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补充镁对老年人原发性失眠的影响:一项双盲安慰剂对照临床试验。

The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial.

作者信息

Abbasi Behnood, Kimiagar Masud, Sadeghniiat Khosro, Shirazi Minoo M, Hedayati Mehdi, Rashidkhani Bahram

机构信息

Faculty of Nutrition and Food Technology, Tehran, Iran.

出版信息

J Res Med Sci. 2012 Dec;17(12):1161-9.

Abstract

BACKGROUND

Nearly 50% of older adults have insomnia, with difficulty in getting to sleep, early awakening, or feeling unrefreshed on waking. With aging, several changes occur that can place one at risk for insomnia, including age-related changes in various circadian rhythms, environmental and lifestyle changes, and decreased nutrients intake, absorption, retention, and utilization. The natural N-methyl-D-aspartic acid (NMDA) antagonist and GABA agonist, Mg(2+), seems to play a key role in the regulation of sleep. The objective of this study was to determine the efficacy of magnesium supplementation to improve insomnia in elderly.

MATERIALS AND METHODS

A double-blind randomized clinical trial was conducted in 46 elderly subjects, randomly allocated into the magnesium or the placebo group and received 500 mg magnesium or placebo daily for 8 weeks. Questionnaires of insomnia severity index (ISI), physical activity, and sleep log were completed at baseline and after the intervention period. Anthropometric confounding factors, daily intake of magnesium, calcium, potassium, caffeine, calories form carbohydrates, and total calorie intake, were obtained using 24-h recall for 3 days. Blood samples were taken at baseline and after the intervention period for analysis of serum magnesium, renin, melatonin, and cortisol. Statistical analyses were performed using SPSS19 and P values < 0.05 were considered as statistically significant.

RESULTS

No significant differences were observed in assessed variables between the two groups at the baseline. As compared to the placebo group, in the experimental group, dietary magnesium supplementation brought about statistically significant increases in sleep time (P = 0.002), sleep efficiency (P = 0.03), concentration of serum renin (P < 0.001), and melatonin (P = 0.007), and also resulted in significant decrease of ISI score (P = 0.006), sleep onset latency (P = 0.02) and serum cortisol concentration (P = 0.008). Supplementation also resulted in marginally between-group significant reduction in early morning awakening (P = 0.08) and serum magnesium concentration (P = 0.06). Although total sleep time (P = 0.37) did not show any significant between-group differences.

CONCLUSION

Supplementation of magnesium appears to improve subjective measures of insomnia such as ISI score, sleep efficiency, sleep time and sleep onset latency, early morning awakening, and likewise, insomnia objective measures such as concentration of serum renin, melatonin, and serum cortisol, in elderly people.

摘要

背景

近50%的老年人患有失眠症,存在入睡困难、早醒或醒来后感觉未恢复精力的问题。随着年龄增长,会出现多种变化,使人面临失眠风险,包括各种昼夜节律的年龄相关变化、环境和生活方式改变以及营养物质摄入、吸收、保留和利用的减少。天然的N-甲基-D-天冬氨酸(NMDA)拮抗剂和γ-氨基丁酸(GABA)激动剂镁离子(Mg²⁺)似乎在睡眠调节中起关键作用。本研究的目的是确定补充镁对改善老年人失眠的疗效。

材料与方法

对46名老年受试者进行了一项双盲随机临床试验,将他们随机分为镁组或安慰剂组,每天分别服用500毫克镁或安慰剂,持续8周。在基线期和干预期结束后完成失眠严重程度指数(ISI)问卷、身体活动问卷和睡眠日志。通过连续3天的24小时回顾法获取人体测量混杂因素、镁、钙、钾、咖啡因的每日摄入量、碳水化合物的卡路里摄入量和总卡路里摄入量。在基线期和干预期结束后采集血样,分析血清镁、肾素、褪黑素和皮质醇。使用SPSS19进行统计分析,P值<0.05被认为具有统计学意义。

结果

两组在基线期评估的变量中未观察到显著差异。与安慰剂组相比,在实验组中,膳食补充镁使睡眠时间(P = 0.002)、睡眠效率(P = 0.03)、血清肾素浓度(P < 0.001)和褪黑素浓度(P = 0.007)有统计学意义的增加,还导致ISI评分(P = 0.006)、入睡潜伏期(P = 0.02)和血清皮质醇浓度(P = 0.008)显著降低。补充镁还使清晨觉醒(P = 0.08)和血清镁浓度(P = 0.06)在组间有轻微的显著降低。尽管总睡眠时间(P = 0.37)在组间未显示出任何显著差异。

结论

补充镁似乎能改善老年人失眠的主观指标,如ISI评分、睡眠效率、睡眠时间和入睡潜伏期、清晨觉醒,同样也能改善失眠的客观指标,如血清肾素、褪黑素和血清皮质醇浓度。

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Sleep disorders in the elderly.老年人睡眠障碍。
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