Division of Sleep Medicine, Department of Neurology, Louisiana State University Health Sciences Center, P.O. Box 33932, 1501 Kings Highway, Shreveport, LA 71130, USA.
Division of Sleep Medicine, Department of Neurology, Louisiana State University Health Sciences Center, P.O. Box 33932, 1501 Kings Highway, Shreveport, LA 71130, USA.
Sleep Med Rev. 2014 Aug;18(4):311-9. doi: 10.1016/j.smrv.2013.07.001. Epub 2013 Sep 26.
Vitamin D is a hormone that interacts with intranuclear receptors to effect transcriptional changes in many cell types including those in gut, bone, breast, prostate, brain, skeletal muscle, and the immune system. Inadequacy of vitamin D is widely prevalent, and leads to the classic diseases of bone demineralization as well as to more recently recognized problems such as nonspecific pain and noninflammatory skeletal myopathy, which may disrupt sleep and directly cause daytime impairment. Emerging lines of evidence suggest that low vitamin D levels increase the risk for autoimmune disease, chronic rhinitis, tonsillar hypertrophy, cardiovascular disease, and diabetes. These conditions are mediated by altered immunomodulation, increased propensity to infection, and increased levels of inflammatory substances, including those that regulate sleep, such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, and prostaglandin D2 (PD2). Together, the recent reports suggest a role for inadequate vitamin D in the development of symptoms of wake impairment commonly associated with sleep disorders. Persistent inadequacy of vitamin D may also increase the risk for obstructive sleep apnea via promotion of adenotonsillar hypertrophy, airway muscle myopathy, and/or chronic rhinitis. Much remains to be learned concerning the complex relationship between chronically low levels of vitamin D, normal sleep, sleep disruption, and daytime neurocognitive impairment.
维生素 D 是一种激素，它与核内受体相互作用，影响包括肠道、骨骼、乳房、前列腺、大脑、骨骼肌和免疫系统在内的许多细胞类型的转录变化。维生素 D 不足广泛存在，并导致经典的骨矿物质脱失疾病，以及最近认识到的非特异性疼痛和非炎症性骨骼肌病等问题，这些问题可能会扰乱睡眠并直接导致白天受损。新出现的证据表明，低维生素 D 水平会增加自身免疫性疾病、慢性鼻炎、扁桃体肥大、心血管疾病和糖尿病的风险。这些病症是通过免疫调节改变、感染易感性增加和包括调节睡眠的物质在内的炎症物质水平增加来介导的，这些物质包括肿瘤坏死因子-α (TNF-α)、白细胞介素 (IL)-1 和前列腺素 D2 (PD2)。总之，最近的报告表明，维生素 D 不足在与睡眠障碍相关的觉醒障碍症状的发展中起作用。持续性维生素 D 不足也可能通过促进腺样体肥大、气道肌肉肌病和/或慢性鼻炎增加阻塞性睡眠呼吸暂停的风险。关于慢性低水平维生素 D、正常睡眠、睡眠中断和白天神经认知障碍之间的复杂关系，还有很多需要了解。
