Sleep disorders suffer 25-30% of all adults in Germany. Most often it affects people with increasing age. The reasons for this are that older people have low serum melatonin levels, are more likely to have chronic diseases and are often on long-term medication, with a simultaneous insufficient intake of nutrients and vital substances (macro- and micronutrients) through the diet. These factors as a whole significantly influence sleep quality and lead to sleep deprivation. Affected individuals exhibit symptoms such as difficulty falling asleep and staying asleep – frequent awakenings followed by difficulty falling asleep again – or poor, restless sleep. The most obvious sign of sleep deprivation is daytime drowsiness and an inability to cope with everyday life and its responsibilities. Prolonged sleep deprivation can be manifested by lapses in concentration, faulty performance of habitual activities, and accidents. Many people complain of symptoms of overtiredness, burning eyes and increasing irritability. In extreme cases, when the need for sleep can no longer be suppressed, regular sleep attacks may occur. A good night’s sleep, on the other hand, is characterized by waking up refreshed, feeling rested, alert, and a high level of concentration and performance during the day. The causes of sleep disorders vary from individual to individual. In most cases, depression, anxiety, schizophrenia, acute stress reactions, stress, lack of exercise, dissatisfaction, imbalance and wrong eating habits lead to sleep disorders. Imbalances in the vital substance balance can also negatively influence the quality of sleep [3.2]. Wrong nutritional habits often result in a deficiency of certain vitamins, minerals and trace elements, which in turn leads to an insufficient supply of nerve cells and a deterioration in the quality of sleep. Lack of sleep itself also increases the need for vital substances.
Effects of sleep disorders on vital substance balance (micronutrients)
Sleep deprivation and vitamin C
If vitamin C deficiencies occur in the body as a result of inadequate dietary vitamin C intake, this can lead to depression, which is usually accompanied by sleep disturbances. These symptoms in turn affect the quality of sleep. Vitamin C is needed for the conversion of the amino acid tryptophan to 5-hydroxytryptophan, the precursor of serotonin. A high level of serotonin in the brain and tissues promotes sleep because the neurotransmitter has a calming and relaxing effect. Thus, a low vitamin C level leads to a low serum serotonin level due to decreased serotonin synthesis – sleep deprivation is the result. People with sleep problems should pay attention to adequate dietary vitamin C intake, as it is able to balance the sleep rhythm and calm the organism.
Sleep deficiency and B vitamins
Vitamin B1 is related to the metabolism of neurotransmitters of the serotonin, acetylcholine and adrenaline systems in the central nervous system. Because the biochemical processes of sleep are based in the nervous system, vitamin B1, as a “nerve vitamin,” can significantly affect sleep quality. Even a slight vitamin B1 deficiency can lower serotonin concentrations in the brain and tissues, cause depression and eventually sleep deprivation Vitamin B3 (niacin) is responsible, among other things, for maintaining the health of the nervous system. Deficiencies of this vitamin lead to disorders in the nervous system and can therefore cause insomnia, in addition to depression and psychological changes. Optimal vitamin B3 concentration accelerates falling asleep and can improve sleep quality. Vitamin B5 (pantothenic acid) is needed for the synthesis of amino acids, proteins, fatty acids, steroid hormones and the important neurotransmitter acetylcholine. If a person does not consume enough pantothenic acid with food, the formation of the above-mentioned nutrients, hormones and messenger substances, for which vitamin B5 is responsible, is inhibited. On the other hand, vitamin B5 deficiency causes a disturbance in the transmission of nerve impulses. Due to these impairments, the sleep rhythm is also significantly disturbed [6.1]. Vitamin B6 is responsible for the conversion of stored proteins and carbohydrates into glucose. Pyridoxine thus serves in particular for the formation of the new monosaccharide (gluconeogenesis).Glucose, in turn, is needed to maintain normal blood glucose levels between meals. If blood glucose levels are low at night due to vitamin B6 deficiencies in the body, frequent or early awakenings can be the result. This is caused by the stimulating hormone adrenaline, which is increasingly released as a result of the lowering of the blood glucose level. In addition to insomnia, a vitamin B6 deficiency also leads to muscle twitching, cramps, anxiety and abnormal brain waves, which also severely impair sleep [6.1]. Since folic acid influences cell division, growth and new cell formation, folic acid deficiency impairs cell division of red blood cells (erythrocytes). Consequently, the process of formation as well as maturation of erythrocyte stem cells in the bone marrow (hematopoiesis) is delayed and there is a reduction in the number of erythrocytes. Due to the high concentration of growth factors for erythrocytes (red blood cells), they become more hemoglobin-rich and larger – development of megaloblasts. Thus, early signs of folic acid deficiency include blood picture disorders with the development of macrocytic hyperchromic anemia. Megaloblastic anemias are usually accompanied by pallor, burning of the tongue, disturbances of the intestinal mucosa, and a reduction in physical as well as intellectual performance. Decreased production of platelets (thrombocytes) in folic acid deficiency increases the risk of bleeding. In addition, the formation of leukocytes (white blood cells) is impaired, reducing the immune response to infections as well as antibody formation. Folic acid deficiency symptoms also include neurological and psychiatric disorders, which can cause depression, anxiety, and resultant sleep deprivation [6.1].
