The Effect of Vitamin D and Calcium Plus Vitamin D on Sleep Quality in Pregnant Women with Leg Cramps: A Controlled Randomized Clinical Trial

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

2 Associate Professor, Department of Midwifery, Research Center of Health Effective Social Factors, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

3 MSc Student, Department of Midwifery, School of Nursing and Midwifery AND Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

4 Associate Professor, Department of Pharmacology, School of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: Evidence indicates that sleep may be affected by using vitamins and minerals or lack of them. This study aimed to determine the effects of vitamin D and calcium-vitamin D in the treatment of sleep disorders in pregnant women with leg cramps.Methods: This triple-blind randomized controlled clinical trial took place on 126 pregnant women referred to Tabriz health centers, Tabriz, Iran, in 2013-2014. Subjects were allocated in to three groups, using block randomization. The groups received vitamin D, calcium-vitamin D and placebo pills daily for 60 days. Sleep score was measured before and after the intervention, using the Pittsburgh Sleep Quality Index. ANCOVA test was used for data analysis.Findings: Controlling baseline score before the intervention, there was no significant differences in the sleep quality score after intervention between the group receiving calcium-vitamin D and the control group (adjusted difference: -0.3, 95% confidence interval: -1.4 to 2.1), the group receiving vitamin D and controls (adjusted difference: -0.007, 95% confidence interval: -1.7 to 1.7) and between the two groups receiving calcium-vitamin D and vitamin D (adjusted difference: -0.3, 95% confidence interval: -1.4 to 2.1). Also, there was no significant difference between the groups in sleep quality subscales (P > 0.05).Conclusion: The results show that calcium-vitamin D and vitamin D does not effect on improving the sleep quality in pregnant women with leg cramps. 

Keywords


  1. Facco FL, Kramer J, Ho KH, Zee PC, Grobman WA. Sleep disturbances in pregnancy. Obstet Gynecol 2010; 115(1): 77-83.
  2. Naud K, Ouellet A, Brown C, Pasquier JC, Moutquin JM. Is sleep disturbed in pregnancy? J Obstet Gynaecol Can 2010; 32(1): 28-34.
  3. Greenwood KM, Hazendonk KM. Self-reported sleep during the third trimester of pregnancy. Behav Sleep Med 2004; 2(4): 191-204.
  4. Mindell JA, Jacobson BJ. Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs 2000; 29(6): 590-7.
  5. Fuller PM, Gooley JJ, Saper CB. Neurobiology of the sleep-wake cycle: sleep architecture, circadian regulation, and regulatory feedback. J Biol Rhythms 2006; 21(6): 482-93.
  6. Markov D, Goldman M. Normal sleep and circadian rhythms: neurobiologic mechanisms underlying sleep and wakefulness. Psychiatr Clin North Am 2006; 29(4): 841-53.
  7. Kendall-Tackett K, Cong Z, Hale TW. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. Clinical Lactation 2011; 2(2): 22-6.
  8. Micheli K, Komninos I, Bagkeris E, Roumeliotaki T, Koutis A, Kogevinas M, et al. Sleep patterns in late pregnancy and risk of preterm birth and fetal growth restriction. Epidemiology 2011; 22(5): 738-44.
  9. Reutrakul S, Zaidi N, Wroblewski K, Kay HH, Ismail M, Ehrmann DA, et al. Sleep disturbances and their relationship to glucose tolerance in pregnancy. Diabetes Care 2011; 34(11): 2454-7.
  10. Marques M, Bos S, Soares MJ, Maia B, Pereira AT, Valente J, et al. Is insomnia in late pregnancy a risk factor for postpartum depression/depressive symptomatology? Psychiatry Res 2011; 186(2-3): 272-80.
  11. Skouteris H, Wertheim EH, Germano C, Paxton SJ, Milgrom J. Assessing sleep during pregnancy: a study across two time points examining the Pittsburgh Sleep Quality Index and associations with depressive symptoms. Womens Health Issues 2009; 19(1): 45-51.
  12. Okun ML, Schetter CD, Glynn LM. Poor sleep quality is associated with preterm birth. Sleep 2011; 34(11): 1493-8.
  13. Lee KA, Gay CL. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol 2004; 191(6): 2041-6.
  14. Beebe KR, Lee KA. Sleep disturbance in late pregnancy and early labor. J Perinat Neonatal Nurs 2007; 21(2): 103-8.
  15. Lee KA, Zaffke ME, McEnany G. Parity and sleep patterns during and after pregnancy. Obstet Gynecol 2000; 95(1): 14-8.
  16. Hertz G, Fast A, Feinsilver SH, Albertario CL, Schulman H, Fein AM. Sleep in normal late pregnancy. Sleep 1992; 15(3): 246-51.
  17. Hensley JG. Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health 2009; 54(3): 211-8.
  18. Young G. Leg cramps. BMJ Clin Evid 2009; 2009.
  19. Sohrabvand F, Karimi M. Frequency and predisposing factors of leg cramps in pregnancy: a prospective clinical trial. Tehran Univ Med J 2009; 67(9): 661-4. [In Persian].
  20. Miller TM, Layzer RB. Muscle cramps. Muscle Nerve 2005; 32(4): 431-42.
  21. Lichstein KL, Payne KL, Soeffing JP, Heith DH, Taylor DJ, Riedel BW, et al. Vitamins and sleep: an exploratory study. Sleep Med 2007; 9(1): 27-32.
  22. Stumpf WE, Bidmon HJ, Li L, Pilgrim C, Bartke A, Mayerhofer A, et al. Nuclear receptor sites for vitamin D-soltriol in midbrain and hindbrain of Siberian hamster (Phodopus sungorus) assessed by autoradiography. Histochemistry 1992; 98(3): 155-64.
  23. Gominak SC, Stumpf WE. The world epidemic of sleep disorders is linked to vitamin D deficiency. Med Hypotheses 2012; 79(2): 132-5.
  24. Holick MF. Vitamin D: a D-Lightful health perspective. Nutr Rev 2008; 66(10 Suppl 2): S182-S194.
  25. Malekzadegan A, Moradkhani M, Ashayeri H, Haghani H. Effect of relaxation on insomnia during third trimester among pregnant women. I Iran J Nurs 2010; 23(64): 52-8. [In Persian].
  26. Buysse DJ, Reynolds CF, III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28(2): 193-213.
  27. Grandner MA, Kripke DF, Naidoo N, Langer RD. Relationships among dietary nutrients and subjective sleep, objective sleep, and napping in women. Sleep Med 2010; 11(2): 180-4.
  28. McCarty DE, Chesson AL, Jr., Jain SK, Marino AA. The link between vitamin D metabolism and sleep medicine. Sleep Med Rev 2014; 18(4): 311-9.
  29. McCarty DE, Reddy A, Keigley Q, Kim PY, Marino AA. Vitamin D, race, and excessive daytime sleepiness. J Clin Sleep Med 2012; 8(6): 693-7.
  30. Virga G, Stanic L, Mastrosimone S, Gastaldon F, da PA, Bonadonna A. Hypercalcemia and insomnia in hemodialysis patients. Nephron 2000; 85(1): 94-5.
  31. Okawa M, Mishima K, Nanami T, Shimizu T, Iijima S, Hishikawa Y, et al. Vitamin B12 treatment for sleep-wake rhythm disorders. Sleep 1990; 13(1): 15-23.
  32. Meolie AL, Rosen C, Kristo D, Kohrman M, Gooneratne N, Aguillard RN, et al. Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence. J Clin Sleep Med 2005; 1(2): 173-87.