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[News] Vitamin D - possible help for sleep apnea patients?
Doctor found vitamin D helped sleep apnea patients

How incredibly sad that a child is brain-dead from a tonsillectomy, which was done to hopefully help her sleep apnea. It is especially sad because a very simple and inexpensive treatment is available that may have helped.

After trying to help many sleep apnea patients, and not always having success, neurologist Dr. Stasha Gominak evaluated her treatment and assessment records, and finally discovered one thing that her difficult patients all had in common. They were all deficient in Vitamin D.

From Dr. Gominak's website:

Quote: Sleep apnea does not just happen to fat people

Despite what has been written about Obstructive Sleep Apnea, most people who have this disorder are not obese and there is nothing abnormal about the way their neck is formed. They do not necessarily snore and are not always witnessed to stop breathing.

In 2009 a couple of my headache patients with sleep apnea told me that the extra vitamin D that they had started made their sleep, and then their headaches, better. This was after 6 years of wondering “why are 9/10 of the sleep studies, even in my young, healthy headache patients abnormal?”

I discovered that all of my patients who had abnormal sleep also had vitamin D deficiency. I looked in the scientific literature to see if anyone had reported that low vitamin D produced sleep disorders. The answer is no, but on looking further, it turns out that there are vitamin D receptors all over the posterior brain-stem, right where the “clock” that times our sleep, and the “paralysis switch” are. What if we might be able to give back something that the brain was lacking and make the sleep return to normal?

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Also from Dr. Gominak's blog:

Vitamin D Hormone

Vit­a­min D and Neu­ro­logic Disorders

If you have a neu­ro­logic prob­lem that is severe enough to see a neu­rol­o­gist, you are prob­a­bly not heal­ing your body as per­fectly as you once did. Most peo­ple who are suf­fer­ing from neu­ro­logic prob­lems such as headache, chronic pain, tremor, bal­ance dif­fi­cul­ties, dizzi­ness, depres­sion, stroke, or mem­ory loss also have abnor­mal sleep. Fix­ing the sleep can often fix the neu­ro­logic problem.

Why Vit­a­min D?

In 2005 one of my patients with daily headache requested a sleep study because she thought she had sleep apnea. Sur­pris­ingly, her headaches went away after a few weeks of using a sleep apnea mask. Because it worked so well for her, I started to per­form sleep stud­ies on all of my headache patients, and real­ized that they all had abnor­mal sleep stud­ies. Then I began to do sleep stud­ies on my patients with other neu­ro­logic prob­lems such as seizures, back pain, dizzi­ness, stroke or bal­ance prob­lems, and most of them also had abnor­mal sleep stud­ies, some­times with­out being aware that their sleep was abnor­mal. After pre­scrib­ing sleep med­ica­tions and sleep apnea masks for sev­eral years, I acci­den­tally dis­cov­ered that most of my patients had abnor­mal sleep because they were vit­a­min D defi­cient. If fix­ing that defi­ciency might help them sleep nor­mally I’d like to do that first before rely­ing on sleep­ing pills, or hav­ing to wear a sleep apnea mask at night.

Vit­a­min D is not a vitamin:

We’ve been taught that Vit­a­min D is the “bone vit­a­min”, but it is really more of a sun hor­mone. The word “vit­a­min” means “some­thing my body needs that I can’t make, so I must get it from the food”. D hor­mone is instead, a chem­i­cal that we make on our skin from sun expo­sure. It is a hor­mone like thy­roid, estro­gen or testos­terone. Using the proper word “hor­mone” reminds us that it affects mul­ti­ple parts of the body and that it is not “extra”. It is essen­tial to every cell in the body and it is not in the food. It is sup­ple­mented in milk but as a cup of milk has only 100 IU of vit­a­min D you would have to drink 100 cups of milk a day to keep from being D deficient.

Why would we make a hor­mone from sun exposure?

D hor­mone is unique among our hor­mones because we make it on our skin from a spe­cific wave­length of light, UVB. Our planet is tilted so as we go north or south from the equa­tor there are sea­sons. In the sum­mer we are closer to the sun, in the win­ter, far­ther from the sun. Where there are sea­sons every liv­ing thing has to deal with 6 months of good weather and avail­able food, and six months of ter­ri­ble cold and no food. The far­ther we move away from the equa­tor the less UVB wave­length there is in the win­ter light so our D hor­mone fluc­tu­ates with the sea­sons; it goes higher in the sum­mer and lower in the win­ter. Any ani­mal that can devise a way to eat more and get strong in sum­mer, and eat less and sleep more in the win­ter, will have a bet­ter chance of sur­vival. Every ani­mal on this planet; mam­mals, rep­tiles, birds, fish and insects use this same chem­i­cal, D3 (chole­cal­cif­erol), made on their skin from UVB light, to do just that.