Sleep deprivation – magnesium and calcium
The largest amount of magnesium in the body is found in the bones. The mineral is also present in connective tissue, especially in the liver and muscles. Its role is to reduce the excitability of muscles as well as nerves and regulate the contraction and slackening of the muscle, as well as the central nervous system. Sleep disturbing symptoms such as muscle cramps, twitching and trembling as well as nervous system hyperexcitability are signs of magnesium deficiency. If the magnesium serum level is decreased in the body due to improper food choices, it leads to hyperactivity and tachycardia (heart palpitations). Such factors also affect sleep and cause sleep deficits [6.2]. Since calcium interacts closely with magnesium and both minerals are in a harmonious balance in the body, calcium deficiency likewise affects sleep quality and may contribute to sleep disorders [6.2].
Sleep deficiency and copper
Copper deficiency leads to longer but poorer quality sleep. In many cases, difficulties falling asleep and staying asleep occur. People with copper deficiencies have elevated levels of adrenaline due to decreased excretion. High levels of the stimulating adrenaline in the blood cause cardiac arrhythmias, which can lead to sleep deprivation
Sleep deprivation and melatonin
Melatonin is a hormone produced by the pineal (pineal) gland that regulates the sleep-wake cycle. The release of melatonin occurs cyclically. During the night, particularly high concentrations of the hormone are reached. This supports sleep, as melatonin has a mild soporific, sedative effect, leading to drowsiness and sleep. Melatonin serum levels are highest during childhood and adolescence. With age, melatonin concentration decreases, which explains the frequent sleep problems in the elderly. In a 60-year-old, the pineal gland produces about half the amount of melatonin it secretes in a 20-year-old. Elderly people often suffer from sleep disturbances because their melatonin levels are lowered and melatonin secretion is reduced, especially during the night. If the hormone is supplemented in people with sleep disorders and used as a sleep aid, it shortens the time it takes to fall asleep, reduces waking during the night, and decreases sleepiness during the day. Under the influence of light, there is an increased release of melatonin, depending on the strength of the light. For this reason, quite a few people often suffer from winter depression, as the exposure to light is reduced due to the shortened daily rhythm.Affected individuals complain of disturbances in biological sleep patterns, mood swings, and personality changes
Sleep deprivation and tryptophan
Tryptophan is an essential amino acid and the starting substance for the biosynthesis of the neurotransmitter serotonin, which takes place in the extracellular space of the central nervous system. The monoamine serotonin is involved, among other things, in the regulation of the sleep-wake rhythm and in mood. The promotion of serotonin synthesis in the brain and tissues, caused by an increased tryptophan supply via food, results in calming, relaxation, mood enhancement, reduction of appetite and increased performance. Tryptophan deficiency, on the other hand, leads to disturbances in serotonin metabolism and thus to agitation, aggressiveness and depressive moods [5.3]. This is followed by sleep difficulties with prolonged time to fall asleep, problems sleeping through the night and considerable sleep deprivation. Only an increased intake of tryptophan-containing foods ensures optimal serum serotonin levels in the brain and tissues. A concurrent carbohydrate-rich diet can enhance the ability of tryptophan to raise serum concentrations of serotonin in the brain. High-carbohydrate diets prevent sleep deprivation because carbohydrates stimulate the production of insulin. When insulin concentrations are low as a result of low carbohydrate consumption, long-chain neutral amino acids compete with tryptophan for passage across the blood-brain barrier as they enter the central nervous system using the same carrier. In high concentrations, insulin is able to transport, for example, the amino acids valine, leucine and isoleucine out of the blood and into the muscles at an increased rate. The increased uptake of the amino acids into the muscles reduces the competition for tryptophan to pass through the blood-brain barrier and its uptake into the brain is increased. Consequently, the level of serotonin in the brain increases, which has a positive effect on mood and sleep quality [3.2]. Tryptophan-rich foods that promote sleep include, in particular, cashew nuts, walnuts, veal and chicken, sunflower seeds, soybeans and soy products, bananas, milk and dairy products, eggs, and fish.
