生酮饮食对复发性多发性硬化症患者睡眠质量的影响

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2024-08-28 DOI:10.1016/j.sleep.2024.08.020

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引用次数: 0

摘要

背景多发性硬化症患者的睡眠障碍很常见，会严重影响整体生活质量。方法45名复发性多发性硬化症患者参加了为期6个月的生酮饮食干预试验，并在开始饮食前和饮食期间使用埃普沃思嗜睡量表（ESS）和睡眠障碍症状检查表-25（SDS）完成了自我报告的睡眠质量和睡眠障碍症状评估。未完成基线和 6 个月睡眠评估的参与者不在分析之列。除睡眠指标外，数据收集还包括人体测量和多发性硬化症相关疲劳评分。结果45名参与者中有39名（87%）完成了规定的睡眠评估。ESS 评分平均降低了 1.90（95 % CI [-2.85, -0.94]，p < 0.001）。服用 KD 6 个月后，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）有所改善。结论KD可改善复发性多发性硬化症患者的白天嗜睡，与睡眠持续时间和常见合并睡眠障碍无关。本文的研究结果支持KD对睡眠质量的益处，并强调了饮食疗法对神经系统疾病睡眠障碍的潜在作用。试验注册信息在Clinicaltrials.gov上注册，注册号为NCT03718247，发布日期为2018年10月24日。首批患者入组日期：2018年11月1日。链接：https://clinicaltrials.gov/ct2/show/NCT03718247?term=NCT03718247&draw=2&rank=1。

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Impact of a ketogenic diet on sleep quality in people with relapsing multiple sclerosis

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Trial registration information

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.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.