Sleep disturbance is a core feature of fibromyalgia, often presenting as nonrestorative sleep in which patients wake feeling unrefreshed despite adequate hours in bed. This poor quality sleep lowers pain thresholds, amplifies central sensitization, and exacerbates the widespread musculoskeletal pain that defines the disorder. A new study published in Medicine (Baltimore) now sheds light on a possible biochemical link with low magnesium levels. Researchers found that fibromyalgia patients with poorer sleep quality also tended to have lower serum magnesium, along with more severe pain and greater functional impairment.
The cross-sectional study evaluated 82 fibromyalgia patients, grouping them based on their Pittsburgh Sleep Quality Index (PSQI) scores. Those with PSQI scores above 5, indicating poor sleep, had significantly more tender points, higher visual analog scale (VAS) pain scores, and worse scores on the Fibromyalgia Impact Questionnaire (FIQ) than their better sleeping counterparts. Their serum magnesium levels were also lower. Statistical analysis revealed a consistent pattern, lower magnesium correlated with more tender points, greater pain severity, worse functional status, and poorer sleep quality.
Magnesium plays a key role in preventing central sensitization by blocking N methyl D aspartate (NMDA) receptors in a voltage dependent manner. Magnesium deficiency has been strongly linked to muscle pain, fatigue, sleep disturbances, and anxiety, which are symptoms frequently observed in fibromyalgia. Some evidence suggests that reduced magnesium levels, through their impact on muscle ATP production, may contribute to the pathogenesis of fibromyalgia. Other studies have reported an association between magnesium deficiency, elevated levels of substance P, a neurotransmitter involved in pain perception, and increased pain intensity in fibromyalgia, suggesting a potential link between magnesium status and the condition.
A randomized double-blind placebo-controlled trial by Macian et al. tested oral magnesium 100 mg daily for one month in fibromyalgia patients. While overall stress scores on the DASS 42 scale did not differ significantly from placebo, patients with mild to moderate stress showed greater reductions in stress (P = 0.003) and pain severity (P = 0.029) with magnesium. Other outcomes showed no significant changes, indicating that short term magnesium supplementation may benefit stress and pain in select fibromyalgia patients.
The findings indicated that lower serum magnesium levels were associated with poorer sleep quality, increased pain severity, and greater functional impairment in FMS patients. The study suggested a potential link between magnesium levels and the pathophysiology of sleep disturbances in fibromyalgia syndrome. However, the cross-sectional design and lack of control for certain confounding variables precluded causal interpretations. The study emphasized that longitudinal and interventional studies would be necessary to clarify these relationships and evaluate the potential clinical utility of magnesium supplementation in fibromyalgia management.
References
- Alisik T, Reis Altan YC, Olkay SG, Sahingoz Bakirci E. Serum magnesium levels and their association with sleep quality and disease severity in fibromyalgia syndrome: An observational cross-sectional study. Medicine (Baltimore). 2025 Jul 18;104(29):e43446.
- Boulis M, Boulis M, Clauw D. Magnesium and Fibromyalgia: A Literature Review. J Prim Care Community Health. 2021 Jan-Dec;12:21501327211038433.
- Macian N, Dualé C, Voute M, Leray V, Courrent M, Bodé P, Giron F, Sonneville S, Bernard L, Joanny F, Menard K, Ducheix G, Pereira B, Pickering G. Short-Term Magnesium Therapy Alleviates Moderate Stress in Patients with Fibromyalgia: A Randomized Double-Blind Clinical Trial. Nutrients. 2022 May 17;14(10):2088.