Sleep deprivation – leucine, isoleucine and valine
Leucine, isoleucine, and valine are amino acids. In excessive amounts due to increased dietary intake – meat, fish, rice, peanuts, whole milk – they can interfere with the transport of amino acids to the brain, which are precursors to serotonin. Too low a serotonin level, in turn, causes sleep problems in addition to mood disorders or migraines
Sleep deprivation – lifestyle and dietary habits
Insomnia can be caused by incorrect and unbalanced diets. If too voluminous a meal is eaten just before bedtime and foods too high in fat, protein, and spices are consumed, heartburn, flatulence (meteorism), and indigestion will disrupt sleep. If the evening meal is too light or omitted altogether, hunger pangs that occur during the night can also have a negative impact on the quality of sleep. To avoid sleep problems, the evening meal should be eaten at least two hours before bedtime. If the meal is very substantial or heavy, it is advisable to allow at least three hours between dinner and bedtime. In particular, foods with a favorable ratio of tryptophan to total protein should be preferred for the evening meal, such as soybeans and soy products, milk and dairy products, and eggs and fish. However, if the proportion of the amino acids phenylalanine, tyrosine, leucine, isoleucine and valine in the diet outweighs that of tryptophan, the absorption of tryptophan into the brain is inhibited. Exclusively at low concentrations of long-chain amino acids, competition for the transport carriers is low. Under these circumstances, tryptophan has the ability to cross the blood-brain barrier The brain metabolism can convert tryptophan into the sleep-promoting serotonin, which supports falling asleep as well as sleeping through the night due to its calming effect. Carbohydrate-rich foods such as potatoes, pasta, rice and Bircher muesli also have a relaxing effect on the central nervous system. The reason for this is that starchy foods stimulate the production of insulin, which increases the uptake of tryptophan into the brain [3.2].A tryptophan-rich dinner together with small amounts of carbohydrates can improve sleep quality and prevent sleep deprivation. Some people are sensitive to natural stimulants. Such are found in small amounts in mature cheeses, bacon, ham, sausage, sauerkraut, eggplant, spinach, and tomatoes. If these foods are consumed in the evening, they may contribute to sleep disturbances.
Sleep deprivation and caffeine
Chocolate and caffeinated beverages such as coffee, tea and cola drinks, stimulate the circulation and should be avoided in the four to six hours before bedtime. It is also advisable to keep caffeine consumption to a minimum during the day, as high amounts of caffeine increase the risk of developing problems falling asleep and staying asleep. Herbal teas or milk, which is rich in tryptophan and calcium, are more suitable as a drink before bedtime, as they have a calming and sleep-supporting effect.
Sleep deprivation – nicotine and alcohol
A large proportion of people exhibit sleep deprivation due to daily nicotine or alcohol consumption. Alcohol and cigarettes initially have a calming effect that may make it easier to fall asleep. However, excessive consumption of these stimulants causes light, restless sleep and nighttime awakenings. Alcohol and nicotine impair deep sleep and disrupt sleep rhythms.
