Do you wake up in the middle of the night tossing and turning due to sleep problems? Do you struggle to fall asleep or stay asleep?
You’re not alone. 40% of Americans manage less than six hours of sleep a night on average (1, 2) while 12% have an official diagnosis of insomnia. (3)
While good sleep hygiene can help you prepare for a better night’s sleep, many people fail to connect diet and sleep. Yet what you are (or aren’t) eating could affect sleep quality.
How Diet Can Affect Sleep
National health surveys have shown correlations between serum nutritional biomarkers, sleep quality and intake of specific dietary nutrients, including vitamin B12, B6, vitamin C, vitamin D deficiency, vitamin E, and more.
Sleep issues have a significant biological component in that nutrients, hormones, and neurotransmitters control how well and how deeply you sleep. Your nutrient intake - or lack of - can cause excessive daytime sleepiness, for example, or may help or hinder sleep onset, insomnia severity, sleep time, the sleep wake cycle, and more.
Insufficient sleep and poor sleep status may be caused by these nutrients being out of whack - technical term!
While everyone struggles with sound sleep here and there, chronic sleep issues could signify that you’re lacking something essential for sleep health .
We’re familiar with vitamin B12 and its role in energy, mood, and cognitive function, but did you know it may also be linked to your ability to get shut-eye and circadian rhythm?
This article digs into the research and covers the basics of B12 and sleep. Read on to find out everything you need to know!
Or if you're in search of a product that'll help you enjoy a great night's rest, check out our guide to the best sleep supplements!
The Importance of Sleep Quality
Getting a good night’s sleep is about more than just the number of hours you spend in bed; it's about sleep quality.
How long it takes you to get to sleep, how often you wake, how easy you find it to drift off again, how long your actual sleep is, and how refreshed you feel in the morning... it all plays a role on your physical and mental health.
Sleep disorders such as insomnia, sleep apnea, and restless leg syndrome can disrupt your sleep patterns and leave you feeling tired and unrefreshed, no matter how long you sleep.
Chronic poor sleep adds up and leaves you with a sleep debt that you might never be able to pay back. It also increases your risk factors for obesity, cancer, diabetes, cardiovascular disease, high blood pressure, and dementia. Sleep deprivation can even age your brain by up to 5 years. (4)
There is some research to suggest that a deficiency in vitamin B12 may contribute to poor sleep quality and may even be a risk factor for developing sleep disorders.
While the relationship between vitamin B12 and sleep health is complex and still being explored, maintaining adequate levels of this essential nutrient is a key step toward overall health and potentially healthy sleep.
Let's examine that more...
The Basics Of Vitamin B12
The B vitamins are a group of nine water-soluble vitamins that play an essential role in several physiological processes, including energy production, cognitive performance, cell metabolism, mood, immunity, and more.
One of the nine B vitamins that doesn’t get much recognition is vitamin B12. Sometimes called cobalamin, B12 plays a significant role in neurological function and energy production.
Like the other B vitamins, vitamin B12 cannot be synthesized in the body and must be obtained through food sources or supplementation. While it’s mainly concentrated in animal foods, it can be found in some plant-based foods such as nutritional yeast, mushrooms, and algae.
Why the Body Needs B12
But why do you need B12? It’s involved in:
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Energy production
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Hematopoiesis (red blood cell formation)
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DNA synthesis
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Brain development
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Nervous system function
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Fatty acid synthesis
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Myelin formation (5)
The difference between vitamin B12 and the other B vitamins is its absorption pathway. While the other B vitamins are water-soluble and absorbed into the bloodstream from the gut, vitamin B12 must first bind to a protein called intrinsic factor (IF) produced in the stomach before it can be absorbed.
If levels of IF aren’t sufficient, B12 cannot be absorbed. However, if B12 is taken via supplements or added to fortified foods, it doesn't need this step. (6)
Sources of B12
You'll find B12 naturally present in many animal foods such as meat, poultry, fish, eggs and dairy products. Some foods, such as breakfast cereals, are also fortified with vitamin B12.
How Much B12 Do You Need?
The Recommended Daily Allowance of B12 for adults is 2.4mcg. Patients being treated for B12 deficiency may receive higher doses, but should be under a doctor's care. (7)
Note that there is no official Upper Level for B12 due to its low toxicity, and the fact that any excess is removed in urine.
