摘要：失眠是一种常见的睡眠障碍，10% 至 30% 的成年人都会遇到这种情况。治疗失眠的主要药物是那些针对大脑的药物。最近的研究强调了微生物群在调节大脑睡眠方面的双向作用。这种观点为通过同时针对大脑和微生物群来治疗失眠提供了新的策略。

How Insomnia May Arise From the Abdomen

失眠是如何从腹部引发的

Microbes in your gut may be disrupting your sleep.

肠道中的微生物可能会扰乱您的睡眠。

Posted September 4, 2025 | Reviewed by Margaret Foley

发布于 2025 年 9 月 4 日 | 玛格丽特·弗利 (Margaret Foley) 审阅

Insomnia is a common sleep disorder experienced by 10 to 30 percent of adults.The primary medications for insomnia are those that target the brain.Recent findings highlight the bidirectional role of the microbiome in regulating sleep by the brain.This perspective provides new strategies for treating insomnia by targeting both the brain and the microbiome.

失眠是一种常见的睡眠障碍，10% 至 30% 的成年人都会遇到这种情况。治疗失眠的主要药物是那些针对大脑的药物。最近的研究强调了微生物群在调节大脑睡眠方面的双向作用。这种观点为通过同时针对大脑和微生物群来治疗失眠提供了新的策略。

Insomnia is an unpleasant event that many of us have experienced. While we try to fall asleep, sleep seems to elude us. This creates stress, which further worsens insomnia. A flood of negative thoughts, worries, and anxieties can rob us of calm and peace, turning sleep into a nightly struggle. This excessive effort keeps the brain on high alert, making our nervous system more active instead of calming it down.

失眠是我们许多人都经历过的一件令人不快的事情。当我们试图入睡时，却似乎无法入睡。这会造成压力，进一步加剧失眠。大量的负面思绪、担忧和焦虑会夺走我们的平静与安宁，使睡眠变成一场彻夜的挣扎。这种过度的努力会使大脑保持高度警觉，使我们的神经系统更加活跃而不是平静下来。

Insomnia is not just a physical problem; it encompasses several profound neurological and psychological aspects. Neuroscience offers a distinct perspective on this phenomenon. Sleep is a highly active and complex brain process regulated by various neurotransmitters and brain structures. Hormones such as melatonin and neurotransmitters like GABA play key roles in initiating and maintaining sleep. Disruptions in the balance of these chemicals or impairments in the brain regions responsible for regulating the body clock (circadian rhythms) can lead to insomnia. Ultimately, insomnia is not merely an inability to fall asleep, but a manifestation of the complex interplay between mind and body, where mental health and brain function are closely intertwined. Understanding these psychological and neurological factors allows us to approach insomnia from a more holistic perspective and develop more effective solutions to address it.

失眠不仅仅是一个生理问题；它涉及多个深层次的神经和心理方面。神经科学为这一现象提供了独特的视角。睡眠是一个高度活跃且复杂的大脑过程，受各种神经递质和大脑结构的调节。褪黑激素等激素和 GABA 等神经递质在启动和维持睡眠方面发挥着关键作用。这些化学物质失衡，或负责调节生物钟（昼夜节律）的大脑区域受损，都可能导致失眠。归根结底，失眠不仅仅是无法入睡，而是身心之间复杂相互作用的表现，其中心理健康和大脑功能紧密相连。了解这些心理和神经因素使我们能够从更全面的角度看待失眠，并制定更有效的解决方案来解决它。

Recent studies have demonstrated that impairments in physical body systems can affect cognitive function. A prime example is the effect of peripheral inflammation on the brain, which can induce depression. However, the role that microbes inhabiting the digestive system play in brain function is even more fascinating. For instance, in 2018, a paper suggested that gut microbes regulate both host sleep and mental state through the gut-brain axis. It appears that some types of gut microbiota deregulate genes involved in the control of circadian rhythms [1]. In a clinical trial involving 156 healthy adults who received probiotics, including a mixture of Lactobacillus reuteri, for eight weeks, participants experienced improvements in depressive and anxiety symptoms, as well as in sleep quality, compared to the placebo group [2].

最近的研究表明，身体系统的损伤会影响认知功能。一个典型的例子是外周炎症对大脑的影响，它会诱发抑郁症。然而，消化系统中的微生物在大脑功能中的作用更加令人着迷。例如，2018 年的一篇论文表明，肠道微生物通过肠脑轴调节宿主的睡眠和精神状态。某些类型的肠道菌群似乎会失调参与控制昼夜节律的基因[1]。在一项涉及 156 名健康成年人的临床试验中，他们接受了八周的益生菌治疗，包括罗伊氏乳杆菌混合物。与安慰剂组相比，参与者的抑郁和焦虑症状以及睡眠质量都有所改善[2]。

A recent study comprehensively investigated the bidirectional causal relationship between gut microbiota and insomnia using Mendelian randomization analysis on large genetic datasets. The researchers demonstrated a significant two-way causal link between the gut microbiome and insomnia. The main finding is that this relationship is bidirectional: Specific types of gut bacteria directly influence the risk of developing insomnia, while a diagnosis of insomnia can, in turn, alter the abundance of certain gut bacteria. The study identified 14 bacterial types that contribute to an increased risk of insomnia, with the genus Odoribacter showing a notably strong positive effect. Conversely, eight other bacterial types were found to have a protective effect against the condition. Additionally, insomnia has been shown to decrease the abundance of certain beneficial bacteria and increase others, potentially creating a feedback loop.

