Table 2. Summaries of magnesium studies reporting sleep-related outcomes.
RCT, randomized control trial; PSQI, Pittsburg Sleep Quality Index; PLMS, Periodic Limb Movements in Sleep; RLS, restless leg syndrome; DASS, Depression, Anxiety, Stress Scales; RDA, recommended daily allowance; DHEA, dehydroepiandrosterone; SWS, slow wave sleep
| Authors | Country | Study design | Participants | Inclusion/exclusion criteria | Intervention | Outcome measures | Relevant results | Positive/negative | ||||||
| N | Population | Inclusion | Exclusion | Magnesium form | Dose | Additional therapies | Duration | Description | ||||||
| Gholizadeh‐Moghaddam et al. (2022) [19] | Iran | Double‑blind RCT | 64; control group N=32, tx group N=32 | Females aged 18-45 | Females sex; age 18-45; PCOS dx per Rotterdam criteria | New or change in medication within two weeks; peri- or post-menopausal status; concurrent use of any other vitamin or mineral supplement; pregnancy | MgO | 250 mg | No | 10 weeks | 250 mg MgO taken for 10 weeks after breakfast | Sleep quality as assessed by the PSQI; serum concentration of magnesium, DHEAs, and testosterone; hirsutism as assessed by the Ferriman–Gallwey questionnaire | Sleep quality did not significantly improve after 10 weeks in either the treatment or the control group; no significance between group differences in regard to sleep quality | N |
| Saba et al. (2022) [20] | Iran | Single-blind controlled trial | 60; control group N=30, tx group N=30 | Hospitalized adults undergoing open heart surgery | Age <70 years old; candidate for elective CABG surgery | Hx of atrial fibrillation prior to CABG surgery; hx of liver or renal failure; hx of stroke or recent TIA; postoperative respiratory failure; liver or kidney failure; emergency surgery during the study period; chronic diarrhea; allergy to study drug; hx of sleep disorders; hx of anxiety or depression; parenteral MgSO4 tx | MgO | 500 mg | No | Five days | 500 mg MgO for five days (two pills of 250 mg MgO each) | Sleep quality as assessed by the PSQI | The mean PSQI score was significantly lower in the treatment group versus the control group at the end of the study period; within-group and between-group differences in PSQI score were significant (P=0.001 and P=0.021, respectively) | P |
| Nielsen et al. (2010) [21] | USA | Double‑blind RCT | 96; control group N=47, tx group N=49 | Adults aged >51 years with PSQI >5 | Age >51 years; PSQI >5; normal CBC, liver and kidney function tests | Use of supplements containing >100 mg of magnesium; BMI >40; COPD; use of O2 or CPAP; use of ACE-inhibitors; use of magnesium or potassium retaining drugs | Magnesium citrate | 320 mg | No | Eight weeks | 320 mg of magnesium citrate across five capsules - two taken with AM meal, one taken with noon meal, and two taken with PM meal | Sleep quality as assessed by the PSQI | PSQI declined significantly from 10.4 to 6.6 (P<0.0001); RBC magnesium increased significantly in both the treatment and placebo groups; hsCRP decreased significantly in the subset of pts with hsCRP>3.0 with magnesium treatment but not placebo | Mixed |
| Hornyak et al. (1998) [22] | Germany | Open pilot study | 10 | Patients with RLS or PLMS | Diagnosed RLS or PLMS | Severe RLS or PLMS; abnormal pre-study medical workup (ECG, EEG, CBC); elevated creatinine; use of sedatives or psychiatric medication within four weeks; uremia; chronic bronchitis; Fe deficiency; pregnancy | MgO | 291.6 mg | No | Four to six weeks (average 5.1 weeks) | 291.6 mg MgO QHS | Sleep quality as assessed by the PSQI; sleep EEG; subjective sleep quality measured by SF-A questionnaire; # of periodic limb movements during sleep | PLMS-associated w/ arousals decreased significantly from 17±7 versus 7±7 events per hour of total sleep time (P<0.05); sleep efficiency increased from 75±12% to 85±8% (P<0.01); PLMS w/o arousals trended lower from 33±16 to 21±23 (P=0.07) | P |
