B Vitamins and Sleep Apnea (Podcast)

John Maher: Hi, I am John Maher and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California. Helping patients recognize the vital connection between dental health and whole body health. And author of the bestselling books, Age with Style, Guide to a Youthful Smile and Healthy Living, and Total Wellness, Understanding the link Between Your Teeth and Your Health. Today our topic is B vitamins and sleep apnea. Welcome Dr. Nammy.

Dr. Nammy Patel: Thanks for having me, John. I’m so excited to talk about vitamins and how important they are to sleep and what they can do for you.

How do B Vitamins Influence Sleep Quality?

Maher: Absolutely. So specifically, how do B vitamins influence your sleep quality and sleep apnea?

Dr. Nammy: So, B vitamins are really important because they work with conjunction with the vitamin D in order to make sure there’s a good healthy microbiome and helps regulatory processes in our body to be able to sleep. Most importantly, what B vitamins are doing is vitamin B1, which is thiamine and B5, it actually makes something called acetylcholine. Acetylcholine is a neurotransmitter that we find and that neurotransmitter actually helps us paralyze our body when we’re sleeping.

So, that gives us REM sleep. So people who have sleep apnea actually can’t get REM sleep. And so having these B vitamins are a great supplement in addition to tongue training exercises and things like that to help sleep apnea. So when we can get our body to have acetylcholine, it actually acetylcholine is made from vitamin B1 and B5. As we have that, it makes acetylcholine that acetylcholine is released in synapses.

So, our nerve endings have a little space in between where it releases neurochemical and it picks up on the other end. As it has that chemical that acetylcholine, the amount of acetylcholine that we have is really needed for restful sleep as we know people with sleep apnea keep waking up. And so acetylcholine helps them stay asleep. And what acetylcholine also does is make sure that their whole body is relaxed and so that their brain can actually detoxify and get rid of any toxins that are in the brain.

The body can repair itself if there’s any cancer cells, if there’s any problems in the body, it can help get rid of it. And that restful sleep is what’s really, really, really, really critical. People with sleep apnea can’t get that sleep, so if we want to help patients get that good restful sleep, we have to look at vitamin D, vitamin B, and also maybe some tongue training exercises or something along those lines.

How to Know If You Have a Vitamin B Deficiency

Maher: Okay. So how do you know whether or not somebody has a deficiency in vitamin B, especially B1 and B5? And if they do show that they have a deficiency in those vitamins, you’re saying that that help or that can cause worsening sleep apnea issues, right?

Dr. Nammy: Yeah, absolutely. And so when I look at my patients and I want to repair sleep apnea and I can do it through a device, I can do it through my functional therapy, I can do it through opening sinuses, all sorts of fun stuff. But the first thing we want to look at and the reason why we want to look at the vitamins is because there’s several components to sleep apnea. There’s a physiological component, the positioning of the tongue and things like that. And then there’s also the brain switch, which is our brain telling us we need to sleep and wake up.

And so when we look at the brain switch and we want to fix the brain switch, we have to look at it from a whole body perspective. So we can’t just fix one thing and the other thing fixes itself. We really need to give our bodies some nutrients it needs in order to heal really well. So the reason why we look at vitamin Bs are because they are really a precursor to a lot of neurotransmitters which help a stay asleep and repair our body. And that’s the reason why we look at the vitamins and that’s how we help sleep apnea.

B Vitamins and Sleep Apnea

Maher: Tell me a little bit more about the different types of B vitamins and why is it that particularly B1 and B5 are helpful for sleep apnea?

Dr. Nammy: Sure. So there’s actually B1, which is going to be thiamine, and then B5, which is pantothenic acid. They actually act as enzymes. So what they do is acetylcholine is a neurotransmitter that needs to be made. When these two enzymes need to confer from one to another, it needs vitamin D. That’s why vitamin D is so important. So you’ve got acetylcholine and that needs to go to acetylcholine enzyme A is utilized, which is vitamin D and with pantothenic acid, it becomes acetylcholine. So it breaks a bond basically.

