Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms
Jack N Losso, John W Finley, Namrata Karki, Ann G Liu, Alfredo Prudente, Russell Tipton, Ying Yu, Frank L Greenway, Jack N Losso, John W Finley, Namrata Karki, Ann G Liu, Alfredo Prudente, Russell Tipton, Ying Yu, Frank L Greenway
Abstract
Background: Insomnia is common in the elderly and is associated with chronic disease, but use of hypnotics increases the incidence of falls. Montmorency tart cherry juice has improved insomnia by self-report questionnaire.
Study question: Is insomnia confirmed by polysomnography and is tryptophan availability a potential mechanism for treating insomnia?
Study design: A placebo-controlled balanced crossover study with subjects older than 50 years and insomnia were randomized to placebo (2 weeks) or cherry juice (2 weeks) (240 mL 2 times/d) separated by a 2-week washout.
Measures and outcomes: Sleep was evaluated by polysomnography and 5 validated questionnaires. Serum indoleamine 2,3-dioxygenase (IDO), the kynurenine-to-tryptophan ratio, and prostaglandin E2 were measured. In vitro, Caco-2 cells were stimulated with interferon-gamma, and the ability of cherry juice procyanidin to inhibit IDO which degrades tryptophan and stimulates inflammation was measured. The content of procyanidin B-2 and other major anthocyanins in cherry juice were determined.
Results: Eleven subjects were randomized; 3 with sleep apnea were excluded and referred. The 8 completers with insomnia increased sleep time by 84 minutes on polysomnography (P = 0.0182) and sleep efficiency increased on the Pittsburgh Sleep Quality Index (P = 0.03). Other questionnaires showed no significant differences. The serum kynurenine-to-tryptophan ratio decreased, as did the level of prostaglandin E2 (both P < 0.05). In vitro, cherry juice procyanidin B-2 dose-dependently inhibited IDO.
Conclusions: Cherry juice increased sleep time and sleep efficiency. Cherry juice procyanidin B-2 inhibited IDO, increased tryptophan availability, reduced inflammation, and may be partially responsible for improvement in insomnia.
Conflict of interest statement
Conflicts of interest: none
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5617749/bin/nihms854648f1a.jpg)
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5617749/bin/nihms854648f1b.jpg)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5617749/bin/nihms854648f2.jpg)
Figure 3
Serum PGE-2 levels after placebo…
Figure 3
Serum PGE-2 levels after placebo or cherry juice treatments. *p<0.05
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- Randomized Controlled Trial
- Aged
- Antioxidants
- Biflavonoids / pharmacology*
- Biflavonoids / therapeutic use
- Caco-2 Cells
- Catechin / pharmacology*
- Catechin / therapeutic use
- Cross-Over Studies
- Double-Blind Method
- Female
- Fruit and Vegetable Juices*
- Humans
- Indoleamine-Pyrrole 2,3,-Dioxygenase / blood
- Kynurenine / blood
- Male
- Middle Aged
- Pilot Projects
- Placebos
- Polysomnography
- Proanthocyanidins / pharmacology*
- Proanthocyanidins / therapeutic use
- Prunus avium / chemistry*
- Sleep / drug effects*
- Sleep Initiation and Maintenance Disorders / blood
- Sleep Initiation and Maintenance Disorders / diagnosis
- Sleep Initiation and Maintenance Disorders / diet therapy*
- Surveys and Questionnaires
- Time Factors
- Tryptophan / blood
- Antioxidants
- Biflavonoids
- Indoleamine-Pyrrole 2,3,-Dioxygenase
- Placebos
- Proanthocyanidins
- procyanidin B
- Kynurenine
- Tryptophan
- Catechin
- Full Text Sources
- Other Literature Sources
- Medical
- Research Materials
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5617749/bin/nihms854648f3.jpg)
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Source: PubMed