Role and mechanism of gut microbiota and metabolites in schizophrenia complicated with sleep disorder

Sep 28, 2026

Uploaded by Fahsai

Schizophrenia (SCZ) is a major mental disorder with high disability, often accompanied by clinically significant sleep disorder (SD) featuring insomnia, sleep fragmentation, reduced slow-wave sleep, and circadian rhythm disturbance. This review summarizes evidence that gut microbiota and their metabolites may shape SCZ-SD comorbidity via the microbiota–gut–brain axis, influencing neurotransmitter metabolism and immune-inflammatory responses. It highlights characteristic microbiota diversity and sleep-related metabolomic features, proposes potential mechanisms, and discusses probiotic or metabolic interventions as future therapeutic directions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Introduction

The microbiota–gut–brain axis and SD in SCZ

Gut microbiota diversity and sleep-related metabolome

Potential mechanisms

Therapeutic implications and future directions

GUT MICROBES 2026, VOL. 18, NO. 1, 2607817 [https://doi.org/10.1080/19490976.2025.2607817](https://doi.org/10.1080/19490976.2025.2607817) REVIEW ARTICLE Role and mechanism of gut microbiota and metabolites in schizophrenia complicated with sleep disorder Ziqi Huanga, 1, Zixuan Huangb, 1, Zhiqiang Dub, Xuezheng Gaob, Ying Jiangb, Zhenhe Zhoua, b and Haohao Zhua, b aWuxi Mental Health Center, Wannan Medical College Graduate Training Unit, Wuxi, People's Republic of China; bAffiliated Mental Health Center of Jiangnan University, Wuxi, People's Republic of China ABSTRACT Schizophrenia (SCZ) is a major mental disorder with a high disability rate, and its pathogenesis involves the interaction of multiple factors such as genetics, environment, immunity, and neurodevelopment. Most SCZ patients are complicated with significant sleep disorder (SD), manifested as insomnia, sleep fragmentation, reduction in slowwave sleep, and circadian rhythm disturbance. This comorbidity not only aggravates the severity of psychiatric symptoms but also significantly impacts treatment adherence and long-term prognosis. In recent years, the role of gut microbiota and its metabolites in mental diseases has received increasing attention. Existing studies have shown that the gut microbiota regulates brain function through the microbiota–gut–brain axis, affects the metabolism of neurotransmitters and immune-inflammatory responses, and thus may play an important role in the occurrence and development of SCZ and SD. However, the specific mechanism is still not clear enough at present, and there are still deficiencies in relevant studies. This article reviews the characteristics of gut microbiota diversity and metabolome related to sleep in SCZ patients, explores the potential mechanism of the role of gut microbiota and its metabolites in SCZ complicated with SD, provides a new microbial-metabolic perspective for understanding the pathogenesis of SD in SCZ patients, and suggests the potential therapeutic value of improving sleep problems in SCZ patients through probiotic intervention or metabolic regulation. These findings not only deepen the understanding of the comorbidity mechanism of mental diseases and SD but also provide a theoretical basis for new intervention strategies based on the gut–brain axis. ARTICLE HISTORY Received 24 August 2025 Revised 11 November 2025 Accepted 17 December 2025 KEYWORDS Schizophrenia; sleep disorder; gut microbiota; metabolites; microbiota–gut–brain axis 1. Introduction Schizophrenia (SCZ) is a severe mental disorder characterized by positive symptoms such as delusions and hallucinations, negative symptoms like loss of motivation and social withdrawal, as well as cognitive symptoms including deficits in working memory and cognitive flexibility.1 In addition, the comorbidity of sleep disorder (SD) is extremely common in SCZ patients. These patients often experience difficulties falling asleep, sleep maintenance problems, disrupted sleep architecture, and circadian rhythm dysregulation, which severely impact their quality of life, social functioning, and long-term disease prognosis.2 Cross-sectional studies indicate that approximately four out of five individuals with psychosis suffer from at least one type of SD, with an average of 3.3 types of SD per patient. This deterioration in sleep quality can further exacerbate psychiatric symptoms, leading to more frequent paranoid ideation, hallucinatory experiences, thought disorganization, and higher levels of depression and anxiety.3 Studies have found that SCZ patients with impaired sleep quality and circadian rhythm disruption exhibit higher scores on the negative symptom dimension of clinical assessment scales and more pronounced cognitive dysfunction.4 Furthermore, not only does SD worsen the psychotic symptoms of SCZ, but the core symptoms of SCZ CONTACT Zhenhe Zhou [zhouzh@jiangnan.edu.cn](zhouzh@jiangnan.edu.cn) Wuxi Mental Health Center, Wan

FAQs

Why is sleep disorder so common and clinically important in schizophrenia?

Most patients with SCZ experience sleep disorder manifested as insomnia, fragmented sleep, reduced slow-wave sleep, and circadian rhythm disturbance. This worsens psychiatric symptom severity and affects treatment adherence and long-term prognosis.

How might gut microbiota influence schizophrenia complicated with sleep disorder?

Gut microbiota may regulate brain function through the microbiota–gut–brain axis, affecting neurotransmitter metabolism and immune-inflammatory responses. This may contribute to the occurrence and development of both SCZ and SD.

What approaches does the review suggest for potential treatment?

The review suggests improving sleep problems in SCZ patients through probiotic intervention or metabolic regulation aimed at modulating gut microbial activity and related metabolites.

Sep 28, 2026

Uploaded by Fahsai