The Effect of Zinc Supplement on Sleep Quality of the Elderly: A Randomized Clinical Trial Study
Zinc Supplement on Sleep Quality of the Elderly
Keywords:
Complementary Medicine, Elder, Sleep Quality, Zinc
Abstract
The use of macronutrient and micronutrient foods is associated with the duration of sleep. This study aimed at determining the effect of zinc supplements on the sleep quality of the elderly. A parallel randomized clinical trial was designed in which 150 elderly who met the inclusion criteria were assigned to intervention and control groups. The elderly in the intervention group received a daily dose of 30 mg zinc supplementation pill for 70 days and the elderly in the control group did not receive any supplement. Sleep quality of the elderly was measured using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Serum zinc level in both groups was measured through the auto-analysis method. The questionnaire was completed and the serum level of zinc was measured twice, before the intervention and 70 days after the intervention. Both groups were homogeneous in terms of demographic variables, sleep quality, and serum zinc level before the intervention. Of all, 73.3% of the elderly in the intervention group and 74.7% of the elderly in the control group had poor sleep quality. Sleep quality of the elderly in the intervention group, as compared with the control group, significantly improved after the intervention. Furthermore, serum zinc levels in the elderly in the intervention group, as compared with the control group, significantly increased after the intervention. Base on the results of this study it is recommended to utilize zinc supplementation as a new therapeutic approach for improving sleep quality in the elderly.
References
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27. Hashemi F, Jalilvand A, Hakimi S, Nourmohammadi I. Assessment of zinc levels in serum samples from personnel of Firouzgar hospital by atomic absorption spectrometry (AAS). Razi Journal of Medical Sciences. 2006; 12(49):173-82.
28. Kvamme J-M, Grønli O, Jacobsen BK, Florholmen J. Risk of malnutrition and zinc deficiency in community-living elderly men and women: the Tromsø Study. Public health nutrition. 2015; 18(11):1907-13.
29. Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long‐term care facility residents in Italy: a double‐blind, placebo‐controlled clinical trial. Journal of the American Geriatrics Society. 2011; 59(1):82-90.
30. Gholipour Baradari A, Alipour A, Mahdavi A, Sharifi H, Nouraei SM, Emami Zeydi A. The Effect of Zinc Supplementation on Sleep Quality of ICU Nurses: A Double Blinded Randomized Controlled Trial. Workplace health & safety. 2018; 66(4):191-200.
31. Luojus MK, Lehto SM, Tolmunen T, Elomaa A-P, Kauhanen J. Serum copper, zinc and high-sensitivity C-reactive protein in short and long sleep duration in ageing men. Journal of Trace Elements in Medicine and Biology. 2015; 32:177-82.
32. Cherasse Y, Saito H, Nagata N, Aritake K, Lazarus M, Urade Y. Zinc‐containing yeast extract promotes nonrapid eye movement sleep in mice. Molecular nutrition & food research. 2015; 59(10):2087-93.
33. Saito H, Cherasse Y, Suzuki R, Mitarai M, Ueda F, Urade Y. Zinc‐rich oysters as well as zinc‐yeast‐and astaxanthin‐enriched food improved sleep efficiency and sleep onset in a randomized controlled trial of healthy individuals. Molecular nutrition & food research. 2017; 61(5):1600882.
34. Liuzzi JP, Lichten LA, Rivera S, Blanchard RK, Aydemir TB, Knutson MD, et al. Interleukin-6 regulates the zinc transporter Zip14 in liver and contributes to the hypozincemia of the acute-phase response. Proceedings of the National Academy of Sciences. 2005; 102(19):6843-8.
35. Samad N, Yasmin F, Naheed S, Zeeshan Bari A, Mazhar Ayaz M, Zaman A, et al. Serum levels of leptin, zinc and tryptophan in obese subjects with sleep deficits. Pakistan journal of pharmaceutical sciences. 2017; 30.
36. Ji X, Liu J. Associations between blood zinc concentrations and sleep quality in childhood: A cohort study. Nutrients. 2015; 7(7):5684-96.
37. Grandner MA, Jackson N, Gerstner JR, Knutson KL. Sleep symptoms associated with intake of specific dietary nutrients. Journal of sleep research. 2014; 23(1):22-34.
38. Danscher G, Stoltenberg M. Zinc-specific autometallographic in vivo selenium methods: tracing of zinc-enriched (ZEN) terminals, ZEN pathways, and pools of zinc ions in a multitude of other ZEN cells. Journal of Histochemistry & Cytochemistry. 2005; 53(2):141-53.