D hor­mone affects our weight and appetite:

In the sum­mer as we have more sun expo­sure our D hor­mone level climbs to 80 ng/ ml, we eat more calo­ries, and store less. The high D mes­sage is it’s sum­mer it’s time to build our strength. We use our calo­ries to build stronger bod­ies. We sleep fewer hours, but more effi­ciently, with a higher per­cent­age of the total sleep spent in deeper stages of sleep. In the win­ter there is no UVB light so we use the vit­a­min D we made and stored in sum­mer. As it gets used up the blood level falls. The low D mes­sage is; sleep longer, store fat for spring. Our meta­bolic rate goes down (we hiber­nate). As the D level falls the thy­roid hor­mone goes down, we sur­vive the win­ter by sleep­ing more hours and using less energy. The lower D level appears to affect the pop­u­la­tions of bac­te­ria in our intes­tine. Who lives in our intes­tine appears to affect not only our appetite, but also what we do with the calo­ries we eat do we store fat or put it into mus­cle. ( See The Econ­o­mist mag­a­zine August 18, 2012 “The human micro­biome: Me myself, us” for a good expla­na­tion of how our colonic biome affects our weight.)

Low D goofs up sleep.

Most of the neu­ro­log­i­cal prob­lems my patients have are not directly related to D hor­mone, they are related to the fact that D hor­mone defi­ciency causes sleep dis­or­ders; insom­nia, sleep apnea, REM related apnea, unex­plained awak­en­ings to light sleep, inap­pro­pri­ate body move­ments dur­ing sleep. All of these dis­or­ders keep us from heal­ing our bod­ies dur­ing sleep. When the sleep improves the headaches, seizures, tremor, back pain, bal­ance dif­fi­cul­ties, depres­sion, mem­ory loss, etc. all get bet­ter. (See the sleep hand­out for more detail about why.)

What does D hor­mone defi­ciency look like?

D hor­mone affects the entire GI tract. There are D recep­tors in our sali­vary glands, our teeth, our esophageal sphinc­ter, and the stom­ach cells that make acid. When the stom­ach sphinc­ter is weak the acid moves up into the esoph­a­gus, where it doesn’t belong, caus­ing acid reflux. The D we make on our skin goes to the liver, then into the bile, it keeps the bile acids dis­solved, pre­vent­ing gall stones from form­ing. Because there are D recep­tors in the islet cells of the pan­creas that make insulin, not enough D may con­tribute to the devel­op­ment of dia­betes. Low vit­a­min D lev­els are related to poor stom­ach emp­ty­ing as well as bloat­ing and con­sti­pa­tion or “irri­ta­ble bowel”. The irri­ta­ble bowel may result from los­ing our “happy, help­ful” bac­te­ria in our lower GI tract. They die off when we don’t sup­ply the vit­a­min D the bac­te­ria also need to sur­vive. Because those same colonic bac­te­ria sup­ply 7/8 of the B vit­a­mins we need on a daily basis, some of my patients have vit­a­min D defi­ciency and sec­ondary B vit­a­min defi­cien­cies. (At least 2 of the B vit­a­mins, B5 and B12, are needed to sleep nor­mally) So there are sec­ondary B vit­a­min defi­cien­cies that may also have to be cor­rected before the sleep will return to normal.

Poor sleep causes hyper­ten­sion, heart dis­ease and stroke:

Fif­teen years ago the sleep dis­or­ders experts began to report that every Amer­i­can with high blood pres­sure had a sleep dis­or­der in the back­ground. There­fore the real killer in Amer­ica is not the long term effects of hyper­ten­sion, but the long term effects of abnor­mal, non-restorative sleep. Vit­a­min D appears to affect our sleep cycles through D recep­tors in the low­est part of the brain called the “brain­stem”, where we con­trol the tim­ing and paral­y­sis of sleep. Sleep occurs every night to allow us to heal and make repairs. It is dur­ing sleep that we make the chem­i­cals that keep our blood pres­sure nor­mal dur­ing the fol­low­ing day. While we sleep our arter­ies repair and stay smooth so they don’t have the cho­les­terol build up that closes off the ves­sels lead­ing to heart attack and stroke. The pace­maker cells in the heart heal so we don’t get atrial fib­ril­la­tion that can lead to strokes.

