Might problems with sleep be as simple as correcting mineral deficiencies? If you search sleep and magnesium on the Internet, you find a lot of claims about magnesium as a quick cure for all kinds of sleep-related problems: restless legs, insomnia, sleepwalking, sleep deprivation, nocturnal presentations of gastroesophageal reflux disease.
Here is a breakdown of magnesium as it relates to sleep health. As always, please don't self-diagnose your health problems; see a physician if you think you might have a magnesium deficiency. A simple blood test and review of symptoms and history can help you and your doctor to put together the right treatment for you.
What magnesium is
This is a mineral found in the body which is also amply available in our food supply. Magnesium helps to regulate body chemistry, especially as it relates to muscle and nerve function, blood pressure, blood glucose balance and the building of proteins. The human body carries about 25 grams of magnesium at any given time, half of it in the bones with the remainder stored in soft tissue. Less than 1 percent can be found in the bloodstream itself. The kidneys process most of the body's magnesium and oversupply is typically excreted through the urine. It is difficult to objectively measure magnesium accurately despite the many tests available to do so (urine, saliva, blood and tolerance assessments).
Most healthy people are not magnesium deficient and can obtain a balance of this mineral through a healthy diet which includes whole foods. Though it is commonly said that most middle-aged women are magnesium deficient, this isn't always safe to assume. Please consult a doctor if you feel you are deficient in magnesium.
When the body becomes deficient in magnesium, it is typically due to the presence of certain health conditions, medication use or chronic alcoholism. Health conditions that can lead to magnesium deficiency include gastrointestinal disorders, kidney disease, heart disease and type II diabetes. Early signs of magnesium deficiency (related to sleep health) include fatigue, mood disorders, nocturnal leg cramping, seizures and abnormal heart rhythms. Chronic low intakes of magnesium can also lead to certain health conditions: hypertension and cardiovascular disease, type II diabetes, osteoporosis and migraine. Also note that low magnesium levels can lead to an increase in stress hormones which encourage the body to excrete magnesium, so people suffering from emotional anxiety may be at risk for magnesium deficiency. Chronic sleep deprivation, too, can result in excess excretion of magnesium through the urine.
It's worth noting that an imbalance of calcium in the body can lead to an imbalance of magnesium as these two minerals are meant to work together harmoniously.
How magnesium helps with sleep
To understand how magnesium helps with sleep, you first need to know what GABA is.
GABA (gamma-amino butyric acid) is an amino acid we all have which effectively tranquilizes the brain so that we can fall asleep. Magnesium works in concert with our GABA receptors to ensure that GABA delivers the calm we need in order to sleep. According to research reported in
Magnesium and the Central Nervous System (Adelaide Press, 2011; eds. Robert Vink and Mihai Nechifor), "the activation of GABA receptors is very important for the initiation and maintenance of non-rapid eye movement (NREM) sleep... Magnesium has a favorable effect with respect to sleep onset and maintenance and also tiredness, which appears as a consequence of sleep deprivation."
Sleep deprivation comes to us in a multitude of ways. We either choose not to sleep, or we suffer from other health issues that lead to sleep deprivation. Several sleep conditions contribute to sleep deprivation, including various forms of insomnia; Delayed Sleep Phase Disorder (DSPD) and other circadian rhythm disorders; movement disorders of sleep such as Periodic Leg Movement Disorder (PLMD) and/or Restless Legs Syndrome (RLS); Obstructive Sleep Apnea (OSA); and Upper Airway Resistance Syndrome (UARS). Nighttime bouts with Gastroesophageal Reflux Disease (GERD) can also fragment sleep and leave a person fatigued and sleep deprived during the day.
The most common connection average people make between magnesium and sleep seems to be in the way it helps with relaxation. Muscle cramping at night is often treated with magnesium supplements, as nerves and muscle tissues are calmed by maintaining adequate amounts of magnesium. Insomniacs also often turn to magnesium to help them to fall asleep. Some studies correlate with the notion that subjective measures of insomnia improve with the use of magnesium supplements.
However, other sleep disorders have been shown to have a magnesium connection, including parasomnias such as night terrors, sleep talking, sleep walking and bruxism occurring during slow wave sleep, but not during REM sleep, which may demonstrate potential evidence of brain damage caused by magnesium deficiency.
While there is limited research on the relationship between magnesium levels and sleep apnea, studies done retrospectively on newborn babies with apnea have shown measurable improvement for those infants given magnesium supplements, while their untreated peers experienced more GERD, bradycardia (rapid heartbeat) and apnea.
