AUTHOR=Fang Haiming , Yao Tingting , Li Wanli , Pan Na , Xu Hang , Zhao Qian , Su Yuan , Xiong Kangwei , Wang Jiajia 

TITLE=Efficacy and safety of fecal microbiota transplantation for chronic insomnia in adults: a real world study

JOURNAL=Frontiers in Microbiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1299816

DOI=10.3389/fmicb.2023.1299816

ISSN=1664-302X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>To assess the efficacy and safety of fecal microbiota transplantation (FMT) for adult chronic insomnia.</p></sec><sec id="sec2"><title>Methods</title><p>Patients treated with FMT for chronic diseases were divided into chronic insomnia and non-insomnia group. The primary endpoint was the efficacy of FMT for insomnia 4 weeks after treatment, the secondary endpoints included the impacts of FMT on anxiety, depression, health-related quality of life, gut microbiota, and adverse events associated with FMT. Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) were utilized to assess the efficacy of FMT on insomnia, self-rating anxiety/depression scale [Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS)] was employed to evaluate anxiety and depression. Quality of life was evaluated by SF-36. 16S rRNA sequencing was employed to analyze the gut microbiota and correlation analysis was performed.</p></sec><sec id="sec3"><title>Results</title><p>Forty patients met the inclusion criteria and seven were excluded. 33 patients were enrolled and stratified into chronic insomnia group (<italic>N</italic> = 17) and non-insomnia group (<italic>N</italic> = 16). Compared to baseline, FMT significantly ameliorated the ISI (17.31 ± 5.12 vs. 5.38 ± 5.99), PSQI (14.56 ± 2.13 vs. 6.63 ± 4.67), SAS (54.25 ± 8.90 vs. 43.68 ± 10.64) and SDS (57.43 ± 10.96 vs. 50.68 ± 15.27) score and quality of life of chronic insomnia patients. 76.47% (13/17) of insomnia patients achieved the primary endpoints. In chronic insomnia patients, the relative abundance of <italic>Eggerthella</italic> marked enhanced at baseline, while the relative abundance of <italic>Lactobacillus, Bifidobacterium, Turicibacter, Anaerostipes</italic>, and <italic>Eisenbergiella</italic> significantly increased after FMT treatment, the latter positive correlated with the efficacy of FMT. Encouragingly, FMT also improved the sleep quality of non-insomnia patients.</p></sec><sec id="sec4"><title>Conclusion</title><p><italic>Eggerthella</italic> may potentially serve as a distinctive genus associated with chronic insomnia. FMT maybe a novel treatment option for adults with chronic insomnia and provide an alternative to traditional treatments for insomnia. The effects were positive correlated with the augmentation of probiotics, such as <italic>Bifidobacterium</italic>, <italic>Lactobacillus</italic>, <italic>Turicibacter</italic>, and <italic>Fusobacterium</italic>.</p></sec>