Poor sleep causes mem­ory prob­lems and depression:

While we sleep we make per­ma­nent mem­o­ries. Dur­ing sleep we also make the sero­tonin that we use dur­ing the day to stay happy and curi­ous, so low D hor­mone can cause depres­sion and mem­ory problems.

Low D affects all the blood cells and can cause ane­mia, autoim­mune dis­ease and cancer:

There are D hor­mone recep­tors on the red and white blood cells. When the white blood cells don’t have enough D they get con­fused, they start attack­ing our body by mis­take. All of the autoim­mune dis­eases: mul­ti­ple scle­ro­sis, lupus, rheuma­toid arthri­tis, pso­ri­a­sis, and ulcer­a­tive col­i­tis, are related to low D hor­mone. Our own white blood cells travel through our bod­ies at night seek­ing out and killing can­cer cells. Thus, increases in breast, colon and prostate can­cer are also believed to be related to low D. Women with breast can­cer who are told they “can’t take hor­mones”, (mean­ing estro­gen), should still take D hor­mone. The right D level (in addi­tion to nor­mal sleep) helps the body’s own immune sys­tem fight cancer.

D hor­mone, bones and calcium:

Even though most of us have been told we need extra cal­cium, D defi­ciency is what causes osteo­poro­sis. D helps the GI tract absorb cal­cium and keeps the cal­cium from leak­ing into the urine, (so low D may also cause kid­ney stones by dump­ing more cal­cium than nor­mal into the urine). If the vit­a­min D level is kept 60–80 cal­cium is prop­erly absorbed from the diet and Fos­amax, Evista, Boniva are not needed to pre­vent bone loss.

Low D causes bal­ance dif­fi­cul­ties and pain:

D defi­ciency can also cause leg pain, burn­ing in the feet, and dif­fi­culty with bal­ance, prob­a­bly through sec­ondary B defi­cien­cies of B12, B5 or B6. Poor sleep results in body pain on awak­en­ing; fibromyal­gia, arthri­tis, chronic low back pain, knee pain, hip pain. Every mov­ing part of the body must get per­fectly par­a­lyzed to repair at night. If paral­y­sis does not occur cor­rectly dur­ing sleep the body doesn’t heal and morn­ing pain can result.

Low D causes infer­til­ity, poly­cys­tic ovary syn­drome and endometriosis:

There are vit­a­min D recep­tors in the ovaries, the tes­ti­cles and the fal­lop­ian tubes to help match our repro­duc­tion to the amount of food avail­able. As the D level climbs in the fall, to 80 ng/ml, we make higher estro­gen and testos­terone lev­els that make us want to mate. Because our babies develop over 9 months, the baby that is con­ceived in Sep­tem­ber is born in June. This guar­an­tees that at birth the baby is in the sun mak­ing her own D hor­mone because there is no D in the breast milk. Low D sup­presses ovu­la­tion so that our babies will be born when mom has food. “Poly­cys­tic ovary” describes an ovary with many eggs that are all try­ing to mature at once. Because ovu­la­tion is inhib­ited by the low D, the ovaries are stuck at the stage of many eggs try­ing to mature and cysts develop, lead­ing to abdom­i­nal pain, often accom­pa­nied by weight gain and acne (the triad of symp­toms called poly­cys­tic ovar­ian syndrome).

Endometrio­sis results from endome­trial tis­sue going back­ward up the fal­lop­ian tube into the abdomen instead of out the cervix, (the open­ing in the uterus), dur­ing men­stru­a­tion. Because the fal­lop­ian tube is open into the abdomen, the only thing that keeps the endome­trial tis­sue head­ing out the cervix are wave-like move­ments in the fal­lop­ian tube push­ing toward the uterus. There are vit­a­min D recep­tors in the fal­lop­ian tubes that influ­ence the propul­sive move­ments, pro­mot­ing or pre­vent­ing fer­til­iza­tion depend­ing on the D level. Also, once the endome­trial cells have arrived in the abdomen, where they don’t belong, the white blood cells are sup­posed to find and kill them. Because the low D also affects the func­tion of the white blood cells the proper elim­i­na­tion of the endome­trial tis­sue doesn’t occur and fixed implants of endome­trial tis­sue appear in the abdomen, caus­ing abdom­i­nal pain dur­ing menstruation.

