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, Alfonso Tortorella and Luca Steardo ()
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Elvira Anna Carbone: Department of Medical and Surgical Sciences, University Magna Graecia, 88100 Catanzaro, Italy
Giulia Menculini: Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
Renato de Filippis: Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
Martina D’Angelo: Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
Pasquale De Fazio: Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
Alfonso Tortorella: Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
Luca Steardo: Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy

IJERPH, 2023, vol. 20, issue 5, 1-13

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.

Keywords: anxiety disorder; calcium; parathyroid hormone; vitamin D; sleep; insomnia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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