… Adding to the research on insomnia
Commentary by Don Maisch July 11, 2023
As reported by the ABC on 28 June 2023, the Sleep Disorders Centre at Brisbane’s Prince Charles Hospital, in conjunction with the Sunshine Coast-based biopharmaceutical company Servatus, is running a clinical trial on the possibility that the human gut could hold a cure for insomnia. Such an investigation is warranted and is supported by related research that finds this is a much needed area of study. In a research paper by Wang, et al, (2022) Multiomics Analysis Reveals Aberrant Metabolism and Immunity Linked Gut Microbiota with Insomnia, published in Microbiology Spectrum, the authors reviewed the relevant literature and confirmed that insomnia is related to gut microbiota and that immunity and metabolism are also associated with insomnia. From the paper’s abstract:
Studies have confirmed that insomnia is related to gut microbiota. Previous research suggests that immunity and metabolism are also associated with insomnia. However, to our knowledge, the integration of these factors has not been investigated in insomnia. Here, we explored the correlations across gut microbiota, serum metabolism, and inflammatory factors in insomnia. Our results showed that the composition and structure of gut microbiota and metabolism in insomnia patients were different from healthy controls. Compared to healthy controls, the relative abundances of Lactobacillus, Streptococcus, and Lactobacillus crispatus were significantly increased in insomniacs. There were five metabolic pathways in insomniacs (glycerophospholipid metabolism; glutathione metabolism; nitrogen metabolism; alanine, aspartate, and glutamate metabolism; aminoacyl-tRNA biosynthesis) significantly different between the two groups. Moreover, we found that IL-1β levels were significantly higher in insomnia patients while TNF-α was significantly reduced. We further identified that the changes in the level of IL-1β and TNF-α were associated with some specific bacteria and metabolites, such as Prevotella amnii, Prevotella buccalis, Prevotella timonensis, and Prevotella colorans. Mediation analysis further determined that the immune factors and metabolites could mediate the relationship between gut microbes and insomnia.
The Sleep Disorder Centre’s clinical trial is certainly timely, considering a 2021 report by the Sleep Health Foundation that more than half of Australians regularly experience disturbed sleep with 14% of the Australian population suffering from chronic insomnia. This is over 3.6 million sufferers and thus constitutes a significant public health issue.
The clinical study is trialing the introduction of a combination of live, beneficial bacteria strains to the gut in a group of 50 participants with chronic insomnia. Dr. Deanne Curtin, director of the Sleep Disorders Centre reported in the ABC article that the initial results were very promising with some improvement in sleep quality and quantity of sleep with the use of the live biotherapeutic agents.
Clinical psychologist Amber Rattray, also interviewed by the ABC, said that insomnia can be triggered by a range of psychological factors and that cognitive behaviour therapy was still the “gold standard” in the treatment for insomnia. Rattray emphasized the importance of focusing on sleep hygiene, meaning limiting napping, establishing a routine around the time we go to sleep and using relaxation strategies to calm ourselves to get to sleep. Ms Rattray also mentioned the importance of “shifting negative sleep thoughts towards positive sleep thoughts and reducing anxiety about sleep, so we can actually get to sleep”.
While Dr Curtain said that the best evidence for treatment of insomnia was psychological, this study is looking for “an effective, safe agent that’s non-traditional pharmaceutical that could be used in conjunction with psychology”. The clinical trial will be expanded in the coming months to test different dosage levels with a larger cohort of patients. 
Possible other factors not yet considered
While the subject matter of the Queensland study is both valid and important it does not include a consideration of the possible role of external environmental factors that may adversely impact upon a person’s gut microbiome or sleep quality. This restriction could lead to conclusions of limited value if there are other unknown factors at play. If this were found to be the case, any conclusions about changing the gut microbiome (or improving psychological thought patterns as an effective treatment for insomnia) may be missing an important factor. For example, an intriguing possiblity is that an imbalance of the gut microbiome diversity can be caused by chronic exposure to non-ionizing electromagnetic energy (EME). To quote from a 2022 conference abstract on this topic:
The relationship between bowel diseases, microbial flora stability and electromagnetic fields becomes thus an appealing avenue of study for better research on the cause of electromagnetic hypersensitivity, particularly when considering the increasing introduction of high-energy mobile networks (5G) and the ubiquitous continuous use of Wi-Fi in homes and offices. Thus, the composition of the bacteria in the gut may be altered sufficiently by exposure to Wi-Fi or high energy mobile networks resulting in adverse effects in the bowel chemistry, yielding many of the emerging pathologies that have been seen in the Western world in the last 20 years (i.e. gluten intolerance, sleep disorders, psychological problems and depression)
In order to test the above hypothesis a recent in vivo study by Saliev, et al., investigated the effect of Wi-Fi radiation (radio frequency) on the gut microbiome of rats. The findings indicated the ability of Wi-Fi radiation to modulate the activity of gut micro-organisms that might affect the health status long term. If EME exposure was found to be a possible factor in some of the study subjects then simply changing their gut microbiota may not be a long-term solution unless the exposure source is also eliminated as that would continue to have an ongoing effect on the gut microbiota and on the patient’s health, such as insomnia. A tricky question remains however; does insomnia cause the changes in gut bacteria or vice versa?