Vitamin B12, Sleep Deficiency and Sleep Disorders
Because B12 levels tend to decline rather slowly, a true B12 deficiency isn’t the most common nutrient deficiency and can take years to develop.
Some of the key signs of low B12 to look out for include:
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Muscle weakness
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Numbness and tingling in the hands and feet
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Difficulty walking
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Nausea
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Weight loss
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Irritability
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Fatigue
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Rapid heart rate (8)
One of the other tell-tale symptoms of a B12 deficiency is constant fatigue or being tired all the time, which can also manifest as sleep disturbances, including insomnia in some people, often requiring sleep medications .
Although sleep disruptions can result from many other factors, if you’re feeling extra fatigued, it could be a sign you’re low in B12.
Who Might Suffer from a B12 Deficiency?
Certain groups of people may struggle to gain enough vitamin B12. They include:
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Vegans and vegetarians: Most B12 is found in animal products. Plant foods do not contain B12, unless fortified. So the dietary intake of vegans and vegetarians may be low in this vitamin.
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Older adults: Potentially up to 43% of older adults may be deficient in B12, depending on the definition used - that's due to not having enough IF to aid absorption. IF levels fall as we age. (9) Because of this, adults over 50 are encouraged to take vitamin B12 dietary supplements or seek out fortified foods. (10)
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Anyone who can't absorb vitamin B12 properly: People suffering from gastritis, Crohn's disease, celiac or any condition that reduces stomach acid may also struggle to absorb B12 effectively. Ditto, anyone suffering from pernicious anemia.
How Can Vitamin B12 Affect Sleep Patterns?
With all of that said, what’s the relationship between vitamin B12 and sleep? That's a tricky question - and it doesn't have a clear answer.
Despite recognising B12's importance on the central nervous system, research into its potential role in sleep disorders and its impact on subjective sleep quality has been sparse and often contradictory.
For example....
B12 and your Circadian Rhythm
The research surrounding vitamin B12 and sleep isn’t substantial, but there is some evidence to support it as a regulator of the sleep-wake cycle due to its role in modulating melatonin production and keeping the circadian rhythms in sync.
B12 works on the pineal gland, which produces the 'sleep hormone' melatonin. Sufficient levels of B12 help support melatonin production during the evening to regulate sleep patterns.
As such, some studies have suggested treatment of B12 may have a beneficial effect on the sleep-wake cycle and may help people suffering from delayed sleep phase syndrome. (Where the start of sleep is delayed, and sufferers then struggle to wake up in the morning).
However, such studies do acknowledge that conflicting results exist, with one study specifically suggesting that increased B12 intake may lead to a quicker falling off of melatonin and a shorter sleep duration. The opposite result! (11, 12, 13)
Meaning B12's influence on the circadian rhythm may not always be positive.
A quick caveat: Here's something I should point out about the clinical research on B12 and sleep: a great deal of it is based on, or refers to, a previous study or research studies that are 20 or nearly 30 years old now. Groundbreaking research at the time, to be sure, but not ones that have been fully replicated or proven in more modern research.
However, I mention them because nearly all modern studies do also, suggesting they are still of clinical relevance.
B12's Link to Sleep Disturbances, such as Insomnia
Can low levels of vitamin B12 cause sleep disorders such as insomnia? Possibly.
One 2023 systematic review discovered that there was a 2.4 times increased risk of insomnia symptoms with low vitamin B12 levels, with the association more significant in the non-obese, older adults and women.
Low levels of vitamin B12 were also correlated with excessive daytime sleepiness in obese participants. (14)
Other research compared participants with insomnia (60%) to healthy sleepers and noted that the dietary habits of those with insomnia involved considerably fewer nutrients than the control group. In particular, the difference between the two groups' intake of vitamin B12 was described as 'highly significant'. Likewise, their intake of Folic Acid (vitamin B9). (15)
While some studies suggest B12 could be beneficial in treating insomnia and sleep disorders, other studies remain largely inconclusive or link high-dose B12 to sleep impairment and short sleep duration - the opposite of what we want. (16) Again, significant differences, I'm sure you'll agree!
