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Higher serum iron concentrations are associated with increased odds of obstructive sleep apnea, while intermediate magnesium concentrations are associated with lower odds of OSA

In a cross-sectional study of 99 participants (54 with OSA, 45 controls), serum iron levels were significantly higher in OSA patients (P=0.04), and higher iron levels were associated with greater odds of OSA (P for trend=0.02). Participants in the fourth iron quartile had borderline higher odds of OSA (OR=3.00, 95% CI: 0.96-10.00, P=0.06), while those in the second and third magnesium quartiles had lower odds (Q2: OR=0.31, 95% CI: 0.09-0.96; Q3: OR=0.26, 95% CI: 0.07-0.82). The overall metal mixture was not significantly associated with OSA (β=-0.22, P=0.59).

Last updated: Aug 29, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association Between Serum Trace Elements and Obstructive Sleep Apnea: Multiple-Exposure Models.

observational

Khazaie H, Nakhaee S, Manoochehri Z, Davarinejad O, Rezaei A, Mansouri B, Elahi A, Kakaei S · Journal of preventive medicine and public health = Yebang Uihakhoe chi (2026)

Participants: 99
Duration: N/A
Intervention: None
Outcome: Obstructive sleep apnea (polysomnography-confirmed), serum iron and magnesium concentrations
Effect Size: OR=3.00 (95% CI: 0.96-10.00) for highest vs lowest iron quartile; OR=0.31 (95% CI: 0.09-0.96) for Mg Q2; OR=0.26 (95% CI: 0.07-0.82) for Mg Q3
Population: Adults recruited from a sleep disorders center in western Iran (54 with OSA, 45 controls)

Result: In a cross-sectional study of 99 participants (54 with OSA, 45 controls), serum iron levels were significantly higher in OSA patients (P=0.04), and higher iron levels were associated with greater odds of OSA (P for trend=0.02). Participants in the fourth iron quartile had borderline higher odds of OSA (OR=3.00, 95% CI: 0.96-10.00, P=0.06), while those in the second and third magnesium quartiles had lower odds (Q2: OR=0.31, 95% CI: 0.09-0.96; Q3: OR=0.26, 95% CI: 0.07-0.82). The overall metal mixture was not significantly associated with OSA (β=-0.22, P=0.59).

PubMed: 42661501DOI: 10.3961/jpmph.25.904

Mechanism Graph

Trace elements like iron and magnesium may influence oxidative stress and inflammation, which are implicated in OSA pathophysiology.
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Higher iron levels could promote oxidative damage or alter neurotransmitter regulation, potentially contributing to upper airway collapsibility.
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Intermediate magnesium levels may improve muscle relaxation or reduce sympathetic activity, lowering OSA risk.
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Result: Higher iron is associated with increased OSA odds, while intermediate magnesium is associated with reduced OSA odds.

Limitations

  • ⚠Cross-sectional design cannot establish causality.
  • ⚠Small sample size (n=99) and single-center recruitment may limit generalizability.
  • ⚠Potential residual confounding from unmeasured factors (e.g., diet, comorbidities).
  • ⚠The association for iron was borderline significant (P=0.06) and the overall metal mixture was not significant.

Frequently Asked Questions

What is the main finding of this study?▼

The study found that higher serum iron levels were associated with increased odds of obstructive sleep apnea, while intermediate magnesium levels were associated with lower odds.

How many participants were included?▼

The study included 99 participants: 54 with OSA and 45 controls without OSA.

What was the effect size for iron?▼

Participants in the highest iron quartile had an odds ratio of 3.00 (95% CI: 0.96-10.00) compared to the lowest quartile, but this was borderline significant (P=0.06).

Was the overall metal mixture associated with OSA?▼

No, the generalized weighted quantile sum regression showed no statistically significant association between the metal mixture and OSA (β=-0.22, P=0.59).

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References

  1. 1.Khazaie H, Nakhaee S, Manoochehri Z, Davarinejad O, Rezaei A, Mansouri B, Elahi A, Kakaei S. "Association Between Serum Trace Elements and Obstructive Sleep Apnea: Multiple-Exposure Models.." Journal of preventive medicine and public health = Yebang Uihakhoe chi, 2026. PMID: 42661501 DOI: 10.3961/jpmph.25.904
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.