However caution is called for here as the two above-mentioned papers are not yet peer reviewed and it is not known if the bacteria they used are the same types used in the insomnia study so this could be a avenue for future research.
Another possible factor is the evidence that artificial light at night, especially blue light which improves attention, reaction times, and mood and is beneficial during the day, can at night interfere with the onset of the circadian rhythm and adversely affect sleep. The Harvard Medical School has written about the problem with many modern appliances and electrical items that now emit light in the blue spectrum and the adverse effects of this light on the production of melatonin.  This raises the question, of how many of the study participants are using such items during the evening hours, such as spending time nightly in front of a computer screen or laptop computer in bed or spending extended time looking at the screen of a smart phone? Unfortunately it does get a bit complicated as research has found that over the past decade the night sky has become nearly 10 percent brighter because of the increasing use of high powered LED lights used externally in street lighting, illuminated billboards and stadium lights, all of which emit higher levels of light in the blue spectrum. Add to that the wide spread use of LED light bulbs in homes and workplaces as the old less energy efficient incandescent globes are no longer available. The possible influencing factor of extended blue light exposure with participants should be determined at the start of such a study. If it is present for any study participants then gut microbiota treatments and/or any psychological attempts to shift negative sleep thoughts may well be missing a significant contributing factor for their insomnia.
Examples of electromagnetic energy (EME) as a factor in some cases of insomnia
1) The Ross House Electrical Substation
First to consider is a Victorian Workcare compensation case (1991-92) that investigated a number of female office workers who suffered fatigue symptoms (later termed Chronic Fatigue Syndrome (CFS). The investigation found an apparent connection between their symptoms and their exposure to excessive power frequency electromagnetic field (EMF) emissions from a major electrical substation located immediately under the floor of their workplace.. Average building exposure levels are in the range of 0.5 to 2.0 milliGauss (mG). By comparison, measurements at the workplace were 90-100 mG at floor level immediately above the substation with an average of 17 mG in the work area.
From the Workcare employee interviews
Employee 1: Chronic tiredness/fatigue, insomnia, stress, inability to concentrate, fluctuating hormone levels, anaemia, facial rash, depression, severe premenstrual syndrome (PMS), viral complaints.
Employee 2: Constant tiredness, listlessness, lightheadedness, insomnia, depression, severe PMS, a “permanent severe case of “jet lag” .
Employee 3: Listlessness, headaches, trouble sleeping, washed out, diminished ability to cope, couldn’t concentrate, viral infections.
Employee 4: Headaches, listlessness, an inability to concentrate, a washed out feeling, prone to any virus that was about, inability to cope with the overall work environment.
When the women stopped working in that office, virtually all of the symptoms ended.
2) Transmission line Research from the Claude Huriez Hospital in Lille France
French research by Hachulla et al. from the Claude Huriez Hospital in Lille France, found an unusual blood condition they termed pseudo iron deficiency in populations living within 100 meters of 400-kV transmission lines and exposed to 2 mG or more. The researchers concluded that populations living in households less than 100m from high-tension lines may be susceptible to “organic health modifications”. Reported symptoms in the exposed population were: chronic fatigue, headaches, insomnia (especially in children), hypertension, anxiety, depression, nausea, dizziness and vision problems. Symptoms disappeared when residents spent time away from their homes (and exposure). It was noted that the children’s insomnia would disappear when the power (and magnetic fields) were lower than usual and return when the power got back to full load. At full load the children often could not sleep at all and often were sent to relatives’ homes, where they could sleep normally  Similar symptoms were also found in a 2008 community survey by the French organisation Criirem. Sleep disturbance, memory problems, headaches, irritability and depression were significantly more frequent amongst those living close to two transmission lines than in those living further away.