Women bear­ing babies are the ones who are most affected:

The rea­son why thy­roid dis­ease, gall­blad­der dis­ease, B12 and iron defi­ciency, obe­sity and sleep dis­or­ders (and there­fore severe headaches) often occur in young, healthy women is because they’re the ones hav­ing the babies. Each baby sucks up mom’s vit­a­min D using it for devel­op­ment. Unfor­tu­nately, each pre­na­tal vit­a­min has only 400 IU of vit­a­min D, which is not nearly enough to pro­vide for mom and the devel­op­ing baby. When we all lived out­doors mom would get preg­nant again as soon as she made enough D to sleep nor­mally and get her body ready for the next baby. Now, each baby uses up mom’s D and if she’s not out in the sun enough after deliv­ery her D deficit is never cor­rected between preg­nan­cies. Each result­ing child is more D defi­cient and each baby sleeps worse than the last. Mom also sleeps badly, being more D defi­cient her­self with each baby. The chronic sleep dis­or­der over sev­eral years can result in post­par­tum depres­sion and occa­sion­ally psy­chosis; (abnor­mal thoughts and hal­lu­ci­na­tions). I believe that once the sleep is very, very abnor­mal, the “sleep switch” (which is designed to be sure that we never dream while we’re awake) may start to mal­func­tion, and dream-like expe­ri­ences (hal­lu­ci­na­tions) may start to leak into wak­ing life.

Some com­monly used med­ica­tions pre­vent REM sleep:

Unfor­tu­nately many of the com­monly used anti­de­pres­sants, though they keep the sero­tonin up dur­ing the day to make us hap­pier, also make the sero­tonin stay up inap­pro­pri­ately at night. High sero­tonin lev­els at night sup­press REM sleep, para­dox­i­cally pre­vent­ing the very phase of sleep that might give us back nor­mal pro­duc­tion of our own sero­tonin. Long term REM depri­va­tion is prob­a­bly the most com­mon cause of depres­sion. Over the last thirty years there has been a dra­matic increase in the inci­dence of depres­sion, sleep dis­or­ders and vit­a­min D defi­ciency in all of the devel­oped coun­tries of the world, I believe these three con­di­tions are linked.

Vit­a­min D and aging:

Even under per­fect cir­cum­stances, with per­fect sun expo­sure, we don’t live for­ever. Humans live about 90–100 years. Every decade our vit­a­min D pro­duc­tion (per hour of sun expo­sure) goes down. At age 70–75 the vit­a­min D pro­duc­tion on our skin goes so low that four com­plaints become com­mon in the elderly; “my bow­els don’t work”, “I’ve got rheuma­tism” (I wake up stiff and in pain), “I don’t sleep well”, and “my nose runs all the time.” When the sleep starts to fail we begin to get hyper­ten­sion, dia­betes, high cho­les­terol, heart dis­ease, stroke or can­cer and die 5–10 years later. There­fore our abil­ity to sleep nor­mally is linked to our life span.

What should my vit­a­min D level be?

How much would my body make nor­mally out in the sun? When we sit in the sum­mer sun, at noon, with chest, face, and arms exposed we make 10,000 IU of vit­a­min D. Whole body expo­sure pro­duces 20,000 IU in 2–4 hours. The rate of pro­duc­tion is depen­dant on the skin color. Darker skinned peo­ple make D more slowly for equal time spent in the sun. Because we don’t have fur or feath­ers cov­er­ing our skin, the melanin col­oration in the skin keeps us from mak­ing too much D. Lighter skinned humans began to appear in far north­ern and south­ern lat­i­tudes because their lighter skin color did not block the D pro­duc­tion. They were stronger and could repro­duce in lower sun envi­ron­ments where D was scarce. How­ever, those bright white or freck­led peo­ple have a dis­ad­van­tage when they move to a high sun envi­ron­ment, they don’t have the nat­ural melanin pro­tec­tion and they burn. When humans are adapted to their lat­i­tude with the “proper” col­oration, and their inter­nal D level is high enough, some of the pro-D on the skin is con­verted to D 1,25 OH, the active hor­mone which goes into the nuclei of the skin cells to repair the UVB induced DNA dam­age, thus help­ing to pre­vent skin can­cer under nor­mal circumstances.