最近的一项研究使用孟德尔随机化分析对大型遗传数据集进行分析，全面研究了肠道菌群与失眠之间的双向因果关系。研究人员证明了肠道菌群与失眠之间存在显著的双向因果关系。主要发现是这种关系是双向的：特定类型的肠道细菌直接影响患失眠的风险，而失眠的诊断反过来又会改变某些肠道细菌的丰度。该研究确定了 14 种会增加失眠风险的细菌类型，其中臭杆菌属表现出显著的积极作用。相反，发现其他八种细菌对失眠有保护作用。此外，失眠已被证明会减少某些有益细菌的丰度，同时增加其他有益细菌的丰度，从而可能形成反馈回路。

This complex interplay is believed to operate through various pathways, including immune system regulation, inflammatory responses, and the modulation of neurotransmitter release. These insights offer a crucial genetic foundation for the future development of novel microbiome-based therapeutic interventions for insomnia, such as targeted probiotics or fecal microbiota transplantation. However, the authors emphasize that their study, which primarily involves individuals of European descent and yields small effect sizes, provides preliminary and hypothesis-generating evidence rather than definitive conclusions, underscoring a clear need for further research to validate these findings [3].

这种复杂的相互作用被认为通过多种途径发挥作用，包括免疫系统调节、炎症反应和神经递质释放的调节。这些见解为未来开发基于微生物组的新型失眠治疗干预措施（例如靶向益生菌或粪便菌群移植）提供了重要的遗传基础。然而，作者强调，他们的研究主要涉及欧洲血统的个体，且效应量较小，因此提供的只是初步的、基于假设的证据，而非确切的结论，这凸显了进一步研究以验证这些发现的必要性 [3]。

Overall, trillions of microorganisms in the intestines influence the brain functions directly through chemical metabolites, neurotransmitters, and immune signals, which in turn affect brain processes such as cognition, mood, and sleep. They also exert indirect effects by influencing the enteric nervous system (ENS). The ENS, often called the "second brain," is a complex network of over 100 million neurons embedded in the gastrointestinal tract. It regulates digestive system functions directly and interacts with the brain via the vagus nerve.

总体而言，肠道中数以万亿的微生物通过化学代谢物、神经递质和免疫信号直接影响大脑功能，进而影响认知、情绪和睡眠等大脑过程。它们还通过影响肠神经系统 (ENS) 发挥间接作用。肠神经系统通常被称为“第二大脑”，是一个由超过 1 亿个神经元组成的复杂网络，位于胃肠道内。它直接调节消化系统功能，并通过迷走神经与大脑相互作用。

Chemical metabolites produced by gut microorganisms include short-chain fatty acids and D-lactic acid, which can directly cross the blood-brain barrier and modulate brain functions. Neurotransmitters such as serotonin, GABA, and dopamine, synthesized by microbes, interact with enteric neurons; subsequently, the ENS sends signals to the brain via the vagus nerve. The vagus nerve also detects inflammation induced by certain gut microbes and transmits inflammatory signals to the brain. These signals physiologically and pathologically alter brain function and influence the brain’s control of bodily processes and cognitive functions such as mood, emotions, and even sleep quality.

肠道微生物产生的化学代谢物包括短链脂肪酸和D-乳酸，它们可以直接穿过血脑屏障并调节大脑功能。微生物合成的血清素、γ-氨基丁酸（GABA）和多巴胺等神经递质与肠道神经元相互作用；随后，肠神经系统（ENS）通过迷走神经向大脑发送信号。迷走神经还能检测某些肠道微生物引起的炎症，并将炎症信号传递到大脑。这些信号在生理和病理上改变大脑功能，并影响大脑对身体过程和认知功能（例如情绪、情感甚至睡眠质量）的控制。

These effects of the gut microbiome on brain function highlight, once again, that our cognition is not solely determined by the brain and body; microbes that are not officially part of the human body also influence it. This perspective offers new insights into developing comprehensive approaches to treating mental illnesses, beyond medications that target only the brain. Moreover, the final interesting aspect of this perspective, at least for me, is that we are not limited to the brain alone; we are a combination of the brain, body, and environmental factors that shape who we are.

肠道微生物群对大脑功能的影响再次凸显，我们的认知并非完全由大脑和身体决定；并非人体正式组成部分的微生物也会影响我们的认知。这一观点为开发治疗精神疾病的综合方法提供了新的见解，超越了仅针对大脑的药物。此外，至少对我来说，这一观点最后一个有趣的方面是，我们并非仅仅局限于大脑；我们是大脑、身体和环境因素的结合体，这些因素塑造了我们。

来源：左右图史