School of Nursing, Faculty of Health and Social Development, 8166University of British Columbia Okanagan campus, Kelowna, British Columbia, Canada.
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Benef Microbes. 2024 Aug 14;15(6):609-641. doi: 10.1163/18762891-bja00034.
Microbiota changes throughout infancy and can be modified by biotic supplementation, which includes probiotics, prebiotics, synbiotics, and post-biotics. Given the potential influence of the microbiome on infant sleep, this systematic review and meta-analysis aimed to determine the effect of biotic supplementation on sleep behaviours in full-term infants aged 0-12 months. In June 2023, we searched seven databases for randomised controlled trials (RCTs) of biotic supplementation intervention studies using synonymous terms for 'infant' AND 'biotic' AND 'sleep' (PROSPERO registration ID: CRD42022358822). Title/abstracts and the full texts were independently screened. Data on infant sleep and settling behaviour outcomes, reported adverse/side effects, and co-morbid conditions were extracted for analysis. Using the modified Cochrane Collaboration tool, two independent reviewers judged the risk of bias. Meta-analyses were conducted using RevMan5. Our search yielded 453 unique studies and 23 RCTs are included in this review. Probiotic supplementation was the most common biotic supplementation (provided in 53% of studies), while 28% and 19% offered prebiotic and synbiotic supplementation, respectively. Sleep duration was the most common (95%) reported outcome for probiotics. No significant differences were reported in sleep duration during the 1st to 4th week of probiotic supplementation. However, in the 5th week of probiotic supplementation, infants who received placebo slept significantly longer (MD = -35.17 min, 95% CI [-69.72, -0.62]), suggesting a borderline significance that is clinically relevant. There were limited studies and timeframe alignment to analyse prebiotics, synbiotics, post-biotics, and para-probiotics effects on infant sleep duration. The study suggests probiotic supplementation does not increase infant sleep duration within the first 4 postpartum weeks and may contribute to reduced sleep duration in the fifth week. Limited studies were available to assess the effects of biotic supplementation over the first 12 postpartum months. Future research should assess the full range of sleep behaviours, infant feeding type, and microbiome.
婴儿期的微生物组会发生变化，并可通过生物补充剂进行调节，包括益生菌、益生元、合生元和后生元。鉴于微生物组对婴儿睡眠的潜在影响，本系统评价和荟萃分析旨在确定生物补充剂对 0-12 个月龄足月婴儿睡眠行为的影响。2023 年 6 月，我们使用同义术语“婴儿”和“生物”和“睡眠”搜索了七个数据库，以查找生物补充剂干预研究的随机对照试验（RCT）（PROSPERO 注册号：CRD42022358822）。我们独立筛选了标题/摘要和全文。提取了婴儿睡眠和安置行为结果、报告的不良反应/副作用和合并症的数据进行分析。使用改良的 Cochrane 协作工具，两位独立审查员对偏倚风险进行了评估。使用 RevMan5 进行荟萃分析。我们的搜索产生了 453 项独特的研究，本综述纳入了 23 项 RCT。益生菌补充剂是最常见的生物补充剂（53%的研究提供），而 28%和 19%分别提供了益生元和合生元补充剂。睡眠持续时间是最常见的（95%）报告的益生菌结果。在益生菌补充的第 1 至 4 周内，没有报告睡眠持续时间的显著差异。然而，在益生菌补充的第 5 周，接受安慰剂的婴儿睡眠时间明显更长（MD=-35.17 分钟，95%CI[-69.72，-0.62]），表明这具有临床意义的边缘显著。由于研究数量有限且时间框架与分析益生元、合生元、后生元和副益生菌对婴儿睡眠持续时间的影响不匹配，因此无法进行分析。该研究表明，在产后的前 4 周内，益生菌补充剂不会增加婴儿的睡眠时间，并且可能导致第五周睡眠时间减少。目前可获得的评估生物补充剂对产后 12 个月内婴儿睡眠影响的研究有限。未来的研究应评估全方位的睡眠行为、婴儿喂养类型和微生物组。