3) Study on Health Effects of the Shortwave Transmitter Station of Schwarzenburg, Berne, Switzerland (Major Report)
In 1939, a short-wave RF transmitter was installed at Schwarzenburg, near Berne. Another antenna was added in 1954 with three 150 kW outputs (6.1-21.8 MHz) and a 250-kW antenna was added in 1971. Health complaints associated with this activity have been reported by the population in the surroundings of the transmitter since the seventies. In March 1990 a petition seeking scientific evaluation of the health damage allegedly caused by the transmitter was handed to the Swiss Federal Department of Traffic and Energy (SFDTE). In October 1990, the Head of SFDTE commissioned a study. In August 1995 the study reported significant changes in various indicators, increasing with proximity to the mast and significantly worse in elderly people. Symptoms included increased nervousness, restlessness, difficulty in falling asleep and maintaining sleep, general weakness, tiredness and joint pains. The conclusion was:
“Insomnias and joint pains, especially in the elderly, were more frequently reported in Zone A than in Zones B and C (decreasing exposures with increased distance). They showed a dose-response relationship with the logistic regression and they were not related to a health-worry personality. Further studies are of need to establish a biophysical mechanism…. “Our results indicate a higher frequency of disorders of a neurovegetative nature among residents up to about 1000 m from the transmitter, and are highly suggestive of a direct effect of the radio shortwave transmitter on sleep quality. The other complaints appear to be mediated by the sleep disorder”.
4) Symptom Development from Exposure to Radiofrequency Fields of Wireless Smart Meters in Victoria, Australia: A Case Series (Frederica Lamech)
A case series study documented the frequently-reported symptoms of 92 people after installation of wireless (900 MHz) smart meters in close proximity to bedrooms. Symptoms were insomnia, headaches, tinnitus, fatigue, cognitive disturbances, dysesthesias (abnormal sensation), and dizziness. Lamech concluded that smart meter radiofrequency emissions “may have unique characteristics that lower people’s threshold for symptom development”.
These “unique characteristics” may be related to the frequent RF pulsing emitted by the wireless smart meters, where over a 24-hour period up to 190,000 brief but frequent transmission pulses can occur.,  The question thus arises, in situations where a sleeper is in close proximity to a transmitting smart meter and constantly exposed to these pulsing emissions what would be the effect be on sleep quality? The Lamech case series suggest that this may be an external factor having a detrimental effect on sleep quality. In order to test whether or not smart meter RF pulsing was a factor with the smart meter network in the Melbourne area, where many of the Lamech case studies were located, a survey was conducted on a typical surburban house and the findings confirmed this to be the case. Additional measurements taken in several Melbourne suburbs confirmed that the RF pulsing seemed to be an integral part of the electrical supply communications network.
5) Reducing the level of 50 Hz Magnetic Fields Lessens Symptoms of Chronic Fatigue and Improves Sleep (2nd International Workshop on the Biological effects of Electromagnetic fields – Poster presentation)
The findings of an Australian study that examined the residential mains power frequency EMF exposures in a group of 49 subjects being treated for symptoms of ongoing chronic fatigue identified an adverse effect on sleep quality. According to the workshop abstract:
Research suggests that people exposed to 50 Hz magnetic fields (MFs) may show symptoms of chronic fatigue (CF) 1. We studied 49 subjects suffering from CF and CFS (Chronic Fatigue Syndrome) who were exposed to mains frequency Magnetic Fields in their homes. Some highly exposed subjects (>2 mG) were given advice on how to reduce their exposure levels. Those exposed to <2 mG were given no such advice. After 6 months, 64% of those in the high exposure group but only 12% in the low exposure group reported improved sleep quality. It is proposed that the sleep quality changes were due to a reduction in the effects of Magnetic Fields on melatonin secretion, a hormone known to be involved in the timing and quality of sleep., 
The current insomnia clinical trial being conducted by the Sleep Disorders Centre at Brisbane’s Prince Charles Hospital may likely come up with improved modalities for the treatment of insomnia. However, the above research and findings briefly examined in this paper suggest that a ‘wider net’ should be cast in order to catch other factors that may play a causative or promotional role in the debilitating condition of insomnia. In order to cast this ‘wider net’ an examination of the electromagnetic energy (EME) environment in the living areas and especially the bedrooms of study participants would be advisable. This would include but not necessarily be limited to: proximity to electrical devices, such as meter boxes, bedside clock radios, cordless DECT phones by the bedhead, electric blankets left on at night, appliance auto-transformers plugged in close to the bedhead, etc. The use of electronic screens (smart phones and computers) in the evenings and at night by the study participants should be an important consideration as well as extended exposure to blue light.
