sleep

Could Vitamin D boost your Mood and Energy?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist
Many students may be aware of Vitamin D and with decreasing sunlight, many might not be getting enough vitamin D.
• Initially thought of as a vitamin, it is now believed that it works more like a hormone and has many functions throughout the body.
• Inadequate vitamin D has been implicated in fibromyalgia (1), sleep (2,3), athletic performance (4), energy levels (5) as well as bone disease (7).
• A recent study had discussed findings regarding vitamin d and depression.

What did this study involve?
• 40 patients between 18 and 65 y of age with Major Depressive disorder.
• Randomly assigned to get either a single capsule of 50 kIU vitamin D per week (n = 20) or placebo (n = 20) for 8 weeks.
• This was a randomized, double-blind, placebo-controlled clinical trial.

What did the authors analyze?
• Fasting blood samples before and after.
• The primary [Beck Depression Inventory (BDI), which examines depressive symptoms].
• Secondary outcomes such as glucose homeostasis variables, lipid profiles, hs-CRP, and biomarkers of oxidative stress.
What did the study show?
• After 8 weeks of treatment with vitamin D, depression scores improved in the patients receiving vitamin D supplementation.
• The improvement was also related to improvement in vitamin d levels.
How can I get vitamin D tested?
• There is a blood test for vitamin D, which can be ordered by your prescriber.

Can I get vitamin D from food?
According to the National Institute of Health (NIH) (7),
• “Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets.
• Fatty fish such as salmon, tuna, and mackerel are among the best sources.
• Beef liver, cheese, and egg yolks provide small amounts.
• Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores, the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
• Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
• Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages; check the labels.”

Is too much Vitamin D harmful?
Too much vitamin D can be harmful.

According to the NIH (7):
“Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. And by raising blood levels of calcium, too much vitamin D can cause confusion, disorientation, and problems with heart rhythm. Excess vitamin D can also damage the kidneys.”

What is the main cause of too much Vitamin D?

• Vitamin D toxicity almost always occurs from overuse of supplements (7).
• Excessive sun exposure doesn’t cause vitamin D poisoning because the body limits the amount of this vitamin it produces (7).

What are some caveats?

• To avoid the risk of harm, taking Vitamin D supplements should be done under the supervision of your prescriber/doctor.
• This is the 1st study showing benefits on depression with high dose weekly Vitamin D supplementation.
• Further studies are needed.
• Some previous studies showed mixed results though under-dosing and other factors may have been involved (6).
• Vitamin D has shown benefits in some studies and in clinical experience in psychiatry for select patients.
• Benefits on vitamin D may extend beyond mood.
• Treatment with vitamin D with supplement or prescription may NOT be suitable for everyone, but it may be worth discussing with your prescriber.

Is your mood, energy level, etc impacted by low vitamin D? Could replacement benefit you? Check with your health care provider if treatment is appropriate for you.
What are some resources regarding Vitamin D?

• https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
• Counseling and Consultation Service
• Wilce Student health center

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References

1. Jesus CA, Feder D, Peres MF. The role of Vitamin D in pathophysiology and treatment of fibromyalgia. Curr Pain Headache Rep. 2013 Aug;17(8):355.
2. Bertisch SM, et al. 25-Hydroxyvitamin D Concentration and Sleep Duration and Continuity: Multi-Ethnic Study of Atherosclerosis. Sleep. 2015 Aug 1;38(8):1305-11
3. McCarty DE, et al. The link between vitamin D metabolism and sleep medicine. Sleep Med Rev. 2014 Aug;18(4):311-9. Epub 2013 Sep 26.
4. B Hamilton. Vitamin D and Human Skeletal Muscle. Scand J Med Sci Sports. 2010 Apr; 20(2): 182–190.
5. Al–Dujaili E, Revuelta Iniesta R. http://www.eurekalert.org/pub_releases/2015-11/sfe-vdp102915.php Preliminary study presented Fall 2015 at the Society for Endocrinology Annual Conference in Edinburgh.
6. Sepehrmanesh Z, et al. Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial. J Nutr. 2015 Nov 25. pii: jn218883. [Epub ahead of print].
7. https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

Blue Blockers and other ways to reduce electronics-induced sleep disruption, and daytime tiredness

By R. “Ryan” S Patel DO, FAPA-OSU CCS Psychiatristblue_light

Blue spectrum light from electronics suppresses melatonin for several hours after use (1,2) and disrupts your circadian (sleep wake cycle) clock (3). This impacts sleep quality and daytime tiredness (4). Sleep disruption can also impact anxiety, depression, and many other health conditions (5).

So it may be worth avoiding use of electronic devices such as computer, tv, tablets, smartphones, etc. 1-3 hours before bedtime.
Some suggest replacing exposure to bright light bulbs with dim light bulbs around bedtime (6) may also be helpful. There are even light bulbs that do not emit blue light.

What if I need to use electronics at bedtime?
Sometimes it may be necessary to be on the computer, tv, smartphone, etc right before bedtime.
Blue blockers may help prevent sleep disruption from electronics.

How do blue blockers work?
They block blue light emitted by electronic devices, thus melatonin is not disrupted (6).

