High-altitude sleep disturbance (HASD), a common physiological disorder caused by hypobaric hypoxia, clinically manifests as insomnia, sleep apnea, and sleep fragmentation. Its pathogenesis involves hypoxia-inducible factor activation, oxidative stress, and neuroendocrine dysregulation, with severe cases potentially leading to irreversible neurological damage. The gut-brain axis, a bidirectional communication network between the central nervous system and the gastrointestinal tract, plays a key role in HASD progression. Gut microbiota, as a critical interface between intestinal and cerebral functions, may modulate sleep disorders through neurotransmitter regulation, short-chain fatty acid production, and hormonal pathway modulation. Traditional Chinese medicine (TCM) and traditional Tibetan medicine (TTM) offer unique therapeutic advantages for HASD management. TCM theory suggests that “gastric imbalance disrupts sleep”, while TTM attributes insomnia to “tri-humoral dysregulation”. Both systems align with the modern gut-brain axis theory, emphasizing sleep quality improvement through spleen-stomach system regulation. This study examines the theoretical foundations of TCM and TTM for preventing and treating HASD, summarizing relevant classical prescriptions, monomeric drugs, active ingredients, and novel formulations. Additionally, it explores the pharmacological mechanisms by which TCM and TTM improve HASD by regulating the gut-brain axis, providing safe and effective strategies for individuals entering high-altitude regions.

high-altitude sleep disturbance  /  brain-gut axis  /  gut microbiota  /  traditional Chinese medicine  /  Tibetan medicine