Effect of lacticaseibacillus paracasei PS23 on anxiety and sleep difficulties among office workers: a double-blind, randomized controlled pilot trial.

BACKGROUND: Over the past decade, sleep disturbances and stress have markedly increased within the general population. Conditions such as insomnia and poor stress management are linked to a range of physical and psychological symptoms, including cardiovascular diseases, sleep disorders, depression, or anxiety. Recent studies have shown that heat-treated Lacticaseibacillus paracasei PS23 (PS23) can alleviate anxiety in clinical nurses experiencing high stress. However, the potential benefits of live PS23- particularly its effects on sleep quality, anxiety, and stress- remain unexplored. METHODS: This study recruited office workers aged 20-65 years who reported moderate to high levels of perceived stress. Participants in the intervention group received a daily dose of 20 billion colony-forming units of live PS23 for six weeks, while the control group received two placebo capsules containing microcrystalline cellulose powder. Outcomes were assessed at baseline and at the end of the trial, including measures of stress, anxiety, sleep quality, fatigue, activity levels, depression, and overall quality of life. Additionally, changes in salivary stress markers and antioxidant levels were evaluated. RESULTS: Of the 50 eligible participants initially enrolled, 45 completed the six-week trial with high compliance (> 80%), including 24 in the PS23 group and 21 in the placebo group. Compared to the placebo group, the PS23 group showed statistically significant improvements in overall insomnia symptoms (group × time interaction, p = 0.011), sleep latency (p = 0.045), sleep maintenance (p = 0.002), and trait anxiety levels (group × time interaction, p = 0.044). CONCLUSION: This pilot randomized controlled trial suggests that live L. paracasei PS23 may offer meaningful improvements in sleep quality and anxiety reduction among office workers experiencing elevated stress levels. REGISTRATION: ClinicalTrials.gov Identifier: NCT05826704; registration date: 4/11/2023. Exploring the Effects of Lactobacillus paracasei PS23 on Workplace-related Stress Symptoms Among Office Workers; URL: https://clinicaltrials.gov/study/NCT05826704.