Therapeutic mechanism of vitamin B12 on sleep wake-rhythm disorders

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Our goal of this study was to clarify the therapeutic mechanism of B12 on sleep in insomniacs by means of polysomnograghy (PSG) using cyclic alternative pattern (CAP) method.Step 11. Subjects : 8 male normal subjects (mean age;36.5±11.2y)2. Drug : methylcobalamine(B12) 500μg i.v. or saline (placebo) 1ml i.v. (23:00)3. Measurements1) Plasma concentration of B12 (23:00,8:00)2) PSG(0:00-7:30. PSG data were analyzed visually using conventional and CAP method)3) Psychomotor vigilance task (PVT)4) Visual analog scale (VAS)3),4) items were performed 8:00,9:00,11:00, and 13:00 next morning after PSG test.4. ResultsBy the administration of B12...1) Concentration of B12 significantly increased. (280.0±90.1→1876.7±1327.3pg/ml, p<0.05)2) Sleep parameters were not statically changed.3) CAP rate was significantly decreased. (37.1±14.6→31.1±15.1%,p=0.0499)Step 21. Subjects: 8 female insomnia patients (mean age;36.5±11.2y), who met the diagnosis of psychophysiological insomnia (PPI) in ICSD-I.2. Drug and Measurements : the same as those of Step 13. ResultsBy the administration of B12...1) Concentration of B12 significantly increased.2) Sleep parameters were not statically changed.3) CAP time, CAP rate, the number of CAP cycles, and the number of subtype Al were significantly decreased. (CAP rate:62.6 ±10.3→53.4±10.4%,P=0.028)4) Subjective sleep quality and PVT variables were not changed next mornings.ConclusionFrom the above-mentioned results, it was reconfirmed that CAP rate in Japanese PPI patients increased (62.6%) as well as those in insomnia patients of oversea.Furthermore, our findings suggested that peripherally infused B12 might have the ability of enforcing sleep stability in insomnia patients. It was also suggested that B12 might act on sleep control system via suppressing subcortical arousal in insomnia patients, because subtype Al was especially decreased.