Serum Magnesium Levels in Patients with Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis

Abstract

Aims: Obstructive sleep apnoea (OSA) affects patients’ quality of life and health. Magnesium (Mg) is an essential mineral and a potent antioxidant. Mg deficiency can worsen oxidative stress caused by sleep deprivation or disorders. The impact of OSA on serum Mg levels and its health consequences remain unclear. Data Synthesis: This study systematically reviewed clinical studies investigating the serum Mg levels of OSA patients and the potential relationships with other biomarkers. Six articles were included for qualitative synthesis and quantitative analysis. Two out of four studies that compared OSA patients to healthy controls found them to have significantly lower serum Mg levels. Our meta-analysis with three studies shows that patients with OSA had significantly lower serum Mg with an effect size of −1.22 (95% CI: −2.24, −0.21). However, the mean serum Mg level of OSA patients (n = 251) pooled from five studies (1.90 mg/dL, 95% CI: 1.77, 2.04) does not differ significantly from the normal range between 1.82 to 2.30 mg/dL. OSA severity appears to affect serum Mg negatively. Serum Mg levels generally improve after treatment, coinciding with the improvement of OSA severity. Low serum Mg levels correlate with the worsening of cardiovascular risk biomarkers of C-reactive protein, ischaemia-modified albumin, and carotid intima-media thickness. The serum Mg levels also potentially correlate with biomarkers for lipid profile, glucose metabolism, calcium, and heavy metals. Conclusions: Sleep deprivation appears to deplete Mg levels of OSA patients, making them at risk of Mg deficiency, which potentially increases systemic inflammation and the risk of cardiovascular and metabolic diseases.

Serum Calcium and Magnesium Levels, Not 25-Hydroxyvitamin D, Are Associated With Sleep Quality in Airline Pilots

“…The correlation between Mg 2+ status and sleep quality within our research sample of APs aligns with previous observational studies conducted on the general population, as reviewed recently by Arab and coworkers [ 25 ]. Notably, sleep deprivation appears to decrease Mg 2+ levels in patients suffering from OSA [ 26 ], a condition commonly observed among APs [ 10 ]. In addition, Mg 2+ levels tend to improve after treatment, mirroring the reduction in OSA severity [ 26 ].…”

“…Notably, sleep deprivation appears to decrease Mg 2+ levels in patients suffering from OSA [ 26 ], a condition commonly observed among APs [ 10 ]. In addition, Mg 2+ levels tend to improve after treatment, mirroring the reduction in OSA severity [ 26 ]. A randomized controlled trial involving 46 elderly individuals with insomnia found that magnesium supplementation improved sleep quality [ 27 ].…”

The Effects of Obstructive Sleep Apnea on the Cardiovascular System: A Comprehensive Review

“…Chronic OSA-related changes in ventilation and gas exchange may lead to electrolyte imbalances, promoting QTc prolongation and predisposition to the development of polymorphic ventricular tachycardia [ 42 , 77 ]. Specifically, hypokalemia and hypomagnesemia have been associated with chronic untreated OSA [ 42 , 78 ]. Significant cardiac chamber remodeling also occurs due to prolonged, untreated OSA.…”

Airways Type-2 Related Disorders: Multiorgan, Systemic or Syndemic Disease?

“…Finally, increased oxidative stress also implicates depletion in circulating electrolytes, which are often a cofactor of several antioxidant enzymes. In particular, according to a recent meta-analysis by Al Wadee et al, OSA patients showed significantly reduced serum magnesium levels, which correlated with worsening of cardiovascular risk biomarkers (e.g., C-reactive protein, ischemia-modified albumin, carotid intima-media thickness) [97]. Therefore, it is well established that the borders of this condition overcome the UA and that OSA, similarly to airways type-2 related disorders, should be addressed as a systemic syndrome.…”