39. Khazdouz M, Mazidi M, Ehsaei M-r, Ferns G, Kengne AP, Norouzy A-R. Impact of zinc supplementation on the clinical outcomes of patients with severe head trauma: a double-blind randomized clinical trial. Journal of dietary supplements. 2018; 15(1):1-10.
40. El-Shazly AN, Ibrahim SAE-H, El-Mashad GM, Sabry JH, Sherbini NS. Effect of zinc supplementation on body mass index and serum levels of zinc and leptin in pediatric hemodialysis patients. International journal of nephrology and renovascular disease. 2015; 8:159.
2. Sun X-H, Ma T, Yao S, Chen Z-K, Xu W-D, Jiang X-Y, et al. Associations of sleep quality and sleep duration with frailty and pre-frailty in an elderly population Rugao longevity and ageing study. BMC geriatrics. 2020; 20(1):1-9.
3. Putilov AA. Sleep Satisfaction, Sleep–Wake Pattern, and Aging. Neurological Modulation of Sleep: Elsevier; 2020. p. 79-86.
4. Zhu X, Hu Z, Nie Y, Zhu T, Chiwanda Kaminga A, Yu Y, et al. The prevalence of poor sleep quality and associated risk factors among Chinese elderly adults in nursing homes: A cross-sectional study. PloS one. 2020; 15(5):e0232834.
5. Lee SY, Ju YJ, Lee JE, Kim YT, Hong SC, Choi YJ, et al. Factors associated with poor sleep quality in the Korean general population: providing information from the Korean version of the Pittsburgh Sleep Quality Index. Journal of affective disorders. 2020; 271:49-58.
6. Harrington JJ, Lee-Chiong Jr T. Sleep and older patients. Clinics in Chest Medicine. 2007; 28(4):673-84.
7. Ifansyah MN, Himmah EF, Pertiwi MR. Complementary Therapies to Improve the Quality of Sleep in the Elderly: A Systematic Review. D'Nursing and Health Journal (DNHJ). 2021; 2(1):11-6.
8. Chan V, Lo K. Efficacy of dietary supplements on improving sleep quality: a systematic review and meta-analysis. Postgraduate Medical Journal. 2021.
9. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012; 380(9859):2224-60.
10. Wessells KR, Brown KH. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PloS one. 2012; 7(11).
11. Stein AJ. Rethinking the measurement of undernutrition in a broader health context: Should we look at possible causes or actual effects? Global Food Security. 2014; 3(3-4):193-9.
12. Prasad AS. Discovery of human zinc deficiency: its impact on human health and disease. Advances in nutrition. 2013; 4(2):176-90.
13. Idei M, Miyake K, Horiuchi Y, Tabe Y, Miyake N, Ikeda N, et al. Serum zinc concentration decreases with age and is associated with anemia in middle-aged and elderly people. Rinsho byori The Japanese journal of clinical pathology. 2010; 58(3):205-10.
14. Ervin RB, Kennedy-Stephenson J. Mineral intakes of elderly adult supplement and non-supplement users in the third national health and nutrition examination survey. The Journal of nutrition. 2002; 132(11):3422-7.
15. Arab A, Mehrabani S, Moradi S, Amani R. The association between diet and mood: A systematic review of current literature. Psychiatry research. 2019; 271:428-37.
16. Hajianfar H, Mollaghasemi N, Tavakoly R, Campbell MS, Mohtashamrad M, Arab A. The association between dietary zinc intake and health status, including mental health and sleep quality, among Iranian female students. Biological Trace Element Research. 2021; 199(5):1754-61.
17. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry res. 1989; 28(2):193-213.
18. Molloy DW, Alemayehu E, Roberts R. Reliability of a standardized mini-mental state examination compared with the traditional mini-mental state examination. Am J Psychiatry. 1991; 148(1):102-5.
19. Rocca WA, Bonaiuto S, Lippi A, Luciani P, Pistarelli T, Grandinetti A, et al. Validation of the Hodkinson abbreviated mental test as a screening instrument for dementia in an Italian population. Neuroepidemiology. 1992; 11(4-6):288-95.
20. Abdullahzadeh M, Naji SA. Effect of Chamomile extract on sleep quality of the elderly. Evidence Based Care. 2014; 4(3):47-56.
21. Farrahi J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A). Sleep and Breathing. 2009; 13(3):259.
22. McPherson RA, Pincus MR. Henry's clinical diagnosis and management by laboratory methods E-book: Elsevier Health Sciences; 2017.
