School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.
Menzies Health Institute Queensland, Gold Coast, QLD, Australia.
Eur J Clin Nutr. 2020 Nov;74(11):1536-1549. doi: 10.1038/s41430-020-0656-x. Epub 2020 May 20.
Inadequate sleep (i.e., duration and/or quality) is becoming increasingly recognized as a global public health issue. Interaction via the gut-brain axis suggests that modification of the gut microbial environment via supplementation with live microorganisms (probiotics) or nonviable microorganisms/microbial cell fractions (paraprobiotics) may improve sleep health. This systematic review and meta-analysis aimed to clarify the effect of consuming probiotics/paraprobiotics on subjective and objective sleep metrics. Online databases were searched from 1980 to October 2019 for studies involving adults who consumed probiotics or paraprobiotics in controlled trials, during which, changes in subjective and/or objective sleep parameters were examined. A total of 14 studies (20 trials) were included in meta-analysis. Random effects meta-analyses indicated that probiotics/paraprobiotics supplementation significantly reduced Pittsburgh Sleep Quality Index (PSQI) score (i.e., improved sleep quality) relative to baseline (-0.78-points, 95% confidence interval: 0.395-1.166; p < 0.001). No significant effect was found for changes on other subjective sleep scales, nor objective parameters of sleep (efficiency/latency) measured using polysomnography or actigraphy. Subgroup analysis for PSQI data suggested that the magnitude of the effect was greater (although not statistically) in healthy participants than those with a medical condition, when treatment contained a single (rather than multiple) strain of probiotic bacteria, and when the duration of treatment was ≥8 weeks. Probiotics/paraprobiotics supplementation may have some efficacy in improving perceived sleep health, measured using the PSQI. While current evidence does not support a benefit of consuming probiotics/paraprobiotics when measured by other subjective sleep scales, nor objective measures of sleep; more studies using well-controlled, within-subject experimental designs are needed.
睡眠不足（即睡眠时间和/或质量不足）正日益被认为是一个全球性的公共卫生问题。通过肠-脑轴的相互作用表明，通过补充活菌（益生菌）或非活菌/微生物细胞部分（后生元）来改变肠道微生物环境，可能会改善睡眠健康。本系统评价和荟萃分析旨在阐明食用益生菌/后生元对主观和客观睡眠指标的影响。从 1980 年到 2019 年 10 月，我们在线数据库中搜索了涉及在对照试验中食用益生菌或后生元的成年人的研究，在此期间，检查了主观和/或客观睡眠参数的变化。共有 14 项研究（20 项试验）纳入荟萃分析。随机效应荟萃分析表明，与基线相比，益生菌/后生元补充剂显著降低了匹兹堡睡眠质量指数（PSQI）评分（即改善睡眠质量）（-0.78 分，95%置信区间：0.395-1.166；p<0.001）。其他主观睡眠量表和使用多导睡眠图或活动记录仪测量的睡眠效率/潜伏期等客观参数的变化没有显著影响。PSQI 数据的亚组分析表明，在健康参与者中，当治疗包含单一（而不是多种）益生菌菌株，并且治疗持续时间≥8 周时，与有医疗条件的参与者相比，效果的幅度更大（尽管没有统计学意义）。益生菌/后生元补充剂可能在改善使用 PSQI 测量的主观睡眠健康方面具有一定疗效。虽然目前的证据不支持通过其他主观睡眠量表或客观睡眠测量来食用益生菌/后生元的益处；但是需要更多使用良好对照、个体内实验设计的研究。