| Hornyak et al. (2004) [23] | Germany | Open pilot study | 11 | EtOH-dependent patients in subacute withdrawal | Primary EtOH dependence in subacute withdrawal (two weeks since last drink) | Cognitive impairment; major medical comorbidities (e.g., renal failure, heart failure); OSA, tx with anti-craving medications; magnesium supplementation within two weeks; prolonged EtOH withdrawal; depression; use of psychoactive medication within seven days | Magnesium L-aspartate | 729 mg | No | Four weeks | 243 mg of magnesium aspartate q AM, 486 mg of magnesium Aspartate QHS | Sleep quality measured by PSQI; sleep EEG; subjective sleep quality measured by SF-A; # of periodic limb movements during sleep | Sleep-onset latency decreased significantly from 40.6 to 21.7 minutes (P=0.03); PSQI subjective sleep quality score improved significantly from a mean of 8.1 to 5.8 (P=0.05); total sleep time and slow wave sleep time increased but did not achieve significance | P |
| Held et al. (2002) [24] | Germany | Double-blind, randomized, placebo-controlled crossover trial | 12; control group N=6, tx group N=6 | Healthy elderly subjects aged 61-81 | Healthy status, as measured by bloodwork, EEG, and ECG | Personal or family psychiatric hx; personal or family hx of neurocognitive disorder; hx of substance abuse; hx of transmeridian flight within three months; shift work; sleep‑related movement disorders or respiratory disorders | MgO | 243 mg for three days, 486 mg for three days, 729 mg for 14 days | No | 20 days | 20 days of active tx - 243 mg for three days (dosed in AM), 486 mg for three days (243 mg dosed in AM and noon), 729 mg for 14 days (243 mg dosed in AM, noon and PM) | Sleep EEG; serum ACTH, cortisol, AVP, renin, ATII, aldosterone, magnesium | Significant increase in SWS from 10.1 min to 16.5 min (P<0.05); increase in delta power and sigma power (P<0.05); renin and aldosterone increased and cortisol decreased significantly versus the control (P<0.05) | P |
| Macian et al. (2022) [25] | France | Double‑blind RCT | 76; control group N=38, tx group N=38 | Adults with fibromyalgia experiencing moderate to severe stress | Aged >18 years; dx of fibromyalgia (as per ACR 2016 criteria); >18 on the DASS stress subscale | Pregnancy; breastfeeding; women of childbearing age not using contraceptive; diabetes mellitus; kidney disease (CrCl <30); hypermagnesemia (plasma magnesium >1.05 mmol/L); antibiotic treatment; other magnesium-containing medications/supplements | MgCl | 100 mg | No | Four weeks | 100 mg daily of low-dose continuous-release MgCl taken for four weeks | Change in sleep quality as assessed by the PSQI; serum and RBC magnesium measurements | No significant change in sleep quality as measured by PSQI after four weeks; no significant change in serum and RBC magnesium after four weeks | N |
| Abbasi et al. (2012) [26] | Iran | Double‑blind RCT | 46; control group N=23, tx group N=23 | Adults aged 60-75; average age 65±4.6 years | Insomnia as dx by ISI; BMI 25-34.9; magnesium intake <75% of RDA; serum magnesium <0.95 mmL | Tx with loop diuretics, cyclosporine, digoxin, amphotericin, any hormonal therapy; renal disease; acute heart failure; sleep‑related movement disorders or respiratory disorders; any psychiatric disorder; recent stressful life event (e.g., divorce; death or acute illness of a family member); substance/alcohol abuse; transmeridian flight within six weeks | MgO | 500 mg | No | Eight weeks | 500 mg MgO for eight weeks | Sleep time, sleep efficiency, ISI score, sleep onset latency; serum cortisol, renin, and melatonin | Increased sleep time (P=0.002) and sleep efficiency (P=0.03); increased concentration of serum renin (P<0.001) and melatonin (P=0.007); decrease of ISI score (P=0.006), sleep-onset latency (P=0.02), and serum cortisol concentration (P=0.008); early morning awakening (P=0.08), serum magnesium concentration (P=0.06), and total sleep time (P=0.37) did not did not achieve significance | P |