Vitamin D 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 & Healthy Living, and Total Wellness: Understanding the link Between Your Teeth and Your Health. Today our topic is vitamin D and sleep apnea. Welcome, Dr. Nammy.

Dr. Nammy Patel: Thank you for having me, John.

What is the Connection Between Vitamin D and Sleep Apnea?

Maher: Sure. So, Dr. Nammy, what is the connection between vitamin D deficiency and sleep apnea?

Dr. Nammy: Vitamin D is critical in sleep apnea. So, we actually get vitamin D from going outside in the sun and we actually absorb it through our skin. And vitamin D is really important because it’s actually a precursor to a lot of different hormones and chemicals that our body actually needs in order to sleep, especially acetylcholine. So, vitamin D is really important in making sure that we are able to tell our body that it’s time to go to sleep, and it’s time for us to rest, and it’s time for us to really rejuvenate.

And vitamin D is also really important in inflammation. Vitamin D is actually a hormone. It actually helps our body reduce inflammation. And what we find in patients with sleep apnea is that they actually have a lot of different diseases. So, vitamin D actually helps sleep better, also helps us fight inflammation, which is really what we want.

Can Vitamin D Deficiency Cause Sleep Apnea?

Maher: Okay. Now, vitamin D doesn’t cause sleep apnea, right? But having a vitamin D deficiency can make it worse; is that right?

Dr. Nammy: Yes. And what we find is that most people with sleep apnea are older. And what usually happens as we get into our forties, fifties, and sixties, the amount of vitamin D that we actually absorb is actually diminished. So, as we get older with life, just like everything else deteriorates and our bodily functions decrease, the amount of vitamin D our body’s able to absorb actually decreases. And what’s really interesting is you’ll find patients or you’ll find people in their twenties who don’t really love being outdoorsy. But when they’re getting in their forties like, “I love to hike, I love to be outdoorsy, I don’t really like going to restaurants as much, I’d rather be outside,” and it’s actually a signal for our bodies to say we want more vitamin D.

Can Vitamin D Supplements Help with Sleep Apnea?

Maher: Okay. So, can also taking vitamin D supplements help with improving the symptoms of sleep apnea?

Dr. Nammy: It absolutely does. And in fact what we do in our practice is we actually test the amount of vitamin D that we have, because we want to make sure that the vitamin D is being converted. And so, we actually take a blood serum test to see what the vitamin D level is because everyone is different. So, we want to customize what your vitamin D levels are going to be. And also where you live. For example, if you live in the equator or near the equator, your vitamin D levels are going to be pretty stable all year round. If you’re where you are in the Northeast, what’s going to happen is the winters are really cold and there’s not as much sun around. So, your vitamin D levels need to be adjusted for that.

So, what we actually recommend is that we titrate, that means that we figure out the exact amount of vitamin D levels that you need and then also test it twice a year, which is summer and winter, so that we can adjust for you accordingly. And that will make a massive difference in your sleep cycles and the rest cycles. And as we know, rest is very important in actually rejuvenating our bodies.

Recommended Dose of Vitamin D Supplements

Maher: So, there’s not just one recommended dose of vitamin D that everybody should take to help with their sleep apnea. It’s really specific to each person.

Dr. Nammy: It is. The reason why is if you take too much vitamin D, it can actually be a problem as well. So, you can get headaches, you can get lots of different things. Too much vitamin D can be problematic. So, what we really want to do is be specific in the amount of vitamin D actually that you need. And we recommend doing that through a blood test.

Can Getting More Sun Help with Sleep Apnea?

Maher: And can people just go outside, spend more time outside and get some more sun? And is that good for them or really is the vitamin D supplement really the way to go?

Dr. Nammy: Really, ideally, the best way that we can do this is by going out in the sun. So, one of the things you always hear about is Blue Zones. So, Blue Zones are really great, and people are living longer there. And if you notice, Blue Zones are near the equator. And so, those Blue Zones are really important because they’re getting a lot of vitamin D, they’re being outdoors, they’re doing a lot of physical activity, they’re also sleeping well, they’re taking care of their health. And that’s one of the factors that they never really looked at is the amount of vitamin D that is actually produced by our bodies. Everyone always equates Blue Zones to be Blue Zones because they think it’s community, they think it’s weather, but it’s really a lot of it is a foundational vitamin D.

And the reason why vitamin D is so important is because it’s a precursor to a lot of our gut microbiome bacteria that we actually need in order to be healthy and to be able to live long. So, when we have the right amount of vitamin D, it’s going to help us make specific bacteria in our gut that’s going to help us fight disease and dysfunction and be more balanced.

Does Sunscreen Block Vitamin D Absorption?

Maher: Now, of course, we’re told not to spend too much time in the sun, getting sunburned or something like that is not good for our skin. Is it okay to wear a sunscreen outside and can you still absorb vitamin D even though you’re wearing a sunscreen?

Dr. Nammy: You can, absolutely. The amount of vitamin D we always like to say is an hour in the sun is usually really great. An hour in direct sun. A lot of times we’re moving, we’re doing things. We’re not necessarily just sitting in the sun and sunbathing. Majority of the time what we’re doing is getting outside. And actually sunscreen does block vitamin D, but we also want to protect from having cancer or anything like that. So, you actually absorb vitamin D outside. You can’t absorb it through windows or anything like that. So, you actually need to go outside and get vitamin D. Skin actually is our biggest organ that makes vitamin D. Absolutely, we’re concerned about cancer, so we really want to be conservative in the amount that we use. And that’s the reason why we titrate the amount of vitamin D each person needs.

For example, you might need less vitamin D or less exposure in the sun than I would. I have melanin, and so my skin is not going to absorb as much vitamin D as yours would. So, it’s very different and very calculated for each person. And looking at the vitamin D levels, going back to your question, do you want to be outside? The answer is absolutely, yes, you do. I would say about an hour a day is what we’re really looking for. And that’s going to give you the amount of vitamin D that you need. And that’s safe and that’s comfortable, and it’s not going to cause disease or dysfunction.

Side Effects of Vitamin D Supplements

Maher: And are there any side effects potentially to taking vitamin D supplements?

Dr. Nammy: If you have too much vitamin D, it can cause an issue in a lot of systems. Vitamin D is actually not a vitamin, as I said earlier. Vitamin D is actually a hormone. And so, that hormone is a precursor to estrogen, to testosterone, to thyroid, to a lot of different things. So, too much vitamin D can be problematic as well. So, what we want to do is really control the amount of vitamin D that we actually have.

How does Vitamin D Help with Sleep Apnea?

Maher: What is it about vitamin D that’s actually improving sleep apnea problems? Is it just that it’s helping us to get a better night’s sleep, helping us to feel more restful when we go to bed, or what’s the situation there with vitamin D?

Dr. Nammy: Vitamin D actually helps really look at our clock. So, vitamin D is part of our circadian rhythm, really. When we’re outside in the sun, it signals our body that it’s time to sleep. It tells our body that it’s time to rest and relax. When we get enough time in the sun or enough time with Vitamin D, what we’re getting is our body is knowing that it’s not daytime when it’s nighttime or it’s not nighttime when it’s daytime. So, it really helps with our circadian rhythm and helping us fall asleep, stay asleep, and wake up in a timely manner where our bodies are rejuvenated. That’s the whole function of vitamin D.

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

Dr. Nammy: Absolutely.

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