Higher potassium intake at dinner linked to fewer sleep disturbances – study

3 months ago (nutraingredients-asia.com)

I wouldn't read too much into the title, the closing parts of the article give a much more balanced take on the whole issue. This study disagrees with some previous work and it's unclear which result makes sense and why. As usual, more research is needed, and while a catchy title is nice, this isn't anything to change your dietary habits by,

What isn't mentioned is that bananas and other potassium-rich foods are alkaline, and so can neutralize stomach acid reflux. Acid reflux is a common source of poor sleep quality. So that could be one explanation for the fewer sleep disturbances.

  • Reflux is solved by MORE acidity or promotion of stomach acid. Lower stomach acid PH means the LES doesn’t close properly. Seems counter intuitive but took me 8 years of symptoms to discover.

    • Not every case of reflux is caused by the same things. Some people's esophageal sphincter (such as mine does) just... decides to let go at random times. For me, that I can tell, the frequency of that happening isn't really affected +/- by the PH of my stomach acid, but the PH sure has an effect on the consequences.

      I am assuming the best thing I can do for it is lose weight, but that's easier said than done.

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    • I think this is true for a long term solution, but the standard treatment to alleviate symptoms of reflux is to consume antacids, so I think parent's point is still valid.

    • > Lower stomach acid PH means the LES doesn’t close properly

      I don't think that's correct. Lower stomach acid pH makes the LES close more tightly, with a max around pH==3.

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    • So hard to teach this to people, even those who've moved past basic understanding. I keep acid/digestive pills near the bedroom in case I have problems with a late meal

  • Bananas have a pH of around 4.5 for unripe bananas to 6 for ripe bananas, so are acidic.

    • Huh. I am admittedly neither a doctor nor chemist, but I was told this by a doctor, and anecdotally bananas seem to help me with reflux. Looking on the web, there does seem to be conflicting advice.

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  • Whenever I see discussions of GERD I like to bring up this paper (and the reedit discussion around it) where they basically tried a supplement with every likely helper and it worked 100% of the time: https://www.reddit.com/r/GERD/comments/adt6vh/regression_of_...

    | The aim of this study was to investigate if a dietary supplementation containing: melatonin, l-tryptophan, vitamin B6, folic acid, vitamin B12, methionine and betaine would help patients with GERD,

    | All patients of the group A (100%) reported a complete regression of symptoms after 40 days of treatment. On the other hand, 115 subjects (65.7%) of the omeprazole reported regression of symptoms in the same period

  • If reflux is the issue follow these tips:

    1) Don't drink while eating or exercising, drink 30min before or 2 hours later.

    2) Don't lay on your belly while sitting, use your back to support your upper body.

    3) Drink just as much water as your body asks, but not more.

    4) Right before going to bed, don't drink and try using the bathroom.

  • Acid reflux is due to too low stomach acid (too high pH). The lower esophageal sphincter closing as a response to acid (pH) is documented in the literature.

I know this isn't related to potassium directly, but anecdotally I have had success using magnesium supplements for insomnia/improving general sleep quality. I have also been consuming electrolyte mixes containing potassium to help with muscle recovery from training, and have found them to help with physical soreness & general well-being.

  • I also take magnesium for sleep. I swear by it.

    I also believe I have an underlying kidney disorder that was causing all sorts of subtle problems and after researching for years decided to try potassium supplements and it relieved the acute symptoms I was having (daytime sleepiness after meals) and also a whole slew of symptoms I didn’t realize I was having (poor workout performance and recovery, constant thirst from sodium/potassium imbalance, heart palpitations, especially at night when lying in bed, temperature regulation when trying to sleep, restless legs at night, and sleep quality).

    Sleep was the most surprising. I used to wake at around 3am and just couldn’t get back to sleep. I still wake up to pee, but I get right back to sleep.

    The single most surprising thing is the quality of my sleep. I now sleep like a rock. So unbelievably hard. And when I wake I feel so rested and more clear headed. I don’t need to sleep as many hours anymore and feel better than when i would sleep 9 hours.

    Recently several sleep studies started talking about how sleep is not a passive activity, but a ‘washing’ of CSF over your brain. I could get some details wrong since I am going off of memory, but I believe the amount of CSF movement and production basically triples when you sleep. I hypothesize that this is simply your bodies way of cleaning the waste products out of your brain. Do you know what precursors are to create CSF? Electrolytes like sodium, potassium, chloride, and bicarbonate. It is my hypothesis that I was ‘using up’ all the potassium available with the first couple of sleep cycles and once it was gone I was unable to effectively create more CSF, rendering my sleep ineffective.

    All I need to take is a couple of 99mg tablets right before bed (along with some magnesium chloride) and I sleep like I did when I was 10. I am 57. To say it has transformed my life would be an understatement.

    • I have every single one of your symptoms and arrived at almost the same conclusion: taking electrolytes tablets intended for workout recovery (just sodium, magnesium and potassium, no sugar) improves alleviates almost all of my symptoms and gives me energy I haven't had since I was 12. I haven't been able to get a doctor to take me seriously for ten years. I will try the potassium + magnesium tablets at night instead of a generic multivitamin. Thank you so much for your comment.

