Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance.
Elvira Anna Carbone,
Giulia Menculini,
Renato de Filippis,
Martina D'Angelo,
Pasquale De Fazio
et al.
Other
International journal of environmental research and public health
2023
19 citazioni
PubMed
DOI
CC-BY
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Study Design
- Tipo di studio
- cross_sectional
- Dimensione del campione
- 211
- Intervento
- Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. None
- Comparatore
- Placebo
- Direzione dell'effetto
- Neutral
- Rischio di bias
- Moderate
Abstract
Patients with a generalized anxiety disorder (GAD) often report preeminent sleep disturbances. Recently, calcium homeostasis gained interest because of its role in the regulation of sleep-wake rhythms and anxiety symptoms. This cross-sectional study aimed at investigating the association between calcium homeostasis imbalance, anxiety, and quality of sleep in patients with GAD. A total of 211 patients were assessed using the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Insomnia Severity Index (ISI) scales. Calcium, vitamin D, and parathyroid hormone (PTH) levels were evaluated in blood samples. A correlation and linear regression analysis were run to evaluate the association of HAM-A, PSQI, and ISI scores with peripheral markers of calcium homeostasis imbalance. Significant correlations emerged between HAM-A, PSQI, ISI, PTH, and vitamin D. The regression models showed that patients with GAD displaying low levels of vitamin D and higher levels of PTH exhibit a poor subjective quality of sleep and higher levels of anxiety, underpinning higher psychopathological burden. A strong relationship between peripheral biomarkers of calcium homeostasis imbalance, insomnia, poor sleep quality, and anxiety symptomatology was underlined. Future studies could shed light on the causal and temporal relationship between calcium metabolism imbalance, anxiety, and sleep.
Full Text
Tables
Table 1
| Deficiency Level | Intermediate Level | Excess Level | |
|---|---|---|---|
| Vit D | <20 ng/mL | 21–29 ng/mL (insufficiency level) | >100 ng/mL |
| Ca++ | <8.8 mg/dL | 8–10 mg/dL | >10 mg/dL |
| PTH | <15 pg/mL | 15–55 pg/mL | >55 pg/mL |
Table 2
| Total Sample | |||
|---|---|---|---|
| N (%) | |||
| Sex | Female | 108 (51.2) | |
| Male | 103 (48.8) | ||
| Diploma | yes | 161 (76.3) | |
| Marital status | Single | 3 (1.4) | |
| Married | 96 (45.5) | ||
| Co-habiting | 78 (37.0) | ||
| Divorced | 32 (15.2) | ||
| Widowed | 2 (0.9) | ||
| Occupation | Unemployed | 73 (34.6) | |
| Employed | 133 (63.0) | ||
| Retired | 5 (2.4) | ||
| Family Psychiatric History | yes | 136 (64.5) | |
| M (SD) | Range | ||
| Age | 46.91 (13.76) | 22–75 | |
| Age at onset of GAD | 27.82 (11.01) | 16–66 | |
| HAM-A | Total score | 25.6 (13.74) | 7–54 |
| PSQI | Quality | 1.75 (1.03) | 0–3 |
| Latency | 1.52 (1.11) | 0–3 | |
| Duration | 1.51 (0.94) | 0–3 | |
| Efficiency | 1.43 (0.99) | 0–3 | |
| Disturbances | 1.43 (1.04) | 0–3 | |
| Medication | 1.62 (1.10) | 0–3 | |
| Dysfunction | 1.64 (1.10) | 0–3 | |
| Total score | 10.96 (6.18) | 0–21 | |
| ISI | Total score | 14.36 (8.22) | 0–33 |
| Calcium level | 9.46 (0.38) | 8.60–11.00 | |
| PTH level | 54.64 (20.45) | 12.40–87.00 | |
| Vit D level | 29.42 (25.10) | 4.0–332.0 | |
Table 3
| Ca++ | PTH | Vit D | HAM-A Total | PSQI Quality | PSQI | PSQI | PSQI | PSQI | PSQI Medication | PSQI Dysfunction | PSQI Total | ISI Total | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ca++ | - | ||||||||||||
| PTH | −0.115 | - | |||||||||||
| Vit D |
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| HAM-A Total |
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| PSQI Quality |
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| PSQI Latency |
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| PSQI Duration |
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| PSQI Efficiency |
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| PSQI Disturbances |
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| PSQI Medication |
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| PSQI Dysfunction |
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| PSQI Total |
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| ISI Total |
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Table 4
| Dependent Variable | Independent Variables | Not Standardized Coefficients | Standardized Coefficients | Sign. | ||
|---|---|---|---|---|---|---|
| B | Error Standard | Beta | t | |||
| PSQI Total | PTH | 0.212 | 0.015 | 0.700 | 140.198 |
|
| Vit D | −0.035 | 0.012 | −0.144 | −20.909 |
| |
| Ca++ | −0.485 | 0.706 | −0.030 | −0.686 | 0.493 | |
| a Model 1 | Dependent variable: PSQI Total; R2 = 0.603; F = 80.752; | |||||
| HAM-A Total | PTH | 0.516 | 0.030 | 0.767 | 170.457 |
|
| Vit D | −0.067 | 0.024 | −0.123 | −20.783 |
| |
| Ca++ | 0.813 | 10.398 | 0.023 | 0.581 | 0.562 | |
| b Model 2 | HAM-A Total; R2 = 0.685; F = 115.137; | |||||
| ISI Total | PTH | 0.306 | 0.018 | 0.759 | 160.781 |
|
| Vit D | −0.035 | 0.015 | −0.108 | −20.375 |
| |
| Ca++ | −10.203 | 0.862 | −0.056 | −10.395 | 0.164 | |
| c Model 3 | Dependent | variable: ISI Total; R2 = 0.672; F = 105.516; | ||||
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