The results of a new observational study are clear: sleep disorders often occur with infections and organ dysfunction. Hence, for the physician from the MVZ Ärztehaus Mitte in Berlin, Sebastian Pfeiffer, the conclusion is obvious: “So, if the treatment of infections leads to an improvement in sleep, antimicrobial therapy of neglected or unrecognized infections and the organ dysfunctions they may cause can be an alternative to treatment methods that often do not achieve sustainable goals.”
In the observational study, 166 patients with chronic sleep disorders were comprehensively examined. Almost all of them had digestive complaints. 80 percent had previously undetected or untreated infections (especially Candida spec. and Helicobacter pylori). Sonographic examinations revealed that 45 patients (27 percent) had visible liver dysfunction and 33 (20 percent) had kidney dysfunction. (Combined with investigations by Traditional Chinese Medicine, even higher proportions of organ dysfunction were seen, particularly in the kidneys, liver, and spleen).
Very little has been studied on the association of infections, especially those with pathogenic yeasts and Helicobacter pylori, and organ dysfunctions with sleep disorders. As a rule, neither the diagnosis nor the therapy of infections is considered in connection with sleep disorders. Even the S3 guideline “Non-restorative sleep/sleep disorders” of the German Society for Sleep Research and Sleep Medicine (DGSM) only mentions infections in general terms as a cause or contributory cause of sleep disorders. Similar to infections, organ disorders and their role in causing sleep disorders are also not systematically considered in the S3 guideline.
Even a recommendation by the Robert Koch Institute in 2004 on the significance of an infestation of the gut with pathogenic fungi for the development of diseases has since initiated hardly any studies that could close this gap. Despite the need formulated in this way: “As always, when the data situation is unsatisfactory it gives rise to room for speculation. Such an unsatisfactory situation for patients as well as the treating physicians can only be mitigated by careful studies and the associated increase in knowledge.”
The fact that study results are now available in this regard is very welcome. The evaluation results of serological and microbiological laboratory analyses, ultrasound examinations and use of ECG should motivate further studies. The documentation of infections and organ dysfunctions in connection with sleep disorders should give reason to scrutinize usual procedures in diagnostics and therapy.
The restorative and regulating properties of sleep are an empirical knowledge that is also scientifically recognized now. The influence of sleep on the immune system has been increasingly studied in recent years. Several studies have shown, for example, that sleep deprivation can influence components of the immune system. Conversely, sleep patterns are also altered during the immune response, suggesting that sleep and immune response are linked by a two-way communication. Sleep is not only a physiological state in which activity and alertness decrease, but a vital process that regulates various physiological functions.
Interactions between brain activities and the immune system thus also affect sleep. Therefore, the question of what role pathogenic fungi and bacteria play in the reciprocal relationship between sleep disorders and inflammatory events through effect-enhancing interaction is of particular interest. The new study is also interesting because it focuses on the topic of “sleep” in connection with bodily functions – and thus opens up other perspectives compared to often purely psychological approaches.
In medical practice, sleep disorders are largely viewed in isolation and diagnosed and treated in the context of psychological or social conditions. Therapy is often limited to prescribing sleeping pills, determining sleep behavior in sleep laboratories and recommending mechanical sleep aids, recommending relaxation exercises such as meditation, behavioral changes to combat obesity and lack of exercise, to reduce psychological stress right up to psychotherapy. All of these measures can be supportive, be it at least temporarily – or in the longer term in case of a relevant cause.
However, like the new study, if one observes patient histories with very long chronic sleep disturbances in part (more than one year to more than ten years!), then one finds physical causes when taking a holistic view, which often unfortunately finds no attention even in the technical literature. This is because the above-mentioned treatment measures often remain permanently, without improvement. In addition, side effects and addictive behavior occur with long-term use of the drugs. In view of this, it seems sensible to consider possible chains of causation, which have so far received little or no attention in medical practice.
Most people know the amount of sleep they need to be refreshed and well-rested from their own experience. As a rule, a sleep disorder (insomnia) is considered “chronic” if people do not get restorative sleep over a longer period of time (more than six months, despite attempts at therapy) and feel permanently impaired in their quality of life and performance as a result. In this respect, the new study also points out that early attention to jointly occurring acute sleep and digestive disorders can help prevent chronic progressions.
According to Pfeiffer, only monitoring of treatment successes and further studies can clarify the question of whether infections and associated digestive and organ dysfunctions interact to be a cause of sleep disorders. With regard to therapy, the patients observed in the study underwent parallel examinations of complementary medicine. Pulse and tongue diagnostics of the traditional Chinese medicine were noticed by the patients in addition to general and specialized medical and laboratory diagnostic methods. However, these and the subsequent conventional and complementary medical treatment of the patients were not the subject of the study presented here. The evaluation of results of the monitoring of treatment success must therefore be left to meta-analytical assessments.