An Australian chronic fatigue syndrome clinical study  conducted in 2002 included many of the factors identified above, with the valuation of home and workplace EME exposures and other external environmental factors considered an essential part of the study. In the opinion of this writer this should also be an important consideration for the gut microbiome insomnia study as these additional external possible factors may act as confounders to the study findings unless identified and addressed.
 Wang Q., et al, Multiomics Analysis Reveals Aberrant Metabolism and Immunity Linked Gut Microbiota with Insomnia, ASM Journals, Microbiology Spectrum, Vol. 10, No. 5, Oct. 3, 2022
 Ross J., “Gut microbiome targeted by insomnia treatment clinical trials in Queensland”, ABC News, June 28, 2023. https://www.abc.net.au/news/2023-06-28/gut-microbiome-servatus-insomnia-treatment-clinical-trials/102504174
 Manzetti S., “On the potential cause of electromagnetic field hypersensitivity: a connection to the gut microbiome”, Fjordforsk Abstracts Conference 2022 – Sogn og Fjordane, Norway, Sept. 2022. https://www.researchgate.net/publication/363800745_On_the_potential_underlying_cause_of_electromagnetic_field_hypersensitivity_a_connection_to_the_gut_microbiome
Saliev T., et al., “An impact of Wi-Fi irradiation on the gut microbiome of rats”, preliminary report, Research Square, https://www.researchsquare.com/article/rs-2673000/v1
 Harvard Health Publishing, Harvard Medical School, “Blue light has a dark side”. July 7, 2020, https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side .
 Kasha P., Kati P., Wolfe D., Sabens E., “LED lights are meant to save energy. They’re creating glaring problems”, The Washington Post, June 23, 2023, https://www.washingtonpost.com/climate-environment/interactive/2023/glaring-problem-how-led-lights-worsen-light-pollution/?location=alert
 Workcare compensation case, Melbourne Victoria, 1991-1992. “Workplace Chronic Fatigue Syndrome (CFS) symptoms attributed to exposure to electromagnetic fields (EMF) due to close proximity to an electrical substation”,https://www.emfacts.com/download/The_Ross_House_Electrical_Substation.pdf
 Hachulla E., et al, Pseudo-iron deficiency in a French population living near high-voltage transmission lines: a dilemma for clinicians. Eur J Int Med, 11(6):341-355, 2000, https://www.ejinme.com/article/S0953-6205(00)00114-X/fulltext
 Associated Press, “The high voltage power lines are a “problem for health”, acknowledges NKM”. Mar. 21, 2008, https://www.emfacts.com/2008/03/871-french-admission-that-powerlines-are-a-problem-for-health/
 Altpeter E, ., Krebs T, Pfluger D, von Kanel J. Blattmann R., et al., 1995: “Study of health effects of Shortwave Transmitter Station of Schwarzenburg, Berne, Switzerland”. University of Berne, Institute for Social and Preventative Medicine, August 1995
 Lamech F., Self-reporting of symptom development from exposure to radiofrequency fields of wireless smart meters in Victoria, Australia: a case series, Altern Ther Health Med, 20(6):28-39, 2014. https://pubmed.ncbi.nlm.nih.gov/25478801/
 Richard Tell Associates, “An Evaluation of Radio Frequency Fields Produced by Smart Meters Deployed in Vermont” http://publicservice.vermont.gov/sites/psd/files/Topics/Electric/Smart_Grid/Vermont%20DPS%20Smart%20Meter%20Measurement%20Report%20-%20Final.pdf
 Podd J., Maisch D., Reducing the level of 50 Hz Magnetic Fields Lessens Symptoms of Chronic Fatigue and Improves Sleep (2nd International Workshop on the Biological effects of Electromagnetic fields) 2002.
 Maisch, D, Rapley B., Podd J, “Changes in Health Status in a Group of CFS and CF Patients Following Removal of Excessive 50 Hz Magnetic Field Exposure”, JACNEM 21 :15-19, 2002.
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