ArticleCureus2026
Beyond the Gut: A Case Report of Antibiotic-Induced Dysbiosis as a Hidden Cause of Chronic Insomnia.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Insomnia is a common sleep disorder that affects many adults on a long-term or intermittent basis. While conventional management includes pharmacotherapy and cognitive behavioral therapy, emerging evidence highlights the gut microbiome as a critical regulator of sleep via the microbiome-gut-brain axis. Prolonged antibiotic exposure can lead to an alteration or imbalance in the structure, composition, and function of the gut microbial community, known as gut dysbiosis. Gut dysbiosis may disrupt neurotransmitter synthesis and circadian rhythm, contributing to refractory insomnia. We report a 40-year-old man with early T-cell precursor acute lymphoblastic leukemia who underwent induction chemotherapy and allogeneic stem cell transplantation. Over two years, he received multiple prolonged antibiotic courses for infectious complications, resulting in significant cumulative exposure. Several months later, he developed severe insomnia, unresponsive to melatonin, mirtazapine, CBT-I, and multiple hypnotics, including zolpidem and lemborexant. Actigraphy revealed sleep latency of 90 minutes, total sleep time <4 hours, and sleep efficiency of 50-55%. Integrative evaluation demonstrated marked gut dysbiosis (low Firmicutes/Bacteroidetes ratio, overgrowth of Streptococcus, Klebsiella, Fusobacterium) and multiple micronutrient deficiencies. Targeted interventions, multistrain probiotics, fermented foods, high-fiber diet, and amino acid/vitamin supplementation, led to progressive improvement. At six months, the patient achieved restorative sleep without pharmacologic support, alongside improved mood, appetite, and functional status. This case underscores the potential role of antibiotic-induced dysbiosis in chronic insomnia through disruption of microbial metabolites (short-chain fatty acids) and neurotransmitter pathways. Restoration of gut health may modulate circadian rhythm and sleep architecture, offering a novel adjunctive strategy for refractory insomnia. Clinicians should consider gut microbiome assessment in persistent insomnia, particularly in patients with extensive antibiotic exposure. Further research is warranted to elucidate mechanisms and validate microbiome-targeted therapies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.