Vitamins, Minerals & Breaking the REM Barrier

Like a car, the body seems to need the correct fuel to run optimally. It seems that I may have been "running on empty" as far as sleep-related vitamins and minerals are concerned...

I ended my last blog-post regarding REM rebound with several questions, all pretty much along the line of "Where is my missing REM?"

Although typically the amount of REM that I have each night is within limits (at the lower end of typical) it was often broken by either periods of wakefulness or light-sleep.

It bothered me that I couldn't seem to achieve the expected REM rebound that conventional wisdom says should occur. What was wrong? Was it the equipment, the method or was it me?

I finished that post by wanting to increase the amount of REM that I have and also by trying to get rid of these periods of being awake.

Not an easy task considering that I can already probably attribute some of these awakenings to temperature drops and apnoeas!

I'd already found a way to decrease the number of apnoeas and hypopneas (AHI) that I had using 5-HTP which left me thinking that maybe I was lacking in other vitamins / minerals / hormones that are essential for sleep.

It was suggested to me that I try Vitamin D3 which is formed when we soak up sunlight during the day. This made sense to me as I am not a fan of bright sunlight (I was sun-burned badly as a child). So it was not outside the realms of possibility that I was lacking in D3.

I took this for a few nights without it seeming to make a difference to my sleep staging (as scored by the Zeo sleep monitor). Maybe I should have given it longer as I like the "scientific method" of only changing one variable at a time, but with the range of vitamins and minerals and other various supplements claiming to improve sleep I decided to go for an "all or nothing" approach.

During the time that I tried to find supplements to help with lucid dreaming (another reason to want more REM) I found many forums where people spoke about their "Sleep Stack" which refers to the stack of pills they take before sleep.

So, the question was: what to include in my "sleep stack"...

A brief look around the internet for supplements to improve sleep will pretty much turn up results for everything and yield many wild claims without much backing. Many refer to studies without citing them using phrases such as "Studies have shown" etc etc. This makes it hard to know where to begin when looking for supplements as science and advertising seem to blur into one.  

Getting to sleep isn't a problem for me (far from it), so I didn't include Melatonin or Valerian (although I've had good experiences with inducing sleep with both).

My chosen regime was:

Morning: Vitamin D3, Multi-vitamins & minerals with Iron

Bedtime: ZMA (Zinc, Magnesium and Vitamin B6)

Occaisionally I added 200mg of 5-HTP to the bedtime regime with the thinking that a reduced number of respiratory events would reduce the awakenings during the night.

My reasoning behind the choices (click for brand and detailed info):

Vitamin D3 (1000 iu / 25 ug)
I took this for the reasons already mentioned. In addition to that, D3 is linked to our Circadian Rhythm, which seems logical, considering it is produced by the skin in sunlight. For that reason I decided to take this in the morning as it seemed that is when it would normally be produced.

A safe dose seems to be 4000iu or 100ug according to Vieth, Kimbell et al (2004) so I didn't see a problem with taking 25ug or even 50ug. 

Multi-Vitamins & Minerals with Iron

I deliberately chose a blend with a high Iron content as Iron is essential for haemoglobin (used in gas transporation around the body). Low iron levels are also associated with Periodic Limb Movements which can cause awakenings during the night.

I also wanted a blend that had B vitamins because I have previously taken Vitamin B6 at night to help with sleep and dreaming. I found that B6 helped, although in a dose that is not recommended for the long term. B6 is also used in the production of serotonin, which links back to my 5-HTP post, so this seemed like an essential one to have.

B12 is also known to have an effect on Melatonin. Mayer, Kröger and Meier-Ewert (1996)

Magnesium may have an effect on Periodic Limb Movements Hornyak et al

With these seeming to be comprehensive multi-vitamins and minerals, I thought I pretty much had any possible deficiencies covered although I did add ZMA in the evenings...

ZMA (Zinc, Magnesium and B6)

This is found in the bodybuilding section of the health food shop. ZMA is to be taken at night (which sounded promising for sleep). It is also discussed anecdotally in body-building forums as having a positive effect on sleep. I thought that an additional boost of B6 and Magnesium (for the reasons given in multi-vitamins) would be useful at night. The Zinc seemed to be an added extra, although it does seem to have a role in regulating hormones and neuro-transmission

I am pleased with the result. A quick look at one of my typical Zeo hypnograms confirms why: 

Aside from how I felt, my criteria for deciding whether I'd had a decent sleep used to be if the amount of wake was less than the amount of deep as the two were usually similar in duration!

This is a graph from a week or so after taking the supplements mentioned above.

