#102 - Magnesium For Sleep: Fact or Fiction?
Think about your job right now …
Even think about your job interview (if you did one). Even the qualification you earned (if you needed to). Would you want a celebrity to do your job for you?
Sleep is the ‘canary in the mine’ when is comes to the destruction of science-backed info.
I saw this over the past decade with the rise of the Sleep Coach.
With Wellbeing Coaches - and now (frickin!) Mindset Coaches - many other fields will experience unqualified misinformers trying to do their job.
With my clinical psychologist registration date looming, I am still wondering whether I should save 500 bucks, give myself a made-up title like ‘Scientific Sleep Coach’, and put that 500 bucks towards a trolley full of Magnesium so that I can sleep better at night.
After all, if celebrities tell us that Magnesium is the way to go - and Australia’s Number 1 Sleep Expert also recommends Magnesium - surely it’s a goer, right?
100 Sleep Tips
Complementary medicines were definitely going to feature in our recent blog describing the evidence behind 100 Sleep Tips (you can access all 100 still by becoming a Member).
But I had to find a meta-analysis on the topic. Meta-analyses are one of the best forms of evidence.
A meta-analysis combines the data from multiple studies on a single topic - which can turn data analyses from 100s of people to 1000s of people. This provides a more precise picture of what we’re trying to understand.
Even now, there are many meta-analyses on the diagnosis and treatment of COVID-19.
I found a meta-analysis for the effects of complementary medicines for sleep - and within that paper, the researchers analysed the specific effects of magnesium.
… You know what - I’m just going to write MG instead of magnesium from now on … it’s easier …
The researchers highlighted some of the trials evaluating MG, suggesting the findings were promising.
But I decided to dig deeper, and critically evaluate these studies on magnesium for my own learning. One of these studies was quite interesting for me.
So I’ve decided to take you on a journey - showing how one can evaluate a scientific study …
MG For Sleep - The Title
In the 100 Sleep Tips blog, Number 76 was about MG - and it cited a study by Abbasi et al. (2012).
The 1st part of a study that can be critically evaluated is the title of the study - and the title of this study showed a few things that were good.
In this study, the researchers evaluated the effects of MG against a placebo - which is great, because placebos by definition have the potential to provide a very small benefit. So if the sleep product you are evaluating only provides only a small benefit, then it may not be enough to warrant it being effective.
The other thing I liked about this study is that it selected a population who really needs assistance with their sleep. That is, not only were these people with insomnia, but they were also older people with insomnia.
Such people may be the most responsive to insomnia treatments, because their insomnia is so bad that there is a lot of room for improvement. So if you don’t see improvement in them - you’re unlikely to see improvement in other people (eg, younger people with insomnia).
MG For Sleep - The Abstract
The 2nd part of a study that can provide some insights is the abstract - which is a summary of what the study did and found.
The summary of the Results (what they found) was very promising (highlighted in green)…
The abstract suggests many aspects of sleep were improved in response to MG. This is indicated by the term ‘statistically significant’. It means if the P-value (eg, P=0.002 for ‘sleep time’) is below 0.05, then there is a difference in the sleep of those who had MG vs those who had the placebo pill.
The simplest explanation of a finding being less than 0.05 is that if we ran the experiment 100 times, there’s a 95% chance that the same finding will occur.
In this case, because all of the green underlined findings for sleep had a P-value that was less than 0.05 - then MG was different to placebo.
But. even if there is a difference, you need to see if the difference is in the direction you would expect.
And in this case it does - with “increases in sleep time”, “sleep efficiency” (ie, percent of time spent asleep in bed), “significant decrease of ISI score” (which means less insomnia symptoms), and decrease of “sleep onset latency” (ie, took less time to fall asleep) - all because of MG.
MG For Sleep - The Effects
Many people may stop at the summary - and that makes sense because you need to be trained at how to analyse a full study. And there’s a small percentage of people in the world who can do this.
Most of these trained human beings are called ‘Scientists’.
Unfortunately I need to say this - because strangely - way too many people on social media think they are scientists.
So let’s take an extra step in the critical analysis of a study.
Even though a study reports a statistically significant finding - in this case whether MG and placebo differ - we need to see how much they differ.
I love the following description by Beatrice Grabowski (2016) …
Beatrice is saying that even if there is a statistically significant finding, this is not black and white. With respect to MG, it means we should not yet make a conclusion that is works for sleep from the abstract. As she rightly highlights - we need to find out if the effect is biologically or clinically important.
Sleep has a significant biological component - and treating sleep problems is a significant clinical issue.
So let’s have a gander at the effects found for sleep, by looking at the Results section of this clinical trial by Abbasi and colleagues (2012).
We can do this by finding a Table in the Results section that reports the sleep of both groups - before and after taking their pill …
On the left-hand side of the Table there are a list of variables - are there are two variables that may be easily interpreted.
One is ‘total sleep time’. This is a common variable used in sleep research to indicate the total amount of sleep.
For the Placebo group, they got 7.6 hours of sleep before the placebo - and after taking the placebo they achieved (* drum roll *) - 7.6 hours of sleep. So this means don’t go to your local pharmacy and buy a bunch of placebos off the shelf. It’s a waste of time.
For the MG group, they got 7.8 hours of sleep beforehand - and after taking MG they achieved 7.9 hours of sleep. That’s 0.1 hours of extra sleep - which is 6 minutes of extra sleep at night.
But hey, maybe people want MG to help them fall asleep quicker? OK, so let’s have a look at the other variable in Table 2 labelled ‘sleep onset latency’.
The Placebo group had no change in their time take to fall asleep - but - the MG group fell asleep 0.2 hours faster - and yes, the decimal point is in the right place. They fell asleep 12 minutes faster.
This, after taking 500mg of MG for 8 weeks.
Conclusions?
Over the past week I chaired a selection committee for entry into postgraduate clinical psychology degrees in 2022. We’ve assessed nearly 200 applications and performed around 40 interviews for 20 very competitive positions.
Our strong belief is that clinical psychologists should be ‘scientist-practitioners’. Professionals who seek the most up-to-date scientific evidence to help their people they treat. Professionals who can unpack scientific studies. Professionals who can use the right information to provides the best relief to those who are suffering.
If you work to educate people about sleep - to help people sleep better - it’s important to ensure you are giving the right advice. That you source information - not from celebrities or Australia’s #1 Sleep Expert. Go to primary sources. The actual studies themselves.
This blog isn’t just about whether MG can improve your sleep. It’s also about how to critically evaluate scientific studies.
I hope these simple steps help you to critically evaluate studies - rather than take the abstract at face value.
Whilst there is still more to learn - Grasshopper - as a group, we can break through the noise of misinformation on social media, and improve the lives of those who are willing to listen to us.
Or do you wish to hold onto that MG for another reason?
Prof MG (aka, the MG that studies show improves the sleep of humans - big and small)