Sleep deprivation – medications and drug abuse
Medications – hormonal contraceptives (birth control pills), beta blockers, weight loss medications – and drugs, such as cannabis (hashish and marijuana), contribute to sleep disturbances. In particular, increased medication use occurs in older people due to chronic illnesses. On average, 65-year-olds and older regularly take two different medications per day, and those over 80 take four. Consumption is even higher for some people, as many medications have to be taken several times a day. High medication consumption further reduces the decreased appetite of older people. The risk of taking in too few vital substances (micronutrients) through food increases. Many drugs have side effects on the digestive tract – nausea, diarrhea – and can also significantly interfere with the absorption of vital substances Drugs that can increase the need for vital substances (micronutrients)
| Drug | Vital substances affected (micronutrients) |
| Antacids (medicines that bind stomach acid), such as aluminum hydroxide | Phosphate, calcium |
| Antibiotics, such as tetracyclines. | Calcium, vitamin K and C |
| Antiphlogistics or analgesics (anti-inflammatory or analgesic drugs), such as acetylsalicylic acid (ASA) and indomethacin | Iron, vitamin C |
| Antiepileptic drugs (drugs used to treat epilepsy), such as phenytoin and phenobarbital | Folate, vitamin D, B3, C |
| Chemotherapeutic agents (drugs used to fight infectious diseases), such as isoniazid | Pyridoxine, vitamin D, B3 |
| Diuretics (drugs used for drainage), such as furosemide, etacrynic acid, and thiazides | Potassium, calcium, zinc, magnesium |
| Laxatives – laxatives, such as senna, phenolpthalein and bisacodyl. | Potassium, calcium |
| Hormonal contraceptives (birth control pills). | Zinc, magnesium, vitamins C, B1, B2, B6, B12, folic acid |
If the elderly lack vitamin C, B3, calcium and magnesium in particular due to reduced dietary intake and the intake of drugs that impair its absorption, the sleep rhythm is disturbed. Frequently, affected individuals suffer from psychological changes, depression, insomnia, as well as sleep deprivation [1.2]. To counteract sleep disorders, some people take sleeping pills. However, when taken regularly, they have the opposite effect of what is expected. Sleeping pills disrupt the body’s natural sleep rhythm and cause uninterrupted sleep. During the day, such drugs lead to states of exhaustion, lack of concentration as well as headaches. The lack of sleep can thus not be compensated. In high doses and with prolonged use, sleeping pills can also be addictive. People who regularly abuse drugs are prone to personality changes, fluctuations in character and mood, and to reactions that are sometimes inappropriate in certain situations.As a result of the influence on the psyche, the quality of sleep is also impaired. Due to the lack of sleep, drug addicts often suffer from concentration disorders, performance and learning deficiencies, listlessness as well as apathy
Sleep deprivation and physical inactivity
A large proportion of people do not exercise enough. The reasons for this vary from individual to individual. On the one hand, there are nowadays predominantly occupations with sedentary activities, with work mainly done in front of the computer. On the other hand, many complain about stress, lack of drive and energy, or they lack the time to integrate sports into their daily routine. Excess energy, due to a wrong and one-sided diet with too many foods rich in fat and sugar in the body, cannot be dissipated with insufficient exercise. Under these circumstances, the body does not find rest at night and cannot recover sufficiently due to occurring sleep disturbances and deficits. The result is a lack of sleep and the body lacks the necessary energy and drive to perform optimally during the day – this also leads to obesity with the associated health risks [6.1]. If a lot of exercise is included in the daily routine, chronic insomnia and the threat of overweight can be counteracted. Endurance and strength training consume excess energy and promote fatigue and thus sleep. In particular, regular aerobic exercise improves sleep quality. During aerobic exercise, the body is supplied with sufficient oxygen. This ensures a high level of aerobic or oxidative enzymes and increases their turnover rate. Energy supply is improved and resistance to fatigue during the day is increased. Aerobic activities include prolonged, low to high intensity exercise such as middle and long distance running, swimming, cycling, rowing, game sports and other endurance activities. Notice. However, high-intensity exercise such as endurance and weight training should not be done in the late evening, but rather during the day or early evening to avoid overstimulation just before bedtime. Autogenic training such as yoga calms and relaxes the organism and likewise promotes sleep.
Sleep deprivation and the immune system
If the body does not get enough sleep and exercise, the immune system is significantly weakened. The immune response is additionally significantly diminished by poor nutrition – too much saturated fats, sugar, alcohol – smoking as well as being overweight. The risk of infection increases
Sleep deprivation in women
Between the ages of 45 and 55, women are in the climacteric period. This period is referred to as the transition after reaching full sexual maturity to the gradual extinction of reproductive ability. The climacteric is characterized by the declining function of the ovaries (ovaries) with decreased hormone production. In about one third of women the transition is disharmonious with changing vegetative as well as psychological complaints. These complaints last for years in about 70% of affected women. In particular, the production of estrogens is reduced, resulting in feedback reactions to the hypothalamus. In addition to psychological processes, the hypothalamus also controls certain bodily functions via specialized receptors. Finally, dysregulations originating from the hypothalamus often result from reduced hormone production, such as disturbances in sleep rhythm, temperature regulation, water balance, and circulatory function
Sleep deprivation and physical as well as mental illnesses
Physical diseases as well as psychosocial impairments are further common causes of sleep disorders and sleep deprivation. The most common physical illnesses are:
- Nocturnal breathing disorders, such as sleep apnea
- Restless legs syndrome – abnormal muscle twitching in the legs
- Myoclonus – recurrent leg, especially lower leg movements
- Narcolepsy – excessive sleepiness or sudden, insurmountable falling asleep during the day with a number of other signs of the disease.