As most of us don’t receive “sun D” every day, our sup­ple­men­tary vit­a­min D require­ments are much higher than the FDA rec­om­mended 800 IU per day, and are prob­a­bly closer to 5,000–10,000 IU per day just to stay the same. To sleep nor­mally the vit­a­min D blood level must be 60–80 ng/ml. The vit­a­min D25OH that we mea­sure in the blood is “stor­age D”. We make the active chem­i­cal; D 1,25 OH every minute of the day, in each organ in rela­tion to its need. When your doc­tor mea­sures your D blood level it should be the D 25 OH, not the D 1,25 OH.

Why FDA rec­om­men­da­tions are so low:

Chole­cal­cif­erol is a hor­mone not a vit­a­min. We would never dream of putting estro­gen or testos­terone or thy­roid hor­mone into the milk. Because it was incor­rectly called a “vit­a­min” the FDA has been put in the very dif­fi­cult posi­tion of mak­ing “rec­om­men­da­tions” for hun­dreds of thou­sands of peo­ple who have dif­fer­ent D lev­els from year to year depend­ing on their lifestyle, where they live and their skin color. The FDA knows that high vit­a­min D lev­els can cause med­ical prob­lems and death, they just don’t really know why. (I think it is because vit­a­min D makes the sleep just as abnor­mal when it goes over 80, as it does when it’s under 60, there­fore every­thing I have described above results from a high vit­a­min D just as eas­ily as from a low vit­a­min D). The FDA has appro­pri­ately rec­om­mended a dose of vit­a­min D, 400–800 IU/day, that is unlikely to hurt any­one. This does not mean that 800 IU is what you need. Each per­son must find out what dose they need by mea­sur­ing their blood level.

Every­one who takes this hor­mone in big­ger doses must fol­low their vit­a­min D blood level. Ask your doc­tor to mea­sure your vit­a­min D 25OH level. Most doc­tors do not know what the “nor­mal” D level really is, so ask for the num­ber, it should be between 60–80 ng/ml. Medicare will pay for vit­a­min D lev­els four times per year if a billing code of 268.9 (vit­a­min D defi­ciency) is used on the lab slip. If you don’t have insur­ance http://www.vitamindcouncil.org will do your level for $75.00. All your ques­tions about vit­a­min D are answered at http://www.vitamindcouncil.org. It is a site started in 2003 to teach you and me about this hor­mone. It has thou­sands of sci­en­tific ref­er­ences link­ing vit­a­min D defi­ciency to var­i­ous dis­eases, and teach­ing about how to use vit­a­min D safely and effectively.

What is the right D hor­mone dose?

For most peo­ple the daily sup­ple­men­tal D dose will be 1–5000 IU per day in sum­mer, 5–7,000 IU per day in win­ter, but if your level is 30 or below and it’s win­ter, I rec­om­mend that you take 10–15,000 IU for 2–3 weeks to get your level back above 50 more rapidly. Then check your level again in 4 weeks to be sure it is above 60. Over 1–2 years mea­sure your D lev­els every 6 to 12 weeks and make sure that you are tak­ing enough to pro­vide a D level between 60–80 ng/ml all year long. Don’t take extra D when you’re using a tan­ning bed or out in the sun in the sum­mer, you’ve just made your daily sup­ply on your skin. Never take doses over 1000 IU/day with­out check­ing your lev­els regularly.

Prac­ti­cal Aspects:

Leg cramps or increase in headaches when you’re start­ing extra D can be caused by low mag­ne­sium, go to http://www.vitamindcouncil.org and read about mag­ne­sium sup­ple­men­ta­tion or eat a hand­ful of sun­flower or other seeds per day if this hap­pens to you.

What kind of D and why so many kinds?

