Resolution of hypersomnia following identification and treatment of vitamin d deficiency

J Clin Sleep Med. 2010 Dec 15;6(6):605-8.


A 28-year-old woman was evaluated for 4 months of excessive daytime sleepiness (EDS), after an overnight polysomnogram (PSG) revealed neither sleep disordered breathing nor a sleep related movement disorder. A full sleep evaluation revealed the presence of heavy daytime napping and pervasive fatigue. Epworth Sleepiness Scale (ESS) Score was 10/24. No features characteristic for depression or narcolepsy were present. Chronic pain in the low back and thighs, as well as chronic daily headaches were identified as potential sleep-disrupting forces. Risk factors for hypovitaminosis D included limited natural sun exposure, dark skin tone, and obesity. A 25-hydroxyvitamin D level was low, at 5.9 ng/mL. Vitamin D supplementation was initiated at a dose of 50,000 IU once weekly, and EDS improved within 2 weeks. One week later, a PSG with next-day multiple sleep latency testing (MSLT) failed to show significant pathology. At follow-up, she reported resolution of thigh pain and headaches, with a significant improvement in her low back pain syndrome. EDS had resolved, and her ESS score was 1/24. Follow-up 25-hydroxyvitamin D level was normal at 39 ng/mL. Mechanisms for her clinical improvement could include enhanced sleep quality due to resolution of hypovitaminosis D-associated noninflammatory myopathy, or a possible immunomodulatory effect of vitamin D decreasing central nervous system (CNS) homeostatic sleep pressure via its effects on tumor necrosis factor-alpha (TNF-α) and/or prostaglandin D2. More research is needed to determine if patients presenting with EDS should be more broadly screened for vitamin D deficiency.

Keywords: Hypersomnia; chronic pain; hypovitaminosis D; osteomalacic myopathy; vitamin D.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Chemical Analysis
  • Diagnosis, Differential
  • Disorders of Excessive Somnolence / diagnosis*
  • Disorders of Excessive Somnolence / drug therapy*
  • Disorders of Excessive Somnolence / etiology
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Polysomnography / methods
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Vitamin D / administration & dosage*
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / drug therapy*


  • Vitamin D