Iron deficiency is a common micronutrient deficiency that can cause fatigue, weakness, and anemia. “Can iron deficiency cause insomnia?” is a quite common question which arises because of the synergy of nutrition and sleep. It may surprise you that iron deficiency and insomnia may negatively impact your health.
Iron is a mineral needed for cellular function, cognitive development, physical growth, and hormone production. The production of hemoglobin and myoglobin, two proteins required for regular, daily body processes, also depends on it. Iron is the “key” for the synthesis of the proteins that enable sleep, which is one of the “normal” processes.
Therefore, iron deficiency can cause sleep disorders such as insomnia, obstructive sleep apnea, and restless legs syndrome. This is because certain neurotransmitters (like serotonin and dopamine, which regulate mood and sleep) require iron to be produced, and people who have iron-deficiency anemia may have reduced amounts of these neurotransmitters.
Both the symptoms of iron deficiency and insomnia are similar, such as:
- Fatigue
- Weakness
- Drowsiness
- Trouble in restful sleep
- Impaired cognitive function
However, iron-rich diets and supplements have shown promising results in treating insomnia and other sleep disorders caused by iron deficiency. Research shows that low iron levels disturb sleep, emphasizing the importance of iron intake for physical and mental health.
How to know if you have Iron Deficiency?
Iron is required for the formation of hemoglobin, the protein in red blood cells that carries oxygen to tissues. The production of energy in every single cell in the human body is directly correlated to the level of oxygen that is available to those cells.
Consequently, iron deficiency can occur gradually without symptoms. As the deficiency advances (severe), symptoms can occur. Iron deficiency involves three stages:
- Stage 1 – Iron depletion: Iron stores are depleted without affecting red blood cell formation (erythropoiesis).
- Stage 2 – Iron deficiency: Iron-deficient erythropoiesis due to red blood cell disruption.
- Stage 3 – Iron deficiency anemia: Iron deficiency anemia develops from low levels of iron for hemoglobin synthesis in red blood cells. This is when symptoms start to occur.
Some symptoms of iron deficiency may vary from mild to severe. Common signs of iron deficiency are:
- Fatigue and Lack of Energy: Low-iron individuals most often complain of fatigue and energy loss. Iron is needed to synthesize myoglobin, another protein that carries oxygen, and muscle tissue contains it, which acts as an alternative when hemoglobin levels drop.
- Pale Skin: Iron deficiency can cause pale skin. This results from lower hemoglobin levels, which render the blood less red.
- Dizziness or Lightheadedness: An iron deficiency can result in low amounts of oxygen in the brain, causing dizziness or lightheadedness.
- Breathing difficulty: People with low iron levels may experience shortness of breath when exercising physically because their bodies aren’t obtaining enough oxygen.
- Cold Hands and Feet: Low hemoglobin levels can result in impaired circulation, which can lead to cold hands and feet.
- Brittle Nails: Due to inadequate levels of iron, nails may become weak and break easily.
- Restless Leg Syndrome: A deficiency of iron in the body may cause RLS, resulting in very unsettling limb sensations, particularly at night.
Causes and Prevalence of Iron Deficiency
Iron deficiency anemia can affect everyone, although some demographic groups are more inclined to suffer from it due to:
- Not receiving enough iron: This might occur due to a poor diet or an inability to absorb iron properly.
- Loss of iron: This primarily affects women with heavy menstrual cycles. It can also occur if you have a medical condition that leads to bleeding or if you have undergone some type of surgery.
- Needing extra iron: Pregnancy requires more iron than normal. Preschoolers and teens also need extra iron during the development phases.
Some of the significant risk factors for iron deficiency are as follows:
Lack of iron in your diet:
The question “Can iron deficiency cause insomnia?” undoubtedly gives rise to a discussion about dietary changes as a possible treatment strategy. Consuming a variety of foods high in iron, such as meats, eggs, and dark green leafy vegetables, is the best dietary source to obtain iron.
