How Probiotics Like Lactobacillus Plantarum Could Help With Depression and Insomnia? This Study May Help

The Effects of Insomnia and How Probiotics may Help

Insomnia can be described as difficulty initiating sleep, difficulty in maintaining sleep, and early morning awakening with inability to return to sleep. It is estimated that 10-60% of the US population have Insomnia. 40% of those insomniacs suffer from psychiatric disorders. Depression and anxiety are the most common symptoms.

Depression is not just sadness but a lack of energy and diminished interest. On the other hand, anxiety is caused by feelings of tension and worry that may cause physical changes like increased blood pressure.

We hypothesized that PS128 can enhance sleep quality by ameliorating mood and reducing cortical excitation in self-reported insomniacs. Therefore, our study was conducted to test if Lactobacillus Plantarum (PS128), a type of probiotic strain, can help with mood and sleep. We tested this by giving Lactobacillus Plantarum to 40 participants who experience feelings of depression or anxiety.

The Study Conducted on Insomnia Patients

40 participants were screened and their sex, age, body mass index (BMI), blood pressure (BP), health habits, and medical history were recorded. Participants also completed sleep logs for one week to record their daily schedules and sleep habits.

The American Academy of Sleep Medicine 2017 manual was used as the sleep staging guideline. 

The sleep parameters recorded were:

  • Total sleep time
  • Sleep onset latency
  • Wake time after sleep onset
  • Sleep efficiency
  • Number of awakenings
  • Arousal index

The participants were then divided into two subgroups: Insomniac and Misperception. This is based on the participant’s  sleep onset latency (SOL) or wake time after sleep onset (WASO) tests.

  • Within the placebo group, nine were identified as Insomniac and ten as Misperception
  • Within the PS128 group, twelve were identified as Insomniac and nine as Misperception.

After the evaluations, participants began taking two capsules of either Lactobacillus Plantarum or a placebo after dinner over a 30 day period. 

A miniature-PSG then evaluates participants for mid-test and end-test data on the 15th and 30th day after taking capsules.

The visual analogue scale (VAS) was used to assess relaxation and fatigue levels, and sleep quality. 

This study used the Pittsburgh Sleep Quality Index and Insomnia Severity Index to evaluate subjective sleep quality and insomnia severity. 

The daytime sleepiness was measured using the Epworth Sleepiness Scale.

Depression was measured using the Beck Depression Inventory-II, anxiety levels were measured using the Beck Anxiety Inventory, and the State-Trait Anxiety Index.

The circadian rhythm was measured using the Morningness-Eveningness Questionnaire.

Results of the Study on Insomnia Patients, Probiotics vs Placebo

Lactobacillus Plantarum did not significantly affect the autonomic nervous system function. A larger sample size is needed to clarify the effects of Lactobacillus Plantarum in alleviating depressive symptoms and cortical excitation to determine whether the timing of Lactobacillus Plantarum intake affects sleep quality. 

However, with the subgroups, Misperception participants’ BMI’s ( Body Mass Index ) were significantly lower in the Lactobacillus Plantarum group than the placebo group. The PSQI scores ( Sleep Quality Score ) of Insomniac participants were significantly higher in the Lactobacillus Plantarum group than in the control group.

Conclusion of the Study

This study found that the administration of Lactobacillus Plantarum could lead to a decrease in:

  • Depressive symptoms
  • Cortical excitation
  • And fatigue level 

It could also lead to an improvement in the quality of deep sleep in self-reported insomniacs. 

Lactobacillus Plantarum could slightly regulate the autonomic nervous system by reducing the sympathetic nervous system and increasing the parasympathetic nervous system during sleep. 

Lactobacillus Plantarum could improve sleep quality by increasing sleep efficiency, maintaining sleep duration, and decreasing sleep latency and the change in sleep quality related to mood.

Other discussions related to microbiota and the gut-brain axis

The microbiota–gut-brain axis is a bidirectional link that involves the: 

  • Central nervous system
  • Enteric nervous system
  • And gut microbiota. 

Accumulated data have demonstrated the importance of the gut microbiota in maintaining gastrointestinal homeostasis, boosting the immune system, promoting nutrient absorption, etc.  

It also became a potential therapeutic target for psychiatric disorders, such as depression, Parkinson’s disease, and dementia. 

The effect of microbiota on the brain occurs through three main pathways of the microbiota–gut-brain axis: 

  • Hormones and neurotransmitters 
  • The immune system, 
  • And the vagus nerve. 

A possible approach to modulate the gut microbiota and improve health is through probiotics (live microorganisms which when administered in adequate amounts, confer a health benefit on the host).

In addition, certain probiotics were identified as “psychobiotics” that can regulate the microbiota-gut-brain axis and bring health benefits to patients with mental illnesses, which is promising for the treatment of Insomnia.


Effects Of Lactobacillus plantarum PS128 on Depressive Symptoms And Sleep Quality In Self-Reported Insomniacs: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial

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