What are some examples of blue light blockers?
Some examples include blue blocker eye glasses, software programs that prevent your device from emitting blue light, plastic filter screens that are placed on top of the screens to block blue light, and light bulbs that do not emit blue light. You can search for “blue light blockers” “blue light filters”, “bedtime reading software” etc. in a search engine, or in an app store.

Do blue blockers work?
There are small studies that show blue blockers work to prevent melatonin disruption and improve quality of sleep and mood.
For example, 20 subjects were randomized to use either blue blocking glasses, or non blue blocking glasses 3 hours before bedtime over a 2 weeks period (7).

What did the results show?
Those who used blue-blocking glasses reported better sleep quality and mood.

Words of caution:
• You still need to be mindful of getting enough hours of sleep—getting 4 or 5 hours of quality sleep when you need 8 will still leave you tired.
• Blue blocking methods may not help with your sleep if your device usage is overly entertaining or emotionally intense.
• You still need to address other causes such as use of caffeine, nicotine, alcohol use, etc.
• This is still a relatively new terrain and further research is needed.

Are you sleeping poorly? Are you tired during the day? Are electronic devices interfering with your sleep; can you cut down your usage before bedtime? Can blue blockers help you?
What are other ways to improve sleep?
National sleep foundation sleep tips.

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References:
1. Brainard GC, Hanifin JP, Greeson JM, Byrne B, Glickman G, Gerner E, et al.
Action spectrum for melatonin regulation in humans: evidence for a novel
circadian photoreceptor. J Neurosci 2001;21(16):6405–12 [August 15, PMID:
11487664].
2. Thapan K, Arendt J, Skene DJ. An action spectrum for melatonin suppression:
evidence for a novel non-rod, non-cone photoreceptor system in humans. J
Physiol 2001;535(Pt 1):261–7 [August 15, PMID: 11507175].
3. Smith MR, Revell VL, Eastman CI. Phase advancing the human circadian clock
with blue-enriched polychromatic light. Sleep Med 2008 [September 18,
PMID: 18805055].
4. Fossum IN, et al. The Association Between Use of Electronic Media in Bed Before Going to Sleep and Insomnia Symptoms, Daytime Sleepiness, Morningness, and Chronotype. Behavioral Sleep Medicine. Volume 12, Issue 5, 2014, pages 343- 357. Published online: 14 Jul 2014. DOI: 10.1080/15402002.2013.819468.
5. http://sleepfoundation.org/sleep-disorders-problems
6. Kayumov L, et al. Blocking Low-Wavelength Light Prevents Nocturnal Melatonin Suppression with No Adverse Effect on Performance during Simulated Shift Work. The Journal of Clinical Endocrinology & Metabolism 90(5):2755–2761.
7. Burkhart K1, Phelps JR. Amber lenses to block blue light and improve sleep: a randomized trial. Chronobiol Int. 2009 Dec;26(8):1602-12. doi: 10.3109/07420520903523719.

Smartphone use before bedtime might impact sleep, and daytime tiredness

Smartphone or cellphones are a useful tool and when used properly can have many benefits.
Many students frequently use cell-phones and often very close to bedtime. Students may not know that cellphone use might impact their ability to sleep at night and this might impact their daytime energy levels.
This study explored the relationship between cellphone use at bedtime and sleep.

Who was studied?
532 students aged 18–39 were recruited from lectures or via e-mail (1).
Mean time of media use per night was 46.6 minutes.

What were the study results?
Mobile phone usage for playing/surfing/texting was positively associated with insomnia.
Computer usage for playing/surfing/reading was positively associated with insomnia.

What do the results mean?
Computer or cellphone use in bed before bedtime may worsen your sleep.

How does screen time impact sleep?
There are various potential causes:
Media use might make it take longer to fall asleep (2).
Media use might mean less time spent sleeping, thus reducing sleep (3).
Bright light emitted by electronic devices might impact sleep quality (4).

Light exposure might be temporarily activating you (5-6).

Are you sleeping poorly? Are you tired during the day? Is screen time before bed impacting your sleep? Will cutting down on screen time improve your sleep? How do you know?

By R. Ryan S Patel DO, FAPA, OSU-CCS Psychiatrist
Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References
1. Fossum IN, et al. The Association Between Use of Electronic Media in Bed Before Going to Sleep and Insomnia Symptoms, Daytime Sleepiness, Morningness, and Chronotype. Behavioral Sleep Medicine. Volume 12, Issue 5, 2014, pages 343- 357. Published online: 14 Jul 2014. DOI: 10.1080/15402002.2013.819468.

2. Higuchi, S., Motohashi, Y., Liu, Y., & Maeda, A. (2005). Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleep and REM sleep. Journal of Sleep Research, 14, 267–273.
3. Van den Bulck, J. (2004). Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep, 27, 101–104.
4. Cain, N., & Gradisar, M. (2010). Electronic media use and sleep in school-aged children and adolescents: A review. Sleep Medicine, 11, 735–742.
5. Cajochen, C., et al. (2011). Evening exposure to a light-emitting diodes (LED)-backlit computer screen affects circadian physiology and cognitive performance. Journal of Applied Physiology, 110, 1432–1438.
6. Campbell, S. S., et al. (1995). Light treatment for sleep disorders: Consensus report. III. Alerting and activating effects. Journal of Biological Rhythms, 10, 129–132.