The largest dose of vit­a­min D3 locally avail­able, over the counter is 5,000 IU. Wal­mart, Sam’s Club, Drug Empo­rium all have it. We doc­tors have been, incor­rectly, taught that it’s safe to give vit­a­min D2, (ergo­cal­cif­erol) as a once a week pill of 50,000 IU. D2 Ergo­cal­cif­erol is not the same as D3 Chole­cal­cif­erol, and may be dan­ger­ous for some. In fact the major­ity of my patients felt that it made their sleep and headaches worse. Make sure what you buy is D3. This impor­tant mis­take resulted from using the rat as the exper­i­men­tal model to look for the “vit­a­min” that pre­vented the bone dis­ease of rick­ets in the 1930’s. Rats are noc­tur­nal ani­mals. In order to spend their lives in the dark, they had to have a mutated vit­a­min D recep­tor that allowed them to use a dif­fer­ent chem­i­cal, D2. D2 is a chem­i­cal made by fun­gus that grows on grain. D2 is sim­i­lar but not iden­ti­cal to what you and I, and all other ani­mals, make on our skin from sun expo­sure. D2 does come in the food, (which is why the “vit­a­min” word was orig­i­nally applied). The rat’s abil­ity to use this chem­i­cal allowed it to be noc­tur­nal, active at night and able to run about our houses eat­ing our food at night. This is why humans don’t like rats and there­fore find exper­i­men­ta­tion on them less objec­tion­able than on other ani­mals. Once D2 was dis­cov­ered it did, in fact, help rick­ets in chil­dren. The first “anti rick­ets” chem­i­cals were D1 and D2, found on grain. Sev­eral years later, D3 was dis­cov­ered on the skin of pigs, (but only after UVB light expo­sure). Because D3 acted sim­i­larly to D2 at bone recep­tors it has been assumed that it would behave the same at all recep­tors. D2 appears to act dif­fer­ently than D3 in the brain, it usu­ally does not improve the sleep, and may make it worse.

“I eat a good diet, why would I have other vit­a­min defi­cien­cies in addi­tion to vit­a­min D deficiency?”

B12 defi­ciency and iron defi­ciency are com­mon sec­ondary defi­cien­cies that also affect sleep. Vit­a­min B 12 defi­ciency results because there are Vit­a­min D recep­tors in the stom­ach cells that make “intrin­sic fac­tor”. Intrin­sic fac­tor is the chem­i­cal that binds to B 12 in our diet and allows us to absorb it. When the D is so low that the intrin­sic fac­tor pro­duc­tion also becomes low we are less able to absorb B12 from our food. I believe B12 also helps pro­duce nor­mal sleep. Iron is a cofac­tor in mak­ing dopamine, one of the chem­i­cals that runs the tim­ing and paral­y­sis of sleep, so when D, B12 and iron defi­ciency all exist together the sleep becomes espe­cially bad. Those two addi­tional defi­cien­cies usu­ally mean that the D has been low for many years. Ask your doc­tor to check your B12 and iron level when you check the D for the first time. The B12 level for nor­mal sleep is above 500. (Again you want to know the num­ber). If the B12 blood level is below 500 I rec­om­mend a pill of B12 of 1000 mcg/day. Shots are not bet­ter than the pills and it will be absorbed as long as the D dose is increased at the same time.

Do our B vit­a­mins really come from our poop?

It’s impor­tant to know that 7/8 of the B vit­a­mins that we need daily are sup­plied by our intesti­nal bac­te­ria. This allowed humans and other ani­mals to go sev­eral weeks with­out food, because they car­ried with them an inter­nal store of the B vit­a­mins. The B vit­a­mins are not stored, they are very short act­ing and elim­i­nated within 1–2 days but we need them daily for proper cel­lu­lar actions through­out the body. There­fore, it is pos­si­ble that when the nor­mal colonic bac­te­ria die off we might become low in some of the B vit­a­mins, despite eat­ing a good diet. If you have pain, arthri­tis, irri­ta­ble bowel, or burn­ing in the hands or feet you may have pan­tothenic acid (B5) defi­ciency. I believe this sec­ondary defi­ciency devel­ops after many years of D defi­ciency because our intesti­nal bac­te­ria become abnor­mal. Our intesti­nal bac­te­ria need our vit­a­min D to thrive. They use the D that we make on our skin, passed down to them in the bile. When they don’t get enough D to sur­vive other species of bac­te­ria begin to dom­i­nate the gut. A nor­mal daily sup­ply of pan­tothenic acid pro­duced by the gut bac­te­ria, appears to be nec­es­sary for nor­mal sleep. If you feel this refers to you do not take large doses of the B vit­a­mins sep­a­rately, take B-50 (B com­plex that has 50 mg of each of the 8 B vit­a­mins) daily but only for 3–4 months. I believe that sup­ply­ing the D and the B com­plex together encour­ages the “right bac­te­ria” to grow back in the gut, so after 3–4 months the intesti­nal bac­te­ria are mak­ing the B vit­a­mins we need in the right pro­por­tion and adding to that with a pill may mean that you are now tak­ing too much. Large doses of pan­tothenic acid appear to dis­rupt the sleep and will keep you from get­ting bet­ter. Large doses of other B vit­a­mins given alone will not bring back the nor­mal colonic bacteria.

