Title: The gut-sleep-brain axis: Targeting the gut microbiota and sleep quality by individualized non-pharmaceutical approaches to promote healthy ageing
Funder: Economic and Social Research Council

Abstract: Our proposal builds on emerging evidence showing a reciprocal relationship between gut health, sleep and brain function. We aim to develop effective, low cost, individually tailored and broadly accessible intervention alternatives with no side effects using a range of food supplements to improve gut health, sleep quality, and brain function in older people. 1. Investigate the feasibility and effectiveness of a combined brief Brief Behavior Therapy for Insomnia (BBTi) and composite novel dietary supplement administration versus a combined BBTi and slow wave sleep enhancement intervention (SWSint) using the Dreem 2 device to improve sleep quality in older people with chronic insomnia. 2. Investigate the feasibility and effectiveness of targeted sleep quality improvement by (SWSint) and BBTi on gut health as reflected by a change in microbiome diversity and function. 3. Clarify those individual features of sleep physiology, microbiome, metabolome, diet, cognition, inflammatory markers, and emotional wellbeing via machine learning approaches that will best predict the positive response to each type of intervention. 4. Develop a screening tool to guide the selection of interventions optimized to the individual.

Lay abstract: Our ultimate vision is to develop an intelligent sleep enhancement platform (ISEP) that would ultimately target the promotion of healthy longevity that is broadly accessible, sustainable, avoids pharmaceutical agents and has a range of solutions tailored for various needs and users ranging from health practitioners, through care homes to finally end users (e.g. people with sleep problems and their family members). In contrast with other existing online platforms that serve similar purposes, ISEP would target the older population and would not anchor to one type of intervention (e.g. CBTi), which has limited efficacy in older people, but build on the combinations of cutting edge innovative approaches such as the modulation of gut health, brain electric activity in sleep, as well as psychological/behaviour approaches (e.g. CBTi, mindfulness). We believe that the future of health technology lies with personalised interventions that predict efficacious intervention based on individual features, reliably monitor physiological changes and provide intervention adjustment in real-time or nearly real-time. For this to happen the quality of monitoring/data acquisition, data analysis, feature extraction and the range of interventions all need progress. Our proposal will address some of these aspects. Based on the feasibility and effect size results from the current study we plan to pursue further research to improve the technology including other dietary supplements and non-pharmaceutical methods to improve sleep with similar or better features, optimise the dosage, timing and length of administration and reliably track impact. Finally, we aim to develop broadly accessible online applications that will provide individualised guidance on a range of interventions adjusted to individual needs and with the best predictable outcome taking into account accessibility, affordability and possible side effects. This tool will not only help both the primary and secondary health care professionals but the everyday end user as well. Finally, by improving sleep our proposed approach could be employed as a preventative treatment strategy and prospectively lower economic and non-economic costs of treating and caring for individuals with dementia. Prevention is key for improving the quality of life in later stages of life and sleep and diets are two important contributors in this strategy.

Research activity codes: 5.1 PHARMACEUTICALS;5.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: NEUROLOGICAL