So I slept better on that night (despite a higher "sleep stealer" score), but what about the rest?

This is from a couple of weeks later:

Although there are still awakenings, they are relatively short (total of about 5 mins a night, well under the average for my age) my weekly average graphs show that the story of higher REM is repeated nightly along with less time spent awake:

(I started taking the D3 on the 19th of December and the additional supplements on the 23rd of December) 

That seems fairly conclusive to me. I hope that the pattern continues. This is all the more impressive as I haven't been doing anything more than taking the supplements. Some nights have been early, some late, some with a couple of drinks etc etc).

I intend to carry on with the regime with some additional monitoring - I'd like to see if the supplements also bring my AHI down, what the effect of 50ug of D3 is and what the combined effect with 5-HTP would be.

I'd then like to try the REM Rebound experiment again now that I seem to have broken my REM barrier.

We are all unique, and all I can say is that this works for me. I would be interested to know if anyone else has had a similar effect.

5-HTP, Serotonin and Sleep

 

For the last 5 days I've been taking 5-HTP.

5-HTP is a precursor to serotonin (that is, it becomes serotonin once metabolised by the body).

I've previously used 5-HTP for experimenting with my sleep composition, and to try to reliably trigger lucid dreams. The dosage that I was taking then was 50 - 100mg at night.

This time I tried a brand that contained "co-factors". These are associated vitamins and minerals that help the body to metabolise the 5-HTP into serotonin. 

I decided on 200mg each night about 10 minutes before getting into bed. 100mg is the recommended maximum daily dose of this brand, although I have seen others that give a maximum daily dose as 300mg.

I have also seen medical literature that cites doses of 150mg-300mg as a daily dose (as a trial for treating depression), so toxicity at this dose seemed unlikely.

Why did I take 5-HTP?

The rather lazy answer is that (as I mentioned above) I've taken it before without ill effect, and that it is mentioned to have a positive effect on sleep, even being cited as having a positive effect on a severe case of insomnia 

A rather cheeky and over-simplified answer is that I have already shown that a depressant (alcohol) increases my AHI, so I wondered if something that has antidepressant properties would have the opposite effect and reduce my AHI.

I have also seen medical literature that suggests a link between depression and sleep apnoea (both as a cause and effect of sleep apnoea). 

Depression is more complicated that just having low serotonin levels, but low serotonin does play a part. Serotonin is a neurotransmitter (it is used in the body's sending and receiving of nerve impulses), so I wondered if increasing my levels would mean that I would have stronger signals to breathe during sleep and that the muscle tone in my airways would be that much "sharper".

Okay, so how did the 5 days go?

I noticed the following effects (sleep related and non-sleep related):

• I wasn't as tired in the evenings, so went to bed later
• I found it easier to wake up
• I didn't feel as hungry during the day, generally ate once at 2pm, then didn't eat in the evening.

Throughout these experiments, I go to bed when I am tired.

I calculated my average bedtime using the Zeo data. As I am doing these 5-day comparisons on weekdays (except the alcohol test - see separate blog for that), the time that I had to wake up was the same each day, hence later to bed meant less time in bed, which oddly with the 5-HTP didn't feel like a bad thing.

 

I wondered if my body "needed" more sleep, afterall I am used to roughly an extra hour (and still crave more), but on two mornings of the week (Fri and Sat) I can have a bit of a lie-in if I need to but I didn't want to lie in when taking 5-HTP at night (It's Saturday and I'm typing this at 7am, after waking up at my normal weekday time of 6:30am)!

It is known that some anti-depressants can decrease the amount of REM sleep that you have, so I suspected that my percentage of REM would decrease.

As percentages, the figures do not show this. In fact they show an increase in the percentage of deep sleep, along with a slight increase in REM and wake...

However, as REM is more abundant at the end of the night, it follows that the less time one spends in bed, the less opportunity there is for REM sleep, hence my actual 5-day-mean time in REM fell by 11 minutes from my baseline of 98 minutes, although it put it more inline to the average for my age of 90 minutes.

My actual time in slow-wave sleep (deep) rose by a mean of 3 minutes.  My mean deep sleep (34 minutes) is still way below the average for my age (69 minutes) but within limits, so I am pleased with this small increase.

I'm not sure if these changes are actually significant, perhaps a longer trial may reveal more?

So, even if 5-HTP didn't affect my AHI, it still had positive effects on several aspects of my sleep composition. 

However, it did have a positive effect on my AHI and it was much more noticeable... 

I've graphed my 5-day-mean AHI alongside the other 5-day-mean AHIs for alcohol and my baseline.

