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

Losso, Jack N. PhD; Finley, John W. PhD; Karki, Namrata PhD; Liu, Ann G. PhD; Prudente, Alfredo PhD; Tipton, Russell MD; Yu, Ying MS; Greenway, Frank L. MD
American Journal of Therapeutics: Post Author Corrections: March 27, 2017
doi: 10.1097/MJT.0000000000000584
Original Investigation: PDF Only

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.

Address for correspondence: Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808. E-mail: Frank.Greenway@pbrc.edu

Supported by the Cherry Marketing Institute which had nothing to do with the design of the trial. Supported in part by a NORC Center grant No. 2P30DK072476 entitled “Nutritional Programming: Environmental and Molecular Interactions” sponsored by NIDDK. This work was supported in part by P50AT002776 from the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Dietary Supplements (ODS) of the National Institutes of Health which funds the Botanical Dietary Supplements Research Center of Pennington Biomedical Research Center and the Department of Plant Biology and Pathology in the School of Environmental and Biological Sciences (SEBS) of Rutgers University. Supported in part by 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health which funds the Louisiana Clinical and Translational Science Center.

The authors have no conflicts of interest to declare.

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