Li Xinyi, Shi Zhenhao, Byanyima Juliana, Morgan Peter T, van der Veen Jan-Willem, Zhang Rui, Deneke Erin, Wang Gene-Jack, Volkow Nora D, Wiers Corinde E
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
Department of Psychiatry, Yale University, New Haven, CT, 06519, USA.
Drug Alcohol Depend Rep. 2022 Dec;5. doi: 10.1016/j.dadr.2022.100092. Epub 2022 Sep 8.
We previously showed that ketogenic diet (KD) was effective in curbing alcohol withdrawal and craving in individuals with alcohol use disorder (AUD). We hypothesized that the clinical benefits were due to improvements in sleep. To test this, we performed a secondary analysis on the KD trial data to (1) examine the effects of KD on total sleep time (TST) and sleep quality and (2) investigate the association between KD-induced alterations in cingulate glutamate concentration and changes in TST and sleep quality.
AUD individuals undergoing alcohol detoxification were randomized to receive KD (n=19) or standard American diet (SA; n=14) for three weeks. TST was measured weekly by self-report, GENEActive sleep accelerometer, and X4 Sleep Profiler ambulatory device. Sleep quality was assessed using subjectively ratings of sleep depth and restedness and Sleep Profiler (Sleep Efficiency [%]). Weekly H magnetic resonance spectroscopy scans measured cingulate glutamate levels.
TST was lower in KD than SA and increased with effect of time. Sleep depth, restedness, and Sleep Efficiency improved with time, but exhibited no effect of diet. In KD and SA combined, week 1 cingulate glutamate levels correlated positively with Sleep Efficiency, but not with TST.
Although cingulate glutamate levels correlated positively with Sleep Efficiency in week 1, KD-induced glutamate elevation did not produce significant sleep improvements. Rather, KD was associated with lower TST than SA. Given the well-established associations between sleep and alcohol relapse, longer follow up assessment of KD's impact on sleep in AUD is warranted.
我们之前表明，生酮饮食（KD）在抑制酒精使用障碍（AUD）患者的酒精戒断和渴望方面有效。我们假设临床益处归因于睡眠改善。为了验证这一点，我们对KD试验数据进行了二次分析，以（1）检查KD对总睡眠时间（TST）和睡眠质量的影响，以及（2）研究KD引起的扣带回谷氨酸浓度变化与TST和睡眠质量变化之间的关联。
正在进行酒精解毒的AUD患者被随机分为接受KD（n = 19）或标准美国饮食（SA；n = 14），为期三周。每周通过自我报告、GENEActive睡眠加速度计和X4睡眠剖析动态设备测量TST。使用对睡眠深度和休息程度的主观评分以及睡眠剖析仪（睡眠效率[％]）评估睡眠质量。每周进行1H磁共振波谱扫描测量扣带回谷氨酸水平。
KD组的TST低于SA组，且随时间推移而增加。睡眠深度、休息程度和睡眠效率随时间改善，但未表现出饮食的影响。在KD组和SA组合并分析中，第1周扣带回谷氨酸水平与睡眠效率呈正相关，但与TST无关。
虽然第1周扣带回谷氨酸水平与睡眠效率呈正相关，但KD诱导的谷氨酸升高并未带来显著的睡眠改善。相反，与SA相比，KD与较低的TST相关。鉴于睡眠与酒精复发之间已确立的关联，有必要对KD对AUD患者睡眠的影响进行更长时间的随访评估。