      Do you have any additional information about this relationship between CSF and electrolyte deficiency? Do you know anything about possible upstream causes of electrolyte deficiency? Any pointers would be super helpful.

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    • Damn, thanks for your insights. I recently discovered how much better I sleep when fasting. During my fasts I'm taking precise amounts of electrolytes (sodium, magnesium, potassium: https://en.wikipedia.org/wiki/Oral_rehydration_therapy). Being off my fasts I'm getting sloppy with my electrolytes intake and here we are: I'm getting the same symptoms you describe. Not severely, but noticeably.

      Now I need to find a proper supplement in Germany. Most electrolytes that also have the recommended amounts of glucose contain artificial sweetener which is a big no-go for daily usage for me.

    • Thanks for sharing- I find that these type of anecdotes often do work for other people, and are not information people can get from a doctor. I’m going to try what you suggest myself- I also tend to wake up at night and not fall back asleep, with no obvious explanation.

  • My wife convinced me to take a bath with magnesium once when I was stressed.

    Afterwards I got up, went to bed, and slept like an absolute rock.

    • That doesn’t tell you a lot. You would have to take a bath with and without magnesium, and without knowing whether it’s with or without magnesium, and then write down the effect for each bath.

      Currently, it could just be the effect of the bath itself or placebo.

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    • If you took a bath in hot water, that has its own effects on the body, as it will lower your blood pressure, it can also relax your muscles, so you need to try it out without the magnesium to see if it did anything.

  • What form of magnesium? It might mean something.

    - https://pmc.ncbi.nlm.nih.gov/articles/PMC4397399

    - https://en.wikipedia.org/wiki/Glycine

    - https://en.wikipedia.org/wiki/Magnesium_glycinate

    ---

    Mg also acts on GABAergic/genic systems directly, but its benefits as a general supplement on sleep are disputed.

    • Depends what you mean by 'general supplement' but a majority of people are deficient in magnesium (~400 mg/d is the recommendation) and its ubiquitous involvement in hundreds of enzyme systems might reasonably indicate that a positive role in normal sleep patterns could be expected as reported in a number of publications. If there is no benefit then other factors are likely to be to the fore.

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  • Magnesium supplements also help me sleep better.

    I experience muscle cramps. (Not restless leg syndrome. It's complicated.)

    For others, be aware that magnesium supplements come in many forms. I don't tolerate magnesium citrate, the most common over the counter option. Tummy issues. After trying a handful of options, I chose magnesium glycine; no adverse effects and reasonable price.

    This is not medical advice. YMMV. Consult your doctors.

Strangely the original study misstates the direction of the main finding, contradicting itself directly.

Is this a typo, or something more nefarious?

From the abstract:

    Multiple regression analyses revealed that individuals with higher AIS scores had higher daily potassium intake

From the body of the paper (supported by the results):

    Multiple regression analysis indicated that individuals with a higher potassium intake had lower AIS scores.

  • That is true. From section 2.6 of the full-text:

    > The sleep disturbances were assessed using the Athens Insomnia Scale [ 19], a self-administered psychometric questionnaire designed to evaluate sleep disorders, particularly insomnia [ 20 ]. It consists of eight items rated on a Likert scale ranging from 0 “no problem at all” to 3 “very severe” [ 20]. The total score ranges from 0 (absence of any sleep-related problems) to 24 (the most severe degree of insomnia). Severity is classified as normal for scores of 3 or less, subclinical insomnia for scores of greater than 3 but less than 6, and clinical insomnia for scores of 6 or more [19,21,22].

    • The contradiction is more clear when comparing the abstract:

      > [...] Results: Multiple regression analyses revealed that individuals with higher AIS scores had higher daily potassium intake; potassium at dinner was especially crucial. [...]

      and section 3.2:

      > 3.2. Association Between AIS Score and Dietary Patterns of Sodium and Potassium > Multiple regression analysis was conducted to investigate the association between AIS scores and dietary patterns of sodium and potassium intake (Table 3). Total daily potassium intake was inversely associated with log AIS score (β = −0.036; p = 0.034). When intake at each meal (breakfast, lunch, dinner, and snacks) was analyzed separately, only potassium intake at dinner remained significantly associated with AIS score (β = −0.066; p = 0.003), suggesting that higher potassium intake at dinner may be linked to fewer sleep disturbances. No significant associations were observed for the sodium-to-potassium ratio.

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PSA: before you start supplementing potassium (or gorging on bananans or potatoes), please be aware that too moch potassium can lead to heart rhythm disturbances, and that some common medications (like anti-hypertensives) can have further predispose you to developing hyperkalemia.

  • While true, this is overblown. RDA for potassium intake is 3500-5000mg daily for an adult male. Most people do not get close to this amount. Potassium supplements are 99mg per pill. You have to take a lot of pills to reach that level. Getting too much potassium by eating potassium-rich foods would be difficult without an underlying kidney disorder.

    Having said that, don’t be a dumb-a* and take too much of a good thing.

    • It depends on how you take it. If you chug almost liter of coconut water (like I did) you can get palpitations (like I did). That has >500mg potassium in a form more bioavailable than say a banana or butternut squash.

