The Correlation Between Serum Vitamin D Levels, Sleep Quality, and Fatigue Among Neurology and Psychiatry Resident Doctors
DOI:
https://doi.org/10.22225/wmj.10.1.12454.28-33Keywords:
Fatigue, Sleep Quality, Vitamin DAbstract
Health workers, including resident physicians, are integral to delivering healthcare services. Engagement in both physical and non-physical tasks under rotating shift schedules may adversely impact sleep quality and precipitate fatigue among this cohort. Given the existing evidence, this study aims to examine the correlation between serum vitamin D levels, sleep quality, and fatigue among resident doctors. An analytical cross-sectional study was performed at Ngoerah Hospital from May to June 2022. Serum 25-hydroxy vitamin D [25(OH)D] concentrations were quantified to ascertain vitamin D status. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), and fatigue severity was measured via the Fatigue Severity Scale (FSS). Serum 25(OH) D levels demonstrated a strong and statistically significant negative correlation with PSQI scores (r = -0.664, p<0.001) and with FSS scores (r = -0.734, p<0.001). Regression analysis revealed that each one-unit increase in serum vitamin D was associated with a 65.7% reduction in PSQI score and a 68.2% reduction in FSS score. Most participants exhibited insufficient to deficient vitamin D status, likely attributable to limited occupational sun exposure. Monitoring and management of vitamin D status, including education on adequate sunlight exposure and consideration of vitamin D supplementation, are critically important for healthcare professionals, who are at elevated risk for deficiency, to support optimal sleep quality and minimize fatigue that may adversely affect clinical performance.
References
1. Salari, N. et al. The prevalence of sleep disturbances among physicians and nurses facing the COVID-19 patients: a systematic review and meta-analysis’, Globalization and Health, 2020:16(1), p. 92. doi:10.1186/s12992-020-00620-0.
2. Sudira, P.G. and Setyaningsih, I. Hubungan tingkat kantuk terhadap derajat kelelahan dokter residen di RSUP Dr. Sardjito’, 2018:17(3), p. 8.
3. Cakir, T. et al. An evaluation of sleep quality and the prevalence of restless leg syndrome in vitamin D deficiency, Acta Neurologica Belgica, 2015:115(4), pp. 623–627. doi:10.1007/s13760-015-0474-4.
4. Kerley, C.P. et al. Serum Vitamin D Is Significantly Inversely Associated with Disease Severity in Caucasian Adults with Obstructive Sleep Apnea Syndrome’, Sleep, 2015:39(2), pp. 293–300. doi:10.5665/sleep.5430.
5. T. Mete et al. Obstructive sleep apnea syndrome and its association with vitamin D deficiency, Journal of Endocrinological Investigation, 2013:36(9). doi:10.3275/8923.
6. McCarty, D.E. et al. The link between vitamin D metabolism and sleep medicine’, Sleep Medicine Reviews, 2014:18(4), pp. 311–319. doi:10.1016/j.smrv.2013.07.001.
7. Harijanto, E., Hidayat, J. and Pratiwi, A. 2017. Gangguan Tidur pada Peserta Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif, Critical Care, 35(1), p. 8.
8. Herwanto, Umboh A. Penurunan Kapasitas Memori Kerja Pada Residen Pediatri yang Kurang Tidur, Jurnal Muara Sains Teknologi Kedokteran dan Ilmu Kesehatan, 2018:1(2) doi:10.24912/jmstkik.v1i2.887
9. Correia, A. et al. Ethnic aspects of vitamin D deficiency, Arquivos Brasileiros de Endocrinologia & Metabologia, 2014:58(5), pp. 540–544. doi:10.1590/0004-2730000003320.
10. Holick, M.F. and Chen, T.C. Vitamin D deficiency: a worldwide problem with health consequences, The American Journal of Clinical Nutrition, 2008:87(4), pp. 1080S-1086S. doi:10.1093/ajcn/87.4.1080S.
11. Lachmann, R. et al. A comparative phase 1 clinical trial to identify anti-infective mechanisms of vitamin D in people with HIV infection, AIDS, 2015:29(10), pp. 1127–1135. doi:10.1097/QAD.0000000000000666.
12. Choi, J.H. et al. Relationship between Sleep Duration, Sun Exposure, and Serum 25-Hydroxyvitamin D Status: A Cross-sectional Study, Scientific Reports, 2020:10(1), p. 4168. doi:10.1038/s41598-020-61061-8.
13. Jung, Y.S. et al. The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea, Annals of Occupational and Environmental Medicine, 2017:29(1), p. 25. doi:10.1186/s40557-017-0187-7.
14. Dyah Sintarani, C.I., Indrasari Utami, D.K. and Laksmidewi, A.A.A.P. Deficiency Serum Vitamin 25 (OH) D Levels Increase Risk Factors of Poor Quality Sleep in Resident at Sanglah Hospital’, International Journal of Research and Review, 2021:8(10), pp. 8–13. doi:10.52403/ijrr.20211002.
15. Roy, S. et al. Correction of low vitamin D improves fatigue: Effect of correction of low vitamin D in fatigue study (EViDiF study)’, North American Journal of Medical Sciences, 2014:6(8), p. 396. doi:10.4103/1947-2714.139291.
16. Johnson, K. and Sattari, M. Vitamin D deficiency and fatigue: an unusual presentation, SpringerPlus, 2015:4(1), p. 584. doi:10.1186/s40064-015-1376-x.
17. McCarty, D.E. et al. Vitamin D, Race, and Excessive Daytime Sleepiness’, Journal of Clinical Sleep Medicine, 2012:8(6), pp. 693–697. doi:http://dx.doi.org/10.5664/jcsm.2266.
18. Massa, J. et al. Vitamin D and Actigraphic Sleep Outcomes in Older Community-Dwelling Men: The MrOS Sleep Study, SLEEP, 2015:38(2), pp. 251–257. doi:http://dx.doi.org/10.5665/sleep.4408.
19. Muscogiuri, G. et al. The lullaby of the sun: the role of vitamin D in sleep disturbance, Sleep Medicine, 2019:54, pp. 262–265. doi:10.1016/j.sleep.2018.10.033.
20. Kantrowitz J, Citrome L, Javitt D. GABA(B) receptors, schizophrenia and sleep dysfunction: a review of the relationship and its potential clinical and therapeutic implications. CNS Drugs. 2009;23(8):681-691. doi:10.2165/00023210-200923080-00005
21. Araújo, T. et al. Qualitative studies of insomnia: Current state of knowledge in the field. Sleep Medicine Reviews, 2017:31, pp. 58–69. doi:10.1016/j.smrv.2016.01.003.
22. Bollinger, T. et al. 2010. Sleep, Immunity, and Circadian Clocks: A Mechanistic Model, Gerontology, 56(6), pp. 574–580. doi:10.1159/000281827.