However, not everyone can consume them. For certain people, gastrointestinal problems or irregular meal ingestion hinder iron absorption. Some people, especially vegetarians and vegans, don’t get enough iron.
Accordingly, how much iron your body receives from diet depends on its storage capacity. Vegetarians obtain 10% of iron from their diets, while Westerners’ diets (which include animal foods) get 18%.
Even when you eat iron-rich foods, your body’s iron stores, notably the liver, may affect iron absorption the most. When your iron stores are high, your body gets less iron from your food. When your iron stores are low, the reverse happens.
Inability to absorb iron:
Even with a well-balanced diet, some people struggle to absorb iron due to gastrointestinal issues and other disorders, such as:
Disorders such as celiac disease can impair the body’s capacity to absorb nutrients, increasing the risk of iron deficiency.
Other major causes of iron deficiency include surgery that removes or bypasses sections of the small intestine. These can significantly impair the body’s capacity to absorb not just iron, but also other nutrients.
Blood loss:
Blood loss is a major cause of iron deficiency because iron is stored in red blood cells. Some of the factors, such as:
Conditions that cause severe blood loss, such as menstruation in women, peptic ulcers, or colorectal cancer, can gradually deplete iron deposits.
Long-term usage of nonsteroidal anti-inflammatory medicines (NSAIDs) might result in gastrointestinal bleeding and worsen iron deficiency.
Gender and economic status:
Compared to men, 20% of adult women suffer iron deficiency anemia. This is because:
Low iron levels are particularly prevalent in pregnant women, with around 50% of them suffering from this condition.
Certain ethnic groups, such as Hispanics and Blacks, as well as people living in low-income areas are also at higher risk.
The prevalence of sickle cell anemia is one among many risk factors for those populations.
Infants and elderly individuals:
Iron deficiency anemia is more common in older individuals and young.
Infants—especially those born preterm or with low birth weight—are more at risk of developing iron deficiency.
Babies need much more iron than what they get from formula or breast milk, which contains very little iron as they continue to grow.
Compared to younger people, older people often eat less, and the foods they eat are less likely to be high in iron.
Vegetarians:
People who follow a vegetarian or vegan diet may be at higher risk of iron deficiency because they avoid non-vegetarian foods and other meats.
Iron Deficiency vs. Iron Deficiency Anemia
Iron deficiency and anemia are often confused, but they are different. Low iron levels are known as iron deficiency, and iron deficiency anemia occurs when the body is unable to produce enough hemoglobin, leading to an insufficient number of healthy red blood cell counts.
Iron deficiency can occur without anemia or after anemia has resolved. Additionally, understanding the difference is essential for accurate diagnosis and treatment.
How Does Iron Deficiency Affect Sleep?
Can iron deficiency cause insomnia? Multiple studies have linked sleep quality to iron deficiency. Iron deficiency can cause fatigue, irritation, and cognitive problems, which may make individuals more restless and unable to get the deep, unbroken sleep they need to feel rested.
In youngsters, sleep disorders caused by iron deficiency may be worse due to rapid brain and body growth. Impaired iron levels (iron deficiency) may hinder the natural progression of the central nervous system’s continuing development. Thus, the worse your iron deficiency, the less you sleep.
Another study found that people with iron deficiency anemia during the first year of life had a considerably higher chance of having shorter sleep duration.
Impact of Iron Deficiency on Neurotransmitters
Iron’s role in neurotransmitter synthesis and regulation is crucial to brain function. Poor sleep has been linked to disorders in the brain’s dopamine (DA) and serotonin (5-HT) systems, which keep humans awake and affect many behaviors.
Dopamine:
The sleep-wake cycle and wakefulness depend on this neurotransmitter. You can’t metabolize dopamine well if you’re low on iron. That could cause strange sleep patterns and increased alertness or nervousness during the day.Serotonin:
Melatonin, which regulates sleep-wake cycles, is produced from this neurotransmitter. Iron deficiency or low iron levels prevent the body from making enough serotonin, which is needed to produce melatonin, resulting in trouble sleeping issues.
