Sleep Disorders in Kids: How the Microbiome Could Be the Key

Did you know that sleep disorders in children are common? Statistics report that up to 50% of children are affected by some type of sleep issue, and these concerns affect children globally, often with different etiologies but similar outcomes. Sleep disorders are not only disruptive to family life, but sleep deprived children may also suffer from:  

  • School performance issues  
  • Learning challenges  
  • Behavioral issues 
  • Potential neurologic and immunologic impacts 

If a child is not sleeping well, then their parents are likely not sleeping either. A common sleep disorder in children is parasomnia (sleep walking and talking/night terrors), and parents who are up helping their child through these occurrences are missing out on valuable sleep as well. Chronic sleep deprivation in parents can cause similar issues with mood, cognition, and other negative health outcomes. Family life is much more challenging when everyone is sleep deprived! 

The usual course of action for families experiencing childhood sleep disorders includes: 

  •  Education  
  • Behavioral modification techniques (unmodified and graduated extinction 
  • Evaluation for possible obstructive sleep apnea (snoring) 
  • Other evaluations for health-related concerns that can affect sleep 

Some practitioners are beginning to consider melatonin disturbances where melatonin levels have possibly been depleted by electromagnetic frequency (EMF) exposures. Many people already supplement Melatonin to aid in falling asleep, which aligns with the research... but more on that later. 

The Brain Microbiome 

Researchers examining autopsied HIV/AIDS patients found the existence of a brain microbiome. Their conclusion was that as we consume microbes in our food, they first enter the gut and then travel to the brain via immune cells (activated T lymphocytes and macrophages). What is exciting about this research is, we now suspect that these microbes may be responsible for brain evolution! Studying the microbes in petri dishes demonstrated how various microorganisms encouraged the neurons to make new connections. It is important to note there wasn’t any evidence of inflammation when these organisms were found in the brain, meaning that these organisms were not there because of an infectious condition like meningitis or encephalitis.  

But, how do the brain microbiome and sleep disorders correlate? 

The brain, like other organs, requires a waste clearance system for the removal of toxins (such as byproducts from microbes) as well as environmental toxicants. The role of the brain glymphatic system is now recognized as the mechanism by which wastes are removed from the brain. This mechanism is driven by arterial pulsation and regulated by contractions and expansions of the extracellular space—breathing. During exhalation, the brain contracts.  

The clearance of brain waste occurs during sleep, and the glymphatic system is more active during REM sleep—when dreaming occurs. The dreaming state is associated with an increase in cerebral blood volume and increased clearance of brain waste. This demonstrates the connection to how sleep disorders can negatively impact brain function by preventing the clearing of waste. 

Dr. Marco Ruggiero, a researcher in the field of psychoneuroimmunology for 35 years, summarizes this relationship well: 

The activity of the glymphatic system—enhanced during sleep and dreaming— is responsible for the circulation of the cells of the immune system (activated lymphocytes and macrophages) that carry the microbes from the gut microbiome to the brain, thus supporting a healthy, self-renewing brain microbiome. 

So, if we look at a specific subset of children with known dyssomnias (sleep disorders), like children with neurologic challenges such as those on the autism spectrum (ASD), these children tend to have less REM sleep, and therefore less dreaming. This means they likely have a reduced ability to clear waste from their brain, which could then result in subsequent inflammation. And, it is now recognized that there is a significant element of neuroinflammation in the brains of children with ASD.  

There are studies that have concluded that certain microbes (i.e., Lactobacillus reuteri) can reverse ASD behaviors in mice. The question is, how do we support sleep/dreaming/brain detoxification/microbial homeostasis as a preventative health measure in the brains of not only children with challenges like ASD, but in ALL children? 

More about the brain and the microbiome... 

Gamma-aminobutyric acid (GABA) is a major inhibitory neurotransmitter in the brain. This neurotransmitter plays a critical role in: 

  • Sleep regulation/circadian rhythm 
  • Mood 
  • Health of other organs 
  • Learning and memory  

Interestingly, much of GABA’s influence takes place in the hippocampus, where high concentrations of microbes have been found. Because researchers have found that microbes from the gut are transported into the brain and can enhance neurologic development, and that distinct microbes can produce GABA, these relationships elucidate exactly how the microbiome, neurologic, and sleep health are all linked.  

So, what about Melatonin? 

Melatonin’s presumed origins were likely in bacteria. Melatonin plays multiple roles in our physiology in addition to sleep/circadian rhythms, including: 

  • Immune enhancement  
  • Antioxidants  
  • Regulation of acid production in the stomach  
  • Anti-cancer properties  

It has also been discovered that gut microbes have a circadian rhythm as well and respond to melatonin. Much of the melatonin in our bodies is produced in the gut by the enterochromaffin cells. When microbes sense melatonin, they become more active. This finding begs the question as to whether this is the microbe’s cue to head up to the brain, riding along inside immune cells, to impact our brains while we sleep. Either way, taking a melatonin supplement can provide sleep support in children who may not be producing enough melatonin on their own. 

Call to Action 

With all of this valuable information, it makes sense that supporting gut health would also promote a healthier brain microbiome, thereby encouraging glymphatic detoxification for better sleep and an overall healthier child. Many companies are now coming together to develop oral microbe drugs that might be used for ASD and other neurocognitive disorders. But in addition to treating the disorder directly with these newly developed drugs, parents could also work to treat microbial imbalances in the gut by supplementing with probiotics. With the gut and brain being so interconnected, healing the gut could potentially be the solution to help these kids (and their parents) get some much needed sleep! 

Dr. Michelle Perro, MD, DHOM

Integrative Pediatrician

With over 38 years in acute and integrative medicine, Dr. Perro is a veteran pediatrician. Over fifteen years ago, she revolutionized her clinical practice to integrate pesticide and health advocacy. During her long career, she both directed and worked as an attending physician in New York’s Metropolitan Hospital and UCSF Benioff Children’s Hospital Oakland. She has also managed her own company, Down to Earth Pediatrics, which innovated a new field of integrative urgent care medicine. Dr. Perro co-authored the acclaimed book, What’s Making our Children Sick, has authored numerous publications, and writes a new column in the journal, Townsend Letter. Currently, she lectures, consults, works at the Northern California integrative health center, Gordon Medical Associates, and is Executive Director of the non-profit scientific-based website

Collective members are paid sponsors and receive compensation for their content, but all opinions are their own.

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