Dept of Neurology, University of Virginia, Charlottesville VA, USA.
Dept of Neurology, University of Virginia, Charlottesville VA, USA; School of Medicine, Medical University of South Carolina, Charleston SC, USA.
Sleep Med. 2024 Oct;122:213-220. doi: 10.1016/j.sleep.2024.08.020. Epub 2024 Aug 28.
Sleep disturbance in MS is common and can significantly impair overall quality of life. The ketogenic diet (KD) associates with improved sleep quality in people living with epilepsy and may have similar benefits when used within MS; however, the impact of a KD on sleep in this population remains poorly defined.
Forty-five patients with relapsing MS enrolled into a 6-month KD intervention trial and completed self-reported assessments of sleep quality and sleep disorder symptoms prior to diet initiation and while on diet, using the Epworth Sleepiness Scale (ESS) and Sleep Disorders Symptom Checklist-25 (SDS). Participants who did not complete sleep assessments at baseline and 6-months were excluded from analysis. In addition to sleep metrics, data collection included anthropometrics and MS-related fatigue scores.
Thirty-nine of 45 (87 %) participants completed the required sleep assessments. There was a mean reduction in ESS score of 1.90 (95 % CI [-2.85, -0.94], p < 0.001). Total SDS score decreased at 6-months on KD (-4.4, 95 % CI [-7.1, -1.7], p = 0.002), with improvements noted in insomnia (-1.55, 95 % CI [-2.66, -0.43], p = 0.008), obstructive sleep apnea (-0.91, 95 % CI [-1.57, -0.25], p = 0.008), and restless leg syndrome screening scores (-1.00, 95 % CI [-1.95, -0.051], p = 0.04). Sleep duration was unchanged on KD.
KD associates with improvements in daytime sleepiness, independent of sleep duration, and common comorbid sleep disorders in people living with relapsing MS. The findings herein support the benefits of KD on sleep quality and highlight the potential role of dietary therapeutics for sleep disorders in neurological disease.
Registered on Clinicaltrials.gov under registration number NCT03718247, posted on Oct 24, 2018. First patient enrollment date: Nov 1, 2018. Link: https://clinicaltrials.gov/ct2/show/NCT03718247?term=NCT03718247&draw=2&rank=1.
多发性硬化症（MS）患者常出现睡眠障碍，这会显著降低整体生活质量。生酮饮食（KD）可改善癫痫患者的睡眠质量，在 MS 患者中使用可能也具有类似的益处；然而，KD 对该人群睡眠的影响仍未得到明确界定。
45 名复发性 MS 患者参与了一项为期 6 个月的 KD 干预试验，并在开始饮食前和饮食期间使用 Epworth 嗜睡量表（ESS）和睡眠障碍症状检查表-25（SDS）自我报告评估睡眠质量和睡眠障碍症状。未在基线和 6 个月时完成睡眠评估的参与者被排除在分析之外。除了睡眠指标外，数据收集还包括人体测量学和 MS 相关疲劳评分。
45 名参与者中有 39 名（87%）完成了所需的睡眠评估。ESS 评分平均降低了 1.90（95%CI[-2.85，-0.94]，p<0.001）。KD 治疗 6 个月时，SDS 总分下降（-4.4，95%CI[-7.1，-1.7]，p=0.002），失眠（-1.55，95%CI[-2.66，-0.43]，p=0.008）、阻塞性睡眠呼吸暂停（-0.91，95%CI[-1.57，-0.25]，p=0.008）和不安腿综合征筛查评分（-1.00，95%CI[-1.95，-0.051]，p=0.04）均有所改善。KD 治疗期间睡眠持续时间无变化。
KD 与复发性 MS 患者日间嗜睡的改善相关，与睡眠持续时间无关，并且改善了常见的共患睡眠障碍。这些发现支持 KD 对睡眠质量的益处，并强调了饮食治疗在神经疾病中治疗睡眠障碍的潜在作用。
在美国临床试验注册中心注册，注册号为 NCT03718247，于 2018 年 10 月 24 日公布。首次患者入组日期：2018 年 11 月 1 日。链接：https://clinicaltrials.gov/ct2/show/NCT03718247?term=NCT03718247&draw=2&rank=1。
