After the transplant, study participants' gut bacteria became more diverse than an untreated group of people with insomnia. Their sleep efficiency, meaning the percentage of time they spent asleep while in bed, also increased, researchers reported July 22 in the Journal of Internal Medicine.
The findings "are aligned with a recent body of work over the last five years indicating that the gut microbiome may play a role in sleep-wake regulation," said Dr. David Gozal, a pediatric sleep specialist at Marshall University in West Virginia who wasn't involved in this study.
The study included 80 adult women and men with chronic insomnia from seven hospitals in China; the participants did not have other health problems, such as migraine or obstructive sleep apnea, that could interfere with the results.
The other half of the participants instead took placebo pills in place of the antibiotics and FMT capsules.
Additionally, the treated group woke up less throughout the night. Their time spent awake after initially falling asleep fell from 79 to 17 minutes, while the same metric increased from 37 to 42 minutes in the placebo group.
It is "encouraging" that FMT treatment seemed to improve sleep not only on objective tests, but also in how the participants themselves rated their insomnia, added Harriët Schellekens, a neuroscientist and microbiome researcher at University College Cork in Ireland, who wasn't involved in the work.
Based on several metrics, the sleep of the treated group improved more than the untreated group in the trial. (Image credit: Kilito Chan via Getty Images)Gut-sleep connection
However, experts noted several caveats. The trial was small and limited to relatively healthy adults in China, so the results may not apply broadly. Sleep was measured only once after treatment, at the one‑month mark, Hashimoto said. And because the treatment combined antibiotics with FMT, it's unclear how much of the benefit came from the donor microbes alone, Schellekens and Hashimoto noted.
The gut and brain communicate in various ways, including via chemicals made by gut microbes that travel to the brain via the bloodstream, Hashimoto explained. These chemicals may steer inflammation, stress responses and the body's sleep-wake control.
In the study, the mix of gut microbes in the FMT group shifted between the start and end of the study, but the placebo group's microbiomes stayed the same. Several types of bacteria became more abundant after FMT, while others decreased, suggesting that FMT reshapes the gut microbiome.
RELATED STORIESNot everyone responded to the treatment, and they mostly differed in what their gut microbiota looked like before FMT, not after. That suggests that a person's initial microbial makeup may help determine how well they respond to the treatment.
More research is needed to understand the biological mechanisms underlying the improvements, Schellekens said. For now, "FMT remains an experimental approach for insomnia and is not something that should be used outside carefully controlled clinical studies."
This article is for informational purposes only and is not meant to offer medical advice.
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