another hypnotic agent. No withdrawal effect was seen. Patients are currently on follow-up with prescription of melatonin 0.5 mg/night in case needed and vitamin D 1000UI/day for a month.
Conclusions: How exactly vitamin D acts on melatonin synthesis and functions needs still to be understood.
Based on our clinical case we suggest to make consider vitamin D deficiency as a probable cause of sleep disturbances and check the levels as a routine test.
Combined treatment of vitamin D with melatonin will accumulate the therapeutic efficacy and help to avoid high doses and long term treatment courses in chronic insomnia.
Disclosure: Dr. Sahakyan has nothing to disclose.
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