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Randomized Controlled Trial
. Mar/Apr 2018;25(2):e194-e201.
doi: 10.1097/MJT.0000000000000584.

Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms

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Free PMC article
Randomized Controlled Trial

Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms

Jack N Losso et al. Am J Ther. .
Free PMC article

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
Figure 1
A. Relative induction of indoleamine 2,3-dioxygenase (IDO) and COX-2 in Caco-2 cells stimulated with IFN-γ and decrease of IDO and COX-2 in cells treated with procyanidin B-2. B. Relative induction of NF-KB in Caco-2 cells stimulated with IFN-γ. 1= control, 2= IFN-γ, 3= 12.5 μM procyanidin B-2, 4= 25 μM procyanidin B-2, and 5= 50 μM procyanidin B-2
Figure 1
Figure 1
A. Relative induction of indoleamine 2,3-dioxygenase (IDO) and COX-2 in Caco-2 cells stimulated with IFN-γ and decrease of IDO and COX-2 in cells treated with procyanidin B-2. B. Relative induction of NF-KB in Caco-2 cells stimulated with IFN-γ. 1= control, 2= IFN-γ, 3= 12.5 μM procyanidin B-2, 4= 25 μM procyanidin B-2, and 5= 50 μM procyanidin B-2
Figure 2
Figure 2
Serum Kyurenine to tryptophan ratio after placebo or cherry juice treatment. *p<0.05
Figure 3
Figure 3
Serum PGE-2 levels after placebo or cherry juice treatments. *p<0.05

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