Journal
SLEEP MEDICINE
Volume 112, Issue -, Pages 181-187Publisher
ELSEVIER
DOI: 10.1016/j.sleep.2023.10.016
Keywords
Ketogenic diet; Multiple sclerosis; Sleep complaints; Poor sleep quality; Excessive daytime sleepiness; Psychological status; Quality of life
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This study found that the ketogenic diet (KD) may improve sleep complaints in patients with multiple sclerosis (MS) and have a positive impact on their psychological status and quality of life (QoL) through improving sleep quality.
Objective/background: Patients with multiple sclerosis (MS) frequently report sleep complaints. The ketogenic diet (KD) is safe and tolerable in MS patients. Our aim was: 1) to investigate the effects of KD on sleep complaints in patients affected by relapsing-remitting MS and 2) to verify if sleep changes can positively impact on psychological status and quality of life (QoL) in these patients. Patients/methods: From January 2020 to November 2022, we consecutively enrolled 21 non-disabled or minimally disabled MS patients. We collected information regarding: 1) anthropometric measures; 2) psychological status by the Depression Anxiety Stress Scale-21; 3) QoL by the Multiple Sclerosis Quality of Life-54 (MSQOL-54); 4) subjective sleep complaints, i.e. sleep quality, by the Pittsburgh Sleep Quality Index (PSQI), and excessive daytime sleepiness (EDS), by the Epworth Sleepiness Scale (ESS). Results: After 6 months of KD therapy, anthropometric measures considerably changed, psychological status significantly improved, and almost all the MSQOL-54 subscales ameliorated. Regarding sleep, we observed that the global PSQI (T0: 7.7 +/- 3.1 versus T1: 4.4 +/- 3.1, p = 0.002) and the ESS (T0: 7.5 +/- 3.9 versus T1: 4.9 +/- 3.2, p = 0.001) scores significantly decreased after KD therapy. At T1, only the global PSQI score was an independent predictor of anxiety, stress, and mental health. Conclusions: For the first time, we demonstrated that KD may improve sleep complaints in MS patients. In addition, KD seems to have a positive impact on psychological status and QoL of MS patients, mainly through improving sleep quality. Further controlled studies with larger sample sizes are needed to confirm these preliminary results.
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