Additionally, people with low dopamine levels are more likely to have RLS and other associated diseases including sleep-disordered breathing and ADHD.
Impact of Iron Deficiency on PLMD and RLS
Studies show that restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) are two sleep disorders associated with iron deficiency. RLS causes uncontrollable leg movements, especially at night, which makes sleeping difficult. PLMD is characterized by poor-quality, inefficient, and fragmented sleep caused by multiple episodes of involuntary leg movement.
These two sleep problems are common in seniors. They are also linked to iron deficiencies and neurologic disorders. However, both conditions get better with iron supplementation. Furthermore, research shows that RLS patients have low iron levels in their spinal fluid, which contributes to these movement disorders.
Impact of Iron Deficiency on Hormone Fluctuation:
Iron regulates various sleep chemicals, including melatonin. Melatonin controls sleep-wake cycles. Iron deficiency can cause hormonal imbalances that make falling and staying asleep difficult.
How long do Iron Deficiency Symptoms last?
Several factors affect how long iron deficiency symptoms last, including the person’s health, the severity of the deficits, and the start of effective treatment.
Mild Deficiency:
Untreated symptoms may last weeks to months.Moderate to Severe Deficiency:
Symptoms may persist until iron levels are restored. Treatment may take months to normalize iron levels.Treatment Response:
Many patients feel better after iron supplements and dietary changes, although not immediately. Some might experience improvements in weeks, while individuals with longer-lasting problems, such as fatigue and sleep issues (like insomnia), may require months.
Iron Deficiency and Insomnia
Insomnia is defined as the prolonged inability to get asleep, stay asleep, or get adequate sleep. Individuals with iron deficiency and insomnia may exhibit a range of symptoms, such as:
- Difficulty falling or staying asleep
- Frequent nighttime awakenings
- Restless sleep
- Daytime exhaustion and drowsiness
- Mood issues, such as anxiety or resentment
The connection between iron levels and sleep quality poses a question: Can iron deficiency cause insomnia? Several studies have shown that people with iron deficiency anemia are more likely to suffer from insomnia. However, these studies could only demonstrate a relationship because they examined cross-sectional data.
A more recent genome-wide analysis examined the genes connected to insomnia and discovered that a specific gene called MEIS1 is highly associated with the disorder. This gene is also associated with restless leg syndrome (RLS), a disorder in which people with iron deficiency anemia have an unsettling urge to move their legs. Stretching relieves this urge during inactivity, especially at night, but people with RLS may still have trouble sleeping.
A Chinese Medical Journal research examined anemia and insomnia in 12,614 Chinese individuals. Those with anemia, indicated by low blood hemoglobin levels, had a 32% higher risk of insomnia over six years. Men were more likely than women to develop insomnia due to severe anemia, which was far more prevalent than mild or moderate anemia.
Why does Iron Deficiency cause Insomnia?
The brain cannot function properly without enough iron. A deficiency can lead to sleep-related cognitive problems. However, insomnia can be caused by many factors, such as:
Restless Leg Syndrome (RLS):
People with iron deficiency are more likely to suffer from RLS. This syndrome causes a strong impulse to move the legs, usually triggered by uncomfortable (“distressing” or “painful”) sensations, which can make it difficult to fall and remain asleep.Oxygen deficiency:
Anemia reduces the blood’s oxygen-carrying capacity, resulting in diminished oxygen delivery to the brain. This shortage of oxygen can cause individuals to awaken during the night. In many ways, It is a complex sleep robber, depriving the brain of both restful sleep and what it needs to operate during waking hours.Increased Anxiety and Stress:
The physical stress associated with iron deficiency can increase anxiety levels, which is a well-known precursor to insomnia. Increased anxiety makes it difficult to get good sleep.Tiredness and Sleep-Wake Cycle Interference:
Chronic fatigue caused by iron deficiency can disrupt the body’s normal sleep-wake cycle, making it more challenging to maintain a regular sleep rhythm, which is essential for proper sleep hygiene.Genetic Factor:
Some research indicates that sleep and iron metabolism are hereditary features (a gene called MEIS1). Genetically predisposed people with low iron levels may experience insomnia.
