The correlation of vitamin D level with sleep quality and mood in patients with chronic insomnia

Abstract

Objective To investigate relationship between vitamin D level and season, sleep quality and anxiety and depression in patients with chronic insomnia. Methods Total 246 patients with chronic insomnia and treated in The First Hospital of Hebei Medical University from August 2020 to August 2022 were included. Serum 25⁃hydroxy vitamin D [25 (OH) D] levels were determined. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, Hamilton Anxiety Rating Scale⁃14 (HAMA⁃14) to evaluate anxiety, and Hamilton Depression Rating Scale⁃24 (HAMD⁃24) to evaluate depression. Results The incidence of serum 25 (OH) D deficiency ( < 20 ng/ml) in chronic insomnia patients was higher than that in control group (χ2 = 78.202, P = 0.000), and serum 25 (OH) D level was lower than that in control group (Z = ⁃ 6.677, P = 0.000). According to the onset season, 246 chronic insomnia patients were divided into winter and spring group (n = 156) and summer and autumn group (n = 90). PSQI score (Z = ⁃ 2.694, P = 0.007), HAMA⁃14 total score (Z = ⁃ 2.166, P = 0.030), somatic anxiety score (Z = ⁃ 2.545, P = 0.011) and HAMD⁃24 score (Z = ⁃ 2.065, P = 0.039) in winter and spring group were higher than those in summer and autumn group. Serum 25 (OH) D level in winter and spring group was lower than that in summer and autumn group (Z = ⁃ 2.681, P = 0.007). According to PSQI score, 246 patients with chronic insomnia were divided into mild ⁃ moderate insomnia group (n = 114) and severe insomnia group (n = 132). In severe insomnia group, the proportion of female (χ2 = 10.733, P = 0.001), HAMA⁃14 total score (Z = ⁃ 4.633, P = 0.000), mental anxiety score (Z = ⁃ 5.273, P = 0.000) and physical anxiety score (Z = ⁃ 2.859, P = 0.004), and HAMD⁃24 score (Z = ⁃ 5.430, P = 0.000) were higher than those in the mild⁃moderate insomnia group, and serum 25 (OH) D level was lower than those in the mild⁃moderate insomnia group (Z = ⁃1.986, P = 0.047). Correlation analysis showed that serum 25 (OH) D was negatively correlated with PSQI score (r = ⁃ 0.331, P = 0.000), HAMA ⁃ 14 total score (r = ⁃ 0.178, P = 0.005) and HAMD ⁃ 24 score (r = ⁃ 0.142, P = 0.027). Conclusions Patients with chronic insomnia have lower vitamin D level, and patients with winter and spring onset have lower vitamin D level, worse sleep quality, and more severe anxiety, depression and somatization symptoms. Patients with worse sleep quality had lower vitamin D level, and more anxiety and depression. Vitamin D deficiency is associated with sleep quality and risk of anxiety and depression in patients with chronic insomnia.

Keywords

• sleep initiation and maintenance disorders
• hydroxycholecalciferols
• anxiety
• depression