Research
- "Blood and brain magnesium in inbred mice and their correlation with sleep quality." Chollet D, Franken P, Raffin Y, Malafosse A, Widmer J, Tafti M. American Journal of Physiology - Regulatory, Integrative and Comparative Physiology. 2000 Dec;279(6):R2173-8.
- "The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial." Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. Journal of Research in Medical Sciences. 2012 Dec;17(12):1161-9.
- "Efficacy of oral magnesium administration on decreased exercise tolerance in a state of chronic sleep deprivation." Tanabe K, Yamamoto A, Suzuki N, Osada N, Yokoyama Y, Samejima H, Seki A, Oya M, Murabayashi T, Nakayama M, Yamamoto M, Omiya K, Itoh H, Murayama M. Japanese Circulation Journal. 1998 May;62(5):341-6.
- "Magnesium therapy for periodic leg movements-related insomnia and restless legs syndrome: an open pilot study." Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D. Sleep. 1998, 21(5):501-505.
- "Parasomnias (non-epileptic nocturnal episodic manifestations) in patients with magnesium deficiency." Popoviciu L, Delast-Popoviciu D, Delast-Popoviciu R, Bagathai I, Bicher G, Buksa C, Covaciu S, Szalay E. Romanian Journal of Neurology and Psychiatry. 1990 Jan-Mar;28(1):19-24. (abstract only)
- "Relief of Night-time Symptoms Associated With Gastroesophageal Reflux Disease Following 4 Weeks of Treatment With Pantoprazole Magnesium: The Mexican Gastroesophageal Reflux Disease Working Group." López-Alvarenga JC, Orr W, Vargas-Romero JA, Remes-Troche JM, Morales-Arámbula M, Soto-Pérez JC, Mateos-Pérez G, Sobrino-Cossío S, Teramoto-Matsubara O, López-Colombo A, Orozco-Gamiz A, Saez-Ríos A, Arellano-Plancarte A, Chiu-Ugalde J, Tholen A, Horbach S, Lundberg L, Fass R. Journal of Neurogastroenterology and Motility. 2014 Jan;20(1):64-73. doi: 10.5056/jnm.2014.20.1.64. Epub 2013 Dec 30.
- "A Retrospective Evaluation of Magnesium Supplementation in Apneic Infants." Caddell JL. Pediatric Research (1984) 18, 314A–314A; doi:10.1203/00006450-198404001-01326 (abstract only)
Dosage
The recommended supplement of elemental magnesium for adults, based on RDAs (recommended daily amounts) established by the Food and Nutrition Board, is between 400-420 mg daily for men and 310-320 mg daily for women.
Don't overlook the value of eating a magnesium rich diet, however. Dark leafy greens, quinoa, low-fat yogurt, shredded wheat, figs, soybeans, nuts and seeds, beans and lentils, brown rice, whole wheat bread, avocado, oatmeal, banana, dark chocolate, fish, raisin bran and beets are all good sources of magnesium.
Types
The easiest forms for the body to metabolize come from our daily diet (see above), but there are a variety of supplementary forms as well. Most recommended are the chelated forms (such as citrate, ascorbate, orotate or glycinate form, or a combination of these). Even then, some people are sensitive to the citrate form.
Note that magnesium oxide salts are not a good delivery of elemental magnesium and should be avoided.
If taking magnesium orally is not a tolerable option for you, you might consider a magnesium spray as the mineral can also be absorbed safely through the skin. Magnesium sprays are generally recognized as safe (GRAS) and often used by people to treat arthritis or muscle pain.
Side effects
Magnesium that is consumed from food sources does not pose a risk for side effects; however, higher concentrations of magnesium in oral supplements can lead to diarrhea, nausea and abdominal cramping. Dr. Andrew Weil suggests that very high doses may also lead to heart problems.
Risk of addiction
The healthy human body has effective processes for eliminating excess magnesium from the body and there are no known addictive or habituating risks to supplementing with this mineral.
Risk of overdose
Very high doses (more than 5,000 mg/day magnesium as may be ingested via laxatives and antacids) can lead to magnesium toxicity, so it is very important to follow label directions for these medications so as not to overdose. People who have impaired renal function or kidney failure are at greatest risk because their kidneys can no longer remove excess magnesium efficiently.
Drug interactions
Certain drugs can be rendered less effective if taken with magnesium supplements, such as drugs used for osteoporosis, diuretics, antibiotics, and certain proton pump inhibitor (PPI) drugs like Nexium and Prevacid.
Sources consulted
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SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.