What are the Best Supplements for Iron Deficiency?
The question “Can iron deficiency cause insomnia?” is often transformed into a topic of iron supplements’ effectiveness. Iron deficiency may not alone be corrected by diet. Therefore, doctors often prescribe iron supplements to boost iron levels.
The iron supplements replenish the body’s iron stores, which are needed to make hemoglobin, the protein in red blood cells (RBCs). Hemoglobin transports oxygen to tissues, giving you energy.
The best and most common types of iron supplements available in the United States are listed below:
Taken orally:
Best supplements for iron deficiency, such as ferrous fumarate, ferrous gluconate, ferrous succinate, and ferrous sulfate. Each supplement is microencapsulated in liposomal form and infused with vitamin C (to increase the bioavailability of the iron).
Received by injection:
Iron dextran, iron sucrose.
Remember that iron supplements are available without a prescription in most grocery stores and pharmacies. Thus, it is recommended to consult a doctor before choosing one. This is because each type of iron supplement preparation has its own dosing schedule, iron salt, complex, combination, and iron content.
Usually, it requires two months of iron supplements for serum iron levels to normalize. However, it may be recommended to continue taking iron supplements to maintain iron levels in your body. The length of time you need iron supplements depends on:
- The severity of your iron deficiency
- The form of supplement (capsules, tablets, chewable tablets, and liquids)
- Administering method (oral, enteral, topical, and parenteral administration)
Important tips: Before starting a supplement program, consult a doctor. This is especially important if you are pregnant or have health issues.
Key Considerations for Iron Deficiency Supplements
Iron deficiency can result from low dietary iron, unhealthy lifestyle, and inadequate iron absorption. Before using iron supplements, consider these key points:
Medical advice:
Consult a doctor to determine the right dosage and form.Dosages:
Stay within the recommended dose to avoid iron toxicity and other health issues.Absorption power:
Take iron supplements on an empty stomach for maximum efficacy. All symptoms suggest maxing absorption by taking the supplement alone, except for iron-induced gastrointestinal discomfort, which requires taking it with meals.Avoid interactions:
Caution of certain medication interactions, such as calcium-antacid interactions, which might limit iron absorption.Nutritional considerations:
To improve absorption, also include vitamin C-rich foods or beverages when taking iron supplements.Monitor side effects:
Report any severe reactions, such as constipation, nausea, or upset stomach, to your healthcare physician.Length of use:
Ask your doctor how long you should take iron supplements since once your iron levels return to normal, you may not need to take them as long or will need a lower dose.Regular blood exams:
Schedule regular blood exams to determine iron levels and verify the necessity and efficacy of supplements.
Treatment for Iron-Deficiency Affiliated Insomnia
Sleep disorders like insomnia and iron deficiencies must be treated to improve overall health. Some of these remedies are:
Accurate Iron deficiency diagnosis:
Iron deficiency is usually detected by blood tests that evaluate hemoglobin, serum ferritin, and other iron indicators. A doctor recommends these tests for anemic patients with disturbing insomnia issues.
In addition to blood tests, a thorough clinical evaluation is essential. This may include a review of eating habits, past health difficulties, and drugs that may affect iron absorption or sleep.
Underlying conditions treatment:
Addressing underlying issues, such as acute gastrointestinal issues, menorrhagia, or other conditions, is essential for replenishing iron reserves and improving sleep quality.
Insomnia Treatment:
Correcting iron deficiency and adopting healthy sleep hygiene habits can help insomnia. Additionally, a patient’s therapy options may include Cognitive Behavioral Therapy for Insomnia (CBT-I), relaxation techniques (e.g., progressive muscle relaxation), and meditation.
If you suspect you have iron deficiency or are having difficulties sleeping issues, such as insomnia, consult a doctor or expert Board-Certified Psychiatrist to diagnose the problem and improve your sleep now. For more information about insomnia treatment, call +18333124222.
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