      Also the RDA is not something you should have all at once. That’s a sure way to disrupt your heart.

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  • Hyperkalemia is most commonly encountered in patients with decreased kidney function.

Learnt from my grandmother to eat plenty bananas before bedtime. It helped with my asthma and swear too that it did wonders for my sleep.

Usually had it with a hot curry at dinner time or dessert (sliced bananas, cubed apples and evaparoted milk.)

The real shocking information I gained from this paper is that the AIS goes from 0-24 (0 = perfect sleep, 24 = total insomnia) and the study participants had an amazing average AIS score of 4.3 (SD 3.3)! Wow, how well all those people must sleep!

As someone scoring 12, it's pretty bad and I am suffering a lot while trying to sleep and during day time because I did not sleep well.

If my understanding of statistics, standard deviations and the standardized partial regression coefficient are correct, potassium supplementation in the evening only DECREASES this score by about 0.2178 (Beta −0.066, multiplied with SD of 3.3), which is kinda worthless.

Please correct me if I am wrong.

  • It decreases the score. It doesn't increase the score. An increase would be harmful. The beta is negative. The abstract is wrong.

    It is not worthless. For good sleep, potassium levels have to be adequate. Once one improves the level, one can move on to other factors.

    As for what works for me, avoiding caffeine after 12 pm helps, as does sunlight exposure in the daytime.

    With regard to a supplement stack, these help: collagen hydrolysate 12g, magnesium citrate, calcium, B6 as P5P, melatonin 4 mg, L-theanine 100-200 mg, and various sleep promoting herbs.

    Ensure your BP is optimal, well below 120/80 for most people under 70.

    Uncorrected acid reflux too worsens sleep, but avoiding consumption in the last three hours and also famotidine help.

IIUC, Na is used like signaling medium in body and alkaline metals that isn't Na tends to reduce blood pressure, slow heartbeat and neural activity. With that in mind, it sounds reasonable that those tendency could lead to slightly deeper sleep. Or is there something else to it?

My main problem is waking up too early. Any silver bullet for that?

There are plenty of studies exploring this that don't come from weird websites.

A recent one:

- https://jcsm.aasm.org/doi/10.5664/jcsm.10168

Many, many more

  • What exactly is it that makes the website you linked not weird, and the original website weird?

    • The original website is a news report of an article. The one he posted is from a peer-reviewed journal which has a much higher standard of reporting. The information there is reported by scientists with expertise in the field. You cannot expect the same level of rigour from journalists that try to sensationalise findings to get more clicks.

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A self reported insomnia study has very poor accuracy. There is no reason in this day and age they are not using a sleep tracker to measure sleep onset.

Also, there is a correlation between potassium and magnesium levels, and they measured potassium intake, but no mention of magnesium. It is possible that the subjects with highest potassium intake also had higher magnesium levels.

I'm not saying the study is wrong, but it does make a good point to the people taking magnesium to help sleep, they should also be taking potassium. I'll be trying that over the next little bit.

Are there any studies on these studies? There are so many of them--and they're issued multiple times of day on television "news"--that there has to be one.

  • I systematically flag “diet” studies here. (And most medicine related, specially if not the study itself, but a random article with yellow title)

    Some dietary studies are little better, some worse, but even the best, are very weak.

    It’s known (from other studies, yes the irony) that people have no idea what they eat. Forget, don’t pay attention… so is difficult to draw conclusions. Also diet habits correlate to so many other habits, that is difficult to know what helps and what doesn’t.

    Often is posted just a journalist view of it, not even the study (like this case) that is another red flag. Means that the article title is probably not so interesting.

    Last but not least, being a forum of mainly CS nerds, you have to really weed through the comments. When speaking about law many start with “not a lawyer but” but seldom I see “not a doctor, but”. I’ve just seen too often people very opinionated about medicine topics of which they have no idea. Luckily is relatively easy to detect, but can be very misleading. The less the people know about something, the more sure they are they know it all. I need to state the obvious: never ever take medical advice at face value from HN.

I have a bottle of potassium based salt substitute that I use to supplement K. Can anyone here clarify the pros/cons of this? It's quite wretched by itself, but if used very sparingly is not bad with many foods.

As I'm sure all know, K in supplemental form is FDA regulated and one would need to take up to 1/2 a bottle to reach the RDA, whereas in salt sub form a single, unpleasant serving can get close to the RDA. I think it's in chloride form...

Edit: fsckin android keypad

choices = [

  1/4 tsp of potassium bicarbonate powder in 8 oz of water,

  200 mg L-theanine,

  30 minutes of a podcast,

]

while choices and not sleep:

  choice = choices.pop(0)

  take_choice(choice)

  wait(25 * 60)

  • Could you elaborate this?

    • You will remove the last listed “choice” from the list and “take” it (presumably one “takes” a podcast by watching it). After taking each choice, you will wait for 25 minutes, during which time you are expected to fall asleep. If you do not fall asleep in those 25 minutes you will repeat this process with the now-current last item in the list. If the list is exhausted and you are still awake, you and the program terminate.

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I haven't heard of potassium before.