Any other vitamins?

Most authors believe that you should always take a mul­ti­vi­t­a­min along with vit­a­min D, there are sev­eral cofac­tors that vit­a­min D must have to do its job prop­erly and these are all con­tained in the rou­tine mul­ti­vi­t­a­min, big­ger B doses are not nec­es­sar­ily bet­ter, and may actu­ally harm your sleep if your intesti­nal bac­te­ria are mak­ing the right amounts for you already.(see above)

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First, the majority of the population in North America is low in vitamin D. So if the majority of sleep apnea patients in North America are low in vitamin D, that is hardly news.

Second, I tested just below the lower level of normal on vitamin D, but after getting my level up to normal with supplements, there was no change in my sleep apnea.

Third, I have a lot of issues with the current vitamin D hysteria. There are a lot of things that the medical community seems to ignore:

1) Vitamin D is normally produced when UVB light hits the skin, specifically by activating endogenously produced substances in the lower levels of the skin (converting them into vitamin D). This fits with evolution: We originated in Africa, presumably with darker skin, but when we got to northern areas where the sun's rays come it at a severe angle (UVB is inhibited by the atmosphere), we evolved lighter skin so more of the precious UVB could get to the lower levels of the skin. But I live in an area where 5% of the population is African-American, yet I see no special mention made that they should take even more pills than their white neighbors. You would think that there would be ads on the sides of buses targeting this population advising them to get tested, but nada.

2) Who says that northern Europeans need the same amount of vitamin D as other populations? What if northern Europeans evolved a lesser need for vitamin D as well as lighter skin? Are the "normal" ranges valid for the entire human race? I mentioned this to my doctor and his reply basically discounted my observation because I don't have a medical degree. Indeed, I have always hated and avoided biology (yuck), but I don't need a medical degree to spot a failure of the scientific method.

But having said all of that, vitamin D toxicity is remarkably rare. You could take pretty massive amounts without danger. So get tested and add supplements if necessary. Just don't expect miracles from it.
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went to the post office today to pick up the mail. had some blood work test results in there. Talking about Vit D....mine is really low, like 12. that is a little unnerving to me, especially since my doctor hasn't called me about these test results. I called and asked if they were in and was told yes and they mailed them to me.
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Yes, that is low but not unusual - VitD amounts vary over the year, and hit their nadir in winter. Plus, drug regimes and certain illnesses will rip VitD out of you, so to speak. Tanking up is necessary only if you are experiencing certain symptoms, like peripheral neuropathy (lack of sensation or tingling in the extremities). For most adults, this is not a real problem and part of the normal cycle. If you had these worths in the summer, that would be another issue.

In adults, your best bet for tanking up on VitD is 15 minutes exposure to the sun three times a week, more or less, even winter sun helps. Just wear a cap or knitted head covering (mutze in German, I forget the English word), so your head doesn't get cold, and let the sun shine on your face during a nice walk. Eating carrots, etc helps, as does cod liver oil, but only take in so much through diet, the rest is sun exposure.

Supplements in the form of drops are most effective if taken just after a meal.

Either way, don't panic - these articles are a wonderful way of raising alarms where there is no reason for it. They drive me nuts, to be honest, because it is disruptive and only sets panic amongst people who don't know how to understand this stuff or what it really means, starting with the journalists who sensationalise it in their articles.We are trained in all this, you know, and have to keep up with the latest in medical advances on a quarterly basis (we get papers and journals every day, but have to do course work pretty much each month or quarter to keep our licenses). If your doc thinks you need to do something about it, he will tell you. You can ask him, and he will give you a supplement, but as I said, don't worry too much.
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Thanks DocWils.

I haven't read the article in full and actually just skimmed it. I have had Vit D deficiency before but I don't remember if it was summer or winter. I don't think it has ever been as low as 12 though.

