Fecal Microbiota Transplantation Shows Promise for Chronic Insomnia

Key takeaways:

• A multicenter, randomized clinical trial found that a fecal microbiota transplantation-based treatment protocol improved objective sleep continuity in adults with chronic insomnia.
• Participants receiving the active treatment experienced a 13.9 percentage point improvement in sleep efficiency compared to the placebo group at one month.
• Subjective sleep outcomes showed sustained improvement from two to six months following the intervention.

In a randomized clinical trial published in the Journal of Internal Medicine, researchers found that ingesting capsules containing fecal microbes from healthy donors helped treat symptoms of chronic insomnia. The study investigated whether targeting the gut microbiome could ultimately offer a new therapeutic pathway.

The multicenter, double-blind, placebo-controlled trial randomly assigned participants to receive either a short-course antibiotic pretreatment followed by donor microbiota capsules or placebo capsules without antibiotic pretreatment. Each group consisted of 40 adults.

One month after treatment, overnight polysomnography results showed that participants receiving the fecal microbiota capsules had significantly higher sleep efficiency and reduced wake after sleep onset. Specifically, the treatment protocol improved sleep efficiency with an adjusted between-group difference of 13.9 percentage points compared to the placebo.

Patient questionnaires, including the Insomnia Severity Index and Pittsburgh Sleep Quality Index, indicated that sleep quality scores sustained improvement from two to six months in the intervention group. The treatment was well tolerated, with only mild, self-limited adverse events reported and no serious adverse events.

“Our findings provide clinical evidence that targeting the gut microbiota may offer a promising new therapeutic strategy for chronic insomnia disorder,” says Yanping Bao, PhD, co-corresponding author at Peking University in Beijing, in a release. “This work also strengthens our understanding of the gut–brain axis as an important regulator of human sleep.”

The intervention increased microbial richness and diversity while altering community structure in the gut. The study authors note that baseline microbial composition may contribute to treatment heterogeneity, a factor that merits further investigation.

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