B12 and Depression
Here's a potentially indirect link between B12 and sleep - its influence on depression. High intakes of vitamin B12 have been linked to a lower risk of depression, which can be a major cause of sleep disorders like insomnia.
Circadian clock disruptions are also a major underlying factor in depression (17, 18).
The Impact of Vitamin B12 on Sleep Duration
When scientists perform sleep research, there are a lot of nocturnal sleep parameters to consider. Research can focus on specific sleep disorders or individual sleep problems, or on wider sleep concerns such as sleep onset (how fast you fall asleep), sleep quality, or total sleep duration.
Some surveys examine healthy adults while others focus primarily on people already diagnosed with sleep problems; others still compare the two.
Many experts would argue that the most research has been conducted on sleep duration -- the length of time you spend asleep while in bed.
The National Sleep Foundation recommends that adults should aim for between 7-9 hours for optimum sleep a night, possibly falling to 7-8 hours for the over-65s. (19)
As we already know, many Americans don't achieve that, according to surveys examining self reported sleep duration. So it's worth asking if their intake of B12 could be an influence.
Here's where it gets complicated: No-one can agree.
One study involving young Japanese women correlated low B12 levels with short sleep duration, as have other studies. (20) Older research taken from the National Health and Nutrition Examination Surveys (NHANES) also linked low B12 levels to shorter sleep duration than normal (up to six hours a night).
But conversely, the very same research also suggested that low levels of B12 contributed to longer sleep duration than normal and posited that it may be because of B12's ability to potentially tackle oxidative stress. (21)
Other studies still have established no clear link between B12 levels and sleep duration. Clear as mud!
The Relationship Between Vitamin B12 and Daytime Sleepiness
Excessive daytime sleepiness (EDS) can interfere with your daily life and is a leading cause of people attending sleep clinics. There are many causes of EDS, such as obstructive sleep apnea, sleep deprivation, depression, circadian rhythm disorders, and more.
Another cause - granted, identified as rare - is a B12 deficiency. In one such case, a 71-year-old man was diagnosed with severe B12 deficiency due to pernicious anemia. He was given B12 daily to be taken orally, and a follow-up was scheduled. At that 6-month follow-up, all signs and symptoms of EDS had been resolved. (22)
Can B12 Supplementation Help Improve Sleep Quality?
Identifying that a B12 deficiency may be linked to insomnia, to poor sleep duration, or to a sleep disturbance isn't the same as proving that B12 supplementation can prevent or cure it. Or that it can boost sleep quality.
In theory, not being deficient in the vitamin would be the logical answer to the problem, but is it as simple as taking a pill? Can a multivitamin, B12 or B-complex vitamin help to improve poor sleep quality? (Anyone classed as seriously deficient should see a doctor and may need B12 injections).
One recent study (2023) focused solely on people with proven B12 deficiency and demonstrated that supplementation (either by injection or tablet) helped to reduce the time to fall asleep, increased sleep duration, and reduced daytime sleepiness. (23)
Other studies, however, have shown that supplementation with low-dose cobalamin (B12) on normal subjects did not affect sleep onset time or total sleeping time. (24). It may be that B12 supplementation is only useful for people already deficient in the vitamin, but more research is needed.
That said, it does appear as though a combination of magnesium, melatonin and a vitamin B complex may offer potential for the treatment of sleep disorders and a healthy sleep. (25)
The Verdict: Does Vitamin B12 Help With Sleep?
There isn’t much conclusive evidence linking vitamin B12 to improved sleep patterns, and what there is is contradictory.
Some studies suggest that an increased intake of B12 may help to resynchronize sleep cycles and normalize sleep patterns, but other studies have come to no such conclusions.
There is a suggestion that B12 supplementation may be useful for those who are already significantly deficient in B12, but doesn't do much for those who are not. Likewise, a vitamin B-complex, which includes folate and other useful B-vitamins, may be more beneficial than B12 alone.
Either way, we would like to see a great deal more research into the role of B12 and sleep quality among both older and younger adults. Specifically, research into its influence on sleep onset latency, sleep duration, sleep symptoms, sleep regulation, primary insomnia and more.
Until then, we would recommend that you seek a different natural sleep aid: one that looks at all the available research and supports sleep accordingly.
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