23. Stewart-Knox BJ, Rae G, Simpson EE, McConville C, O’Connor J, Polito A, et al. Supplemented zinc does not alter mood in healthy older European adults–a randomised placebo-controlled trial: the Zenith study. Public health nutrition. 2011; 14(5):882-8.
24. Sawada T, Yokoi K. Effect of zinc supplementation on mood states in young women: a pilot study. European journal of clinical nutrition. 2010; 64(3):331-3.
25. Lindstrom V, Andersson K, Lintrup M, Holst G, Berglund J. Prevalence of sleep problems and pain among the elderly in Sweden. The journal of nutrition, health & aging. 2012; 16(2):180-3.
26. Aliasgharpoor M, Eybpoosh S. Quality of sleep and its correlating factors in residents of Kahrizak nursing home. The Journal of Urmia Nursing and Midwifery Faculty. 2011; 9(5):374-83.
27. Hashemi F, Jalilvand A, Hakimi S, Nourmohammadi I. Assessment of zinc levels in serum samples from personnel of Firouzgar hospital by atomic absorption spectrometry (AAS). Razi Journal of Medical Sciences. 2006; 12(49):173-82.
28. Kvamme J-M, Grønli O, Jacobsen BK, Florholmen J. Risk of malnutrition and zinc deficiency in community-living elderly men and women: the Tromsø Study. Public health nutrition. 2015; 18(11):1907-13.
29. Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long‐term care facility residents in Italy: a double‐blind, placebo‐controlled clinical trial. Journal of the American Geriatrics Society. 2011; 59(1):82-90.
30. Gholipour Baradari A, Alipour A, Mahdavi A, Sharifi H, Nouraei SM, Emami Zeydi A. The Effect of Zinc Supplementation on Sleep Quality of ICU Nurses: A Double Blinded Randomized Controlled Trial. Workplace health & safety. 2018; 66(4):191-200.
31. Luojus MK, Lehto SM, Tolmunen T, Elomaa A-P, Kauhanen J. Serum copper, zinc and high-sensitivity C-reactive protein in short and long sleep duration in ageing men. Journal of Trace Elements in Medicine and Biology. 2015; 32:177-82.
32. Cherasse Y, Saito H, Nagata N, Aritake K, Lazarus M, Urade Y. Zinc‐containing yeast extract promotes nonrapid eye movement sleep in mice. Molecular nutrition & food research. 2015; 59(10):2087-93.
33. Saito H, Cherasse Y, Suzuki R, Mitarai M, Ueda F, Urade Y. Zinc‐rich oysters as well as zinc‐yeast‐and astaxanthin‐enriched food improved sleep efficiency and sleep onset in a randomized controlled trial of healthy individuals. Molecular nutrition & food research. 2017; 61(5):1600882.
34. Liuzzi JP, Lichten LA, Rivera S, Blanchard RK, Aydemir TB, Knutson MD, et al. Interleukin-6 regulates the zinc transporter Zip14 in liver and contributes to the hypozincemia of the acute-phase response. Proceedings of the National Academy of Sciences. 2005; 102(19):6843-8.
35. Samad N, Yasmin F, Naheed S, Zeeshan Bari A, Mazhar Ayaz M, Zaman A, et al. Serum levels of leptin, zinc and tryptophan in obese subjects with sleep deficits. Pakistan journal of pharmaceutical sciences. 2017; 30.
36. Ji X, Liu J. Associations between blood zinc concentrations and sleep quality in childhood: A cohort study. Nutrients. 2015; 7(7):5684-96.
37. Grandner MA, Jackson N, Gerstner JR, Knutson KL. Sleep symptoms associated with intake of specific dietary nutrients. Journal of sleep research. 2014; 23(1):22-34.
38. Danscher G, Stoltenberg M. Zinc-specific autometallographic in vivo selenium methods: tracing of zinc-enriched (ZEN) terminals, ZEN pathways, and pools of zinc ions in a multitude of other ZEN cells. Journal of Histochemistry & Cytochemistry. 2005; 53(2):141-53.
39. Khazdouz M, Mazidi M, Ehsaei M-r, Ferns G, Kengne AP, Norouzy A-R. Impact of zinc supplementation on the clinical outcomes of patients with severe head trauma: a double-blind randomized clinical trial. Journal of dietary supplements. 2018; 15(1):1-10.
40. El-Shazly AN, Ibrahim SAE-H, El-Mashad GM, Sabry JH, Sherbini NS. Effect of zinc supplementation on body mass index and serum levels of zinc and leptin in pediatric hemodialysis patients. International journal of nephrology and renovascular disease. 2015; 8:159.
Published
2025/12/21
Section
Originalni rad / Original article