Now days, with an article or news report coming out all the time with new things that cause cancer, I have just pretty much ignored them because if I listened to them, there wouldn't be any food that didn't cause cancer, no water that didn't cause cancer, can't drink out of any glasses or cups because the material they are made from will cause cancer..........I think you get what I am saying.

Thanks again.
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It is good to make sure you have adequate Vitamin D for many reasons but I doubt that it will rid you from sleep apnea.
Make sure you get tested before you take a lot of it. There are problems if you take too much of it.
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(01-20-2014, 09:36 AM)Lukie Wrote: It is good to make sure you have adequate Vitamin D for many reasons but I doubt that it will rid you from sleep apnea.
Make sure you get tested before you take a lot of it. There are problems if you take too much of it.

No, Vit D won't cure sleep apnea. I got tested and my Vit D is 12.
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I just went in for my six month checkup. My sleep therapist noted that I go to sleep quickly but then have trouble staying asleep. She recommended I take 2000 iu of D3 daily. It does seem to help me stay asleep better and if I do wake up I don't stay awake as long. Too soon to draw any real conclusions, however.
"Sometimes the magic works . . . and sometimes it doesn't" -- Chief Dan George in the movie Little Big Man
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DocWils makes some good points, especially the comment about the media sensationalizing the vitamin D issue. I should add my personal experience, because it points out how individual data varies widely.

I was tested about two and a half years ago, in late summer. Weather permitting, I go hiking for two hours every day. By "hiking" I mean out the front door of my house in the city and down the street. In the summer I wear just a t-shirt, shorts, and sandals, and when the temperature approaches 30 degrees I go shirtless too, and I never use sunscreen. And my genetics are northern Germany; I am blond and light-skinned. Needless to say, while sitting in my doctor's office getting the test results I was tanned to the point of having tan lines on my feet from the straps on the sandals. In spite of the obvious sun exposure I tested just below the lower limit of the normal range.

According to Wikipedia 100 IU of vitamin D3 supplement is supposed to raise your test results by one nanogram per mL. The lab reported that they tested 25-hydroxyvitamin D and their normal range is 20 ng/mL to 80 ng/mL, and my results were 19 ng/mL. Therefore, if I wanted my level to be in the middle of the normal range I should take one 400 IU supplement daily. (In my part of the world D3 pills are available in 400, 600, 1000, 2000 and 5000 IU over the counter.) But after taking a 400 IU D3 supplement daily for a couple of months I had another test, and this one came in at 21 ng/mL. Eventually I discovered that a 5000 IU pill daily raises me to 36 ng/mL.

So this raises a lot of interesting questions. Why was I low when I was tested in late summer, when I obviously had been experiencing massive sun exposure for months? And did Wikipedia lie when it said that 100 IU should raise your level by one ng/mL?

It seems clear to me that my body must either be not producing the same amount of vitamin D as normal people would with my amount of sun exposure, or I am not assimilating or using it in a manner that will show up on a test for 25-hydroxyvitamin D, more likely the latter, since I had equally poor lab results with the supplements.

Note carefully: I am not suggesting that anyone else take 5000 IU daily as I do. I started taking that amount only after several lab tests and consulting with my physician.

I should also mention that last winter I was in a class with a woman from Saudi Arabia. She dresses in the traditional garb for women in her country; ie., only her hands and the front of her face were ever exposed. She told me that her doctor had prescribed 50,000 IU once a week while here. (My latitude is about the same as the English Channel, with the same mild, but foggy, drippy winters.) And again, I emphasize that this woman was taking that amount only on medical advice.

My main purpose in posting this is to point out the vast range of variation in the population in the matter of vitamin D.

And now to a more practical question: Do I feel any better? Well, I only started CPAP about eight months after I was first tested, so by then my 25-hydroxyvitamin D levels were in the normal range. Hence, I cannot say what effect it might have had on my sleep apnea. But I do note that winters are not as depressing as they used to be. The improvement in my attitude toward the world is subtle, but noticeable, albeit impossible to quantify. That reason alone is enough to keep me taking the pills, but I assume there are a lot of other internal benefits as well - better calcium absorption, for example, and a lot of other stuff is probably functioning better as well.

Bottom line: if you live in a latitude like mine where the sun's ray's come in at a 45 degree angle, get yourself tested.
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