It brings my mean AHI down to a level that puts me in the "normal" category (<5 AHI = normal). Maybe this is the reason for not wanting to sleep so early and finding it easier to wake in the mornings.

For the sake of showing that this is a consistent effect, I also graphed the data on a night by night basis... 

For now, this seems too good to be true: 

• Lower AHI
• Normal bedtimes
• Less time in bed
• Increase in slow-wave sleep

So what now? Keep on taking the tablets?

Based on my limited data, I wouldn't dare go so far as to claim that this is a effective treatment for mild (very mild) obstructive sleep apnoea, nor would I suggest that it would work for others, but it is intriguing and does need looking at further.

It leaves me wanting to know more about the mechanism behind this effect. Yes, it's good that it has helped me as far as my AHI is concerned, but I want to know how. In a previous post, I noted that my sleep apnoea seems to be REM related. Serotonin related activity drops dramaticaly during REM sleep, so maybe the higher levels due to 5-HTP reduced that effect?

Is my pseudo-science hypothesis correct, or is there more to it than that?

I'd be interested to see if this effect carried on, or if my body got used to the 5-HTP and the effect faded.

I'd also like to try this with a lower dose of 5-HTP (after all, why take a high dose if you don't need to)? I'd also like to see if sustained-release 5-HTP is more effective.

I was planning to try the mandibular advancement device next, but after such a positive effect, I think I'll stay with 5-HTP for a while and see if I can improve on the results even more. I'd like to bring my sleep latency (time to sleep onset) down.

Yes, this is good news but I can't help feeling a little like Lizzy in "Drop Dead Fred", she knows that she's taking a pill that will stop her seeing things that others can't. Will taking 5-HTP, increasing my serotonin levels and bringing my AHI down stop me from having sleep paralysis, lucid dreams and seeing/hearing the sleep-wake border imagery that I have grown so used to? 

I hope not.

I'll explain how and why I came to like sleep paralysis in an upcoming blog-post. Hopefully it may be of use to anyone that fears it as I used to.

I have to say that this is a test with a tiny sample size, and of limited duration. I am not suggesting that anybody should try this, and certainly not use it in place of recognised treatments. 

Update on Saturday, May 12, 2012 at 7:54PM by Hypnagogia Blog

I've also found that 5-HTP helped reduced residual snoring after lowering my AHI with positional therapy.

Snoring Remedies? Results for 5-HTP

Zeo & CPAP / BiPAP

I've posted on a couple of CPAP boards (and read at more) and it's clear that there are a lot of us who like to see what the ventilators are doing overnight and how many apnoeas & hypopneas there are. Quite a few of us own pulse-oximeters too, so this data can also be included.

One problem is that each device has it's own printout making comparing them tricky.

I created an A4 page in Photoshop and found that it was then easy to align all the graphs as long as all the monitors were were started and stopped at the same time (or as close as you can manage).

You can either print all the various outputs to PDF files using either Adobe or the free CutePDF then open them in Photoshop or you can take a screenshot from each piece of software.

Then cut and paste each graph onto your A4 blank and stretch them so that the start and stop times align.

Below is an example of one from a night of my son's BiPAP data. 

It includes: 

• BiPAP output (Pressure, RR, flow rate, triggered breaths, apnoeas etc)
• Transcutaneous CO2 (actually a reprocessed photo of the onboard graph)
• Oximetry trend
• Pulse rate
• Zeo 30 second resolution hypnogram
• Zeo 5 minute resolution hypnogram

I then pasted bits of relevant data from Zeo and the oximeter around the edge.

This is from a night of making adjustments to the backup rate of breaths and is a good example of what aligning the data can reveal.

Take a look at the highlighted strip and work down from the top...

• The backup rate had been increased a couple of hours before. 
• Then in the highlighted part you can see that the number of breaths increased even more.
• However, there was a much higher increase in the number of breaths he was doing for himself

Why?

When you look down to the Zeo hypnogram it becomes clear. The extra breaths were waking him from sleep, hence his spontaneous respiratory rate increased even more.

The backup rate was too high, so I reduced it.

I have also tried the Zeo with CPAP on myself.

Here is a simple overlay of the Zeo hypnogram onto the ResScan report. (I pasted the hypnogram into a new layer in Photoshop and then made it semi transparent).

A correlation between minute ventilation and periods of being awake (actually broken REM according to the 30 second hypnogram) is easy to see.

Also the apnoea flags point to me losing deep sleep due to apnoeas.

More about that and what I plan to do about it in another post though.