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NAD+ precursors (nicotinamide riboside and nicotinamide mononucleotide) and sleep quality: grade C

Limited evidence. Direction: No effect.

C LimitedSubjective outcome only

Educational guidance, not medical advice

Why this grade

Rubric condition met: One industry-run positive RCT, one RCT without a reported NMN-specific effect, and a network meta-analysis whose abstract reports no improvement

In 60 older adults, 250 mg/day of NMN for 12 weeks lowered global PSQI scores compared with placebo in a trial run by researchers employed by Meiji Holdings. In 108 older Japanese adults, the abstract reports group interactions only for the sit-to-stand test and drowsiness, not for PSQI. The 2026 network meta-analysis abstract reports that no precursor significantly improved sleep quality, though its full text says sleep was excluded from the network analysis for lack of connectivity. The evidence is limited and mixed.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)202020252030Meta-analysisRCTGao 2026, 2026: meta-analysis, n = 1,599, result not recordedKim 2022, 2022: RCT, n = 108, result not recordedMorifuji 2024, 2024: RCT, n = 60, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Kim 20222022RCT108result not recorded
Morifuji 20242024RCT60result not recorded
Gao 20262026meta-analysis1599result not recorded

Ingestion of β-nicotinamide mononucleotide increased blood NAD levels, maintained walking speed, and improved sleep quality in older adults in a double-blind randomized, placebo-controlled study.

Morifuji M, Higashi S, Ebihara S. Ingestion of β-nicotinamide mononucleotide increased blood NAD levels, maintained walking speed, and improved sleep quality in older adults in a double-blind randomized, placebo-controlled study Geroscience, 2024. PMID 38789831

Result not recorded
Design
Randomized, placebo-controlled, double-blind, parallel-group trial, 12 weeks
Sample
n = 60
Population
Older adults
Funding
not stated in the PubMed or Crossref record; authors employed by Meiji Holdings

Effect of 12-Week Intake of Nicotinamide Mononucleotide on Sleep Quality, Fatigue, and Physical Performance in Older Japanese Adults: A Randomized, Double-Blind Placebo-Controlled Study.

Kim M, Seol J, Sato T. Effect of 12-Week Intake of Nicotinamide Mononucleotide on Sleep Quality, Fatigue, and Physical Performance in Older Japanese Adults: A Randomized, Double-Blind Placebo-Controlled Study Nutrients, 2022. PMID 35215405

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial, 12 weeks, four groups
Sample
n = 108
Population
Older Japanese adults
Funding
not stated in the PubMed or Crossref record; full text not read

Domain-specific effects of NAD(+) precursors on fatigue and functional performance: a systematic review and network meta-analysis.

Gao Y, Li S, Guan J. Domain-specific effects of NAD(+) precursors on fatigue and functional performance: a systematic review and network meta-analysis Front Nutr, 2026. PMID 42774067

Result not recorded
Design
Systematic review and network meta-analysis of 25 RCTs and 2 quasi-experimental studies
Sample
n = 1,599
Population
Adults, including clinical cohorts (NR, NMN, NADH and nicotinamide)
Funding
not stated in the PubMed or Crossref record (authors declare no commercial or financial relationships)

Search and history

Search (): (nicotinamide mononucleotide[tiab] OR nicotinamide riboside[tiab]) AND (fatigue[tiab] OR sleep[tiab] OR cognitive[tiab] OR cognition[tiab]) AND clinical trial[pt]

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page