The poor sleeper group had significantly higher levels of tryptophan and kynurenine in their stool after surgery compared to the good sleeper group.
may be linked to altered intestinal flora composition.
Fecal microbiota from poor sleepers resulted in reduced REM sleep in pseudo-germ-free rats.
PGF rats receiving gut microbiota from poor sleepers showed REM sleep at 4.8% ± 2.0%, compared to 11.4% ± 1.6% in those receiving microbiota from good sleepers.
Reduced levels of 5-hydroxytryptophan in the prefrontal cortex were observed in rats transplanted with poor sleeper gut flora.
Dysfunction in specific enzymes involved in tryptophan metabolism may contribute to sleep loss after surgery.
Simplified
BACKGROUND: The composition of the intestinal flora and the resulting metabolites affect patients' sleep after surgery.
METHODS: We intended to elucidate the mechanisms by which disordered intestinal flora modulate the pathophysiology of in hosts. In this study, we explored the impacts of anesthesia, surgery, and postoperative sleep duration on the fecal microbiota and metabolites of individuals classified postprocedurally as poor sleepers (PS) and good sleepers (GS), as diagnosed by the bispectral index. We also performed in pseudo-germ-free (PGF) rats and applied Western blotting, immunohistochemistry, and gut permeability analyses to identify the potential mechanism of its effect.
RESULTS: Research finding shows the PS group had significantly higher postoperative stool levels of the metabolites tryptophan and kynurenine than the GS group. PGF rats that received gut microbiota from PSs exhibited less rapid eye movement (REM) sleep than those that received GS microbiota (GS-PGF: 11.4% ± 1.6%, PS-PGF: 4.8% ± 2.0%, p < 0.001). Measurement of 5-hydroxytryptophan (5-HTP) levels in the stool, serum, and prefrontal cortex (PFC) indicated that altered 5-HTP levels, including reduced levels in the PFC, caused sleep loss in PGF rats transplanted with PS gut flora. Through the brain-gut axis, the inactivity of tryptophan hydroxylase 1 (TPH1) and TPH2 in the colon and PFC, respectively, caused a loss of REM sleep in PGF rats and decreased the 5-HTP level in the PFC.
CONCLUSIONS: These findings indicate that postoperative gut dysbiosis and defective 5-HTP metabolism may cause postoperative sleep disturbances. Clinicians and sleep researchers may gain new insights from this study.
Key numbers
4.8%
REM Sleep Percentage Decrease
REM sleep percentage in PS- rats.
11.4%
REM Sleep Percentage Increase
REM sleep percentage in GS- rats.
Higher levels of tryptophan and kynurenine
Stool Metabolite Levels Comparison
Postoperative stool metabolite levels in PS vs. GS groups.
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