- Organic diseases – disorders in the endocrine system, cardiovascular disorders such as hypertension (high blood pressure)
- Mental disorders – depression, schizophrenia, anxiety and eating disorders, mania with inappropriately elevated mood, increase in drive, overestimation of self and disinhibition [3.2].
The cause of sleep apnea is a narrowing of the upper airway. During sleep, this narrowing leads to loud, irregular snoring to obstruction of the airway. Affected individuals struggle to breathe, toss and turn restlessly in bed, and then fall back asleep. This cycle repeats hundreds of times per night, interrupting sleep each time. During the day, there is subsequently a pronounced daytime fatigue. Alcohol and sedative tablets can also contribute to such difficulties by dampening the central nervous system. In people with sleep apnea, alcohol and sedative tablets exacerbate symptoms. Overweight (obesity) also impairs respiratory function. The high fat masses can restrict diaphragmatic mobility and disrupt breathing patterns. The increased oxygen consumption and carbon dioxide production due to the larger total body mass cause respiratory muscle disease – respiratory insufficiency. This impairment of the respiratory muscles entails serious consequences. Hypoxia (insufficient oxygen supply in body tissues) , impairment of blood-brain barrier function and oxygen deficiency in the blood eventually follow Respiratory activity is significantly disturbed. During the night, breathing may stop. Normal breathing resumes upon awakening. Since such attacks occur every night in severely overweight individuals, the result is chronic sleep deprivation. These nocturnal symptoms further lead to restlessness, accelerated heartbeat as well as increase in blood pressure (hypertension) – furthermore, cardiac arrhythmias may be the consequence.
Sleep deprivation and chronic heavy metal exposure
With the onset of industrialization, lead increasingly became a global environmental hazard. Analyses of human bones showed that their lead content is at least a hundred times higher today in industrialized countries than it was 1600 years ago. Vehicle traffic is the strongest source of lead dispersion. Dust and gaseous lead compounds also enter the air through waste incinerators and coal combustion in industries. In the form of heavy metal-containing mineral fertilizers and lead-containing dust particles, the heavy metal gets into agricultural soils and onto cultivated plants, respectively. Food from agricultural production is contaminated with lead in this way. Foodstuffs from industrial production show increased lead concentrations due to the lead sealing of the canned food. The heavy metal thus enters the food chain. The consequences of lead exposure include not only sleep disorders but also high blood pressure (hypertension), heart disease, as well as depression and lack of appetite, which additionally disrupt sleep rhythms and cause insomnia. Mercury enters the sea in the form of industrial effluents and agricultural soils and crops through industrial discharges and landfills. As a result, high concentrations of mercury can be found in food – especially fish. Small amounts of mercury are also present in amalgam fillings. Via release in the mouth, the heavy metals contained in amalgam distribute throughout the body and burden it. Mercury can thus affect the central nervous system, cause headaches, and be the cause of respiratory problems and immune deficiency, and finally lead to insomnia. These consequences of mercury for humans are highly controversial among scientists. Forms of sleep disorders
- Insomnia – “sleeplessness”, inadequate or insufficiently restful sleep due to mental disorders, such as depression, schizophrenia, anxiety and eating disorders, mania with inappropriately elevated mood, increased drive, overestimation of self and disinhibition; organic disorders, such as disorders of the endocrine system, cardiovascular disorders; sleep disorders caused by medications, such as thyroid hormones, preparations for respiratory disorders, appetite suppressants, antihypertensive drugs, certain psychotropic drugs and others [3. 2.]
- Hypersomnia – such as sleep apnea syndrome, narcolepsy, nocturnal myoclonus, restless legs syndrome.
- Parasomnia – unusual events that occur during sleep or at the threshold between wakefulness and sleep, including sleepwalking, night startling, teeth grinding and wetting, anxiety dreams [3.2].
- Disturbances of the sleep-wake rhythm – the periodic alternation of waking and sleeping within the 24-hour day does not correspond to the sleep-wake pattern, for example, in shift or night work, intercontinental flights through different time zones, irregular social obligations or shifting leisure time into later and later night hours, it comes as a result of the disturbances of the sleep-wake rhythm’ to overtiredness and Befindlichkeitseinbußen.
Lack of sleep – increased vital substance requirements (macro- and micronutrients).
- Vitamin C
- B vitamins such as vitamin B1, B3, B5, B6, B9
- Magnesium
- Calcium
- Copper
- Melatonin
- Amino acid tryptophan