The reason why thiamine is important and pantothenic acid is important is those are the building blocks and then vitamin D comes in and actually connects them together via enzyme, and that’s how we get acetylcholine, which is what we really need in order to stay asleep. Also, to have that neurotransmitter give us restful REM sleep is what we call.

Can B Vitamins Cause Sleep Apnea?

Maher: So it’s important to have vitamin B1, B5 and vitamin D. Can other types of B vitamins, I know there’s B3, B12, can increases of those vitamins actually work against you with sleep apnea?

Dr. Nammy: That’s actually a really interesting question because what usually we do with our patients is we have them start with vitamin B50, which is really great, is 50 MCGs of these vitamins, and the reason why we want that is we usually have them for about 90 days. Your body will start making these vitamins naturally on its own after 90 days. All we’re doing is helping your body put the foundation down initially because you’re depleted. So when you’re depleted, we want to add these vitamins as supplements, but you do need to stop them because if you don’t stop them, you’ll get headaches, you’ll get a lot of other problems.

And that’s the reason why we want to be, again, specific and controlled with the amount of vitamin D, the amount of vitamin B, and even B12 that we actually give our patients. We really want to go and we really go by symptoms too. So we’ll do check-ins with patients, so we’ll see how they’re doing. Are they getting morning headaches? Are they getting pain in the morning when they wake up? Is their back hurting? Is their knee hurting? Is their flare-up of arthritis, which all is influenced by again, vitamin D, vitamin B, sleep, and those are the things that we really look at.

What Doses of B Vitamins Are Needed for Sleep Apnea?

Maher: Are there particular recommended doses for B vitamins that will help individuals with sleep apnea?

Dr. Nammy: Yes, there are. As far as D vitamins, ideally the range is going to be from 60 to 80 nanograms per liter or milliliters is what we look at. So vitamin D, that’s in the blood, so that’s what we look at for D. For B, it’s titrated. Typically, they say you can take a vitamin B and you’ll be fine, like a hundred I believe, or actually I take that back. It’s about 10 MCGs a day. But typically what we do is in the depleted stages you actually need more. So we actually have to look at how much vitamin B do you need? And so we actually do that through titration and symptoms and check-ins and also a sleep journal because we want to know what vitamins you’re taking because your multivitamin has B vitamins, plus if you’re taking a supplement you may be getting too much or too little.

So, we actually titrate what you need based upon what your symptoms are like. So we can give you a half a pill of B50, we can give you a full pill of B50. Sometimes some patients need a pill and a half of 50, depending on their symptoms. So we really have to work with the patient to again, make sure and titrate it to be specific for each person.

Side Effects of Vitamin B Supplements

Maher: And are there any potential risks or side effects associated with B vitamin supplements for sleep apnea?

Dr. Nammy: Yes. If you have too much, you can get headache, body pains, you can get a lot of different things that most patients with sleep apnea complain about, restless sleep, waking up at 3:00 A.M. All of those things are all possible if there’s too much B vitamins. The interesting thing here is that if you have too little, you’ll have the same symptoms. If you have too much, you’ll have the same symptoms. So you have to really titrate and figure out what is going to work for each person.

Maher: What do you mean by titrate?

Dr. Nammy: Titrate means that we figure out the exact amount. So for example, you may need one pill, I may need half a pill, somebody else may need three quarters of a pill. So titrate means that we find the specific amount that each person needs by increasing the dose and decreasing the dose. We increase the dose and see how the patient responds. Do you get headaches, do you have back pain? Are you having knee pain? How are you sleeping? Are you waking up in the middle of the night? If the patient says, “I’ve been taking this vitamin B pill for about a week now and all of a sudden I feel great, I was feeling great day three, but then day four I added a vitamin and then I couldn’t sleep anymore,” their dose is too high, so we have to bring them back down. So when we say titration, we’re actually specifically figuring out by increasing and decreasing the levels, what is specific for each person.

Maher: All right, well that’s really great information, Dr. Nammy. Thanks again for speaking with me today.

Dr. Nammy: Thanks John.

Maher: And for more information, you can visit the website at Sfgreendentist.com or call 415-433-0119.