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Effects of probiotics and paraprobiotics on subjective and objective sleep metrics: a systematic review and meta-analysis

European Journal of Clinical Nutrition volume 74, pages 1536–1549 (2020)Cite this article

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Abstract

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.

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Fig. 1
Fig. 2: Forest plot displaying the effect of consuming probiotics/paraprobiotics treatment vs. placebo on Δ PSQI score.
Fig. 3: Forest plot displaying the effect of consuming probiotics/paraprobiotics vs. placebo on subjective sleep ratings (OSA, VAS, ESS, mESS).
Fig. 4: Forest plot displaying the effect of consuming probiotics/paraprobiotics vs. placebo on sleep efficiency (%) determined by objective measures (EEG and Actigraphy).
Fig. 5: Forest plot displaying the effect of consuming probiotics/paraprobiotics vs. placebo on sleep latency (min) determined by objective measures (EEG and Actigraphy).

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  1. School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia

    Christopher Irwin & Ben Desbrow

  2. Menzies Health Institute Queensland, Gold Coast, QLD, Australia

    Christopher Irwin

  3. The University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW, Australia

    Danielle McCartney

  4. Physical Activity Research Group, Appleton Institute & School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, QLD, Australia

    Saman Khalesi

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All authors were involved in the conception and design of this review. CI and SK were responsible for collating manuscripts and retrieving data. CI conducted the analysis of the data. All authors contributed to the drafting and revising of the article, and the final approval of the published version of the manuscript.

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Irwin, C., McCartney, D., Desbrow, B. et al. Effects of probiotics and paraprobiotics on subjective and objective sleep metrics: a systematic review and meta-analysis. Eur J Clin Nutr 74, 1536–1549 (2020). https://doi.org/10.1038/s41430-020-0656-x

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