Ketogenic diet improves sleep quality in children with therapy-resistant epilepsy
Ketogenic diet improves sleep quality in children with therapy-resistant epilepsy
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DOI：
10.1111/j.1528-1167.2006.00834.x
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发表时间：
2007-01-01
期刊：
影响因子：
5.6
通讯作者：
Rosen, Ingmar
中科院分区：
文献类型：
--
作者：
Hallbook, Tove;Lundgren, Johan;Rosen, Ingmar
目的：本研究的目的是评估生酮饮食（KD）治疗儿童难治性癫痫的睡眠结构，并与可能的改变癫痫发作减少，癫痫发作的严重程度，生活质量（QOL），和behavior.Methods：18名儿童进行了检查，最初和3个月后的KD治疗动态多导睡眠图记录的临床效果的变化。11名儿童继续KD，并在12个月后进行了评估。估计睡眠参数。发作频率记录在日记中，发作严重程度记录在国家健康发作严重程度量表（NHS 3）中。采用视觉模拟量表评估QOL。结果：川崎病患儿总睡眠时间（p = 0.05）和夜间总睡眠时间（p = 0.006）均显著减少;慢波睡眠得以保留，快速眼动（REM）睡眠增加（p = 0.01），睡眠阶段2减少（p = 0.004），睡眠阶段1不变。11名儿童继续KD，并在12个月后进行了评估。他们显示白天睡眠显著减少（p = 0.01），REM睡眠进一步增加（p = 0.06）。在3个月和12个月时，癫痫发作频率（p = 0.001，p = 0.003）、癫痫发作严重程度（p <0.001，p = 0.005）和QOL（p < 0.001，p = 0.005）均显著改善。注意力行为也得到改善，在3个月时显著改善（p = 0.003）。有一个显着的相关性增加REM睡眠和改善QOL（斯皮尔曼r = 0.6，p = 0.01）在3 months.Conclusion：KD减少睡眠，改善睡眠质量的儿童难治性癫痫。睡眠质量的改善，随着REM睡眠的增加，似乎有助于生活质量的改善。
Purpose: The study purpose was to evaluate sleep structure during ketogenic diet (KD) treatment in children with therapy-resistant epilepsy and to correlate possible alterations with changes in clinical effects on seizure reduction, seizure severity, quality of life (QOL), and behavior.Methods: Eighteen children were examined with ambulatory polysomnographic recordings initially and after 3 months of KD treatment. Eleven children continued with the KD and were also evaluated after 12 months. Sleep parameters were estimated. Seizure frequency was recorded in a diary and seizure severity in the National Health Seizure Severity Scale (NHS3). QOL was assessed with a visual analogue scale. Child behavior checklist and Ponsford and Kinsella's rating scale of attentional behavior were used.Results: KD induced a significant decrease in total sleep (p = 0.05) and total night sleep (p = 0.006). Slow wave sleep was preserved, rapid eye movement (REM) sleep increased (p = 0.01), sleep stage 2 decreased (p = 0.004), and sleep stage 1 was unchanged. Eleven children continued with the KD and were also evaluated after 12 months. They showed a significant decrease in daytime sleep (p = 0.01) and a further increase in REM sleep (p = 0.06). Seizure frequency (p = 0.001, p = 0.003), seizure severity (p < 0.001, p = 0.005) and QOL (p < 0.001, p = 0.005) were significantly improved at 3 and 12 months. Attentional behavior was also improved, significantly so at 3 months (p = 0.003). There was a significant correlation between increased REM sleep and improvement in QOL (Spearman r = 0.6, p = 0.01) at 3 months.Conclusion: KD decreases sleep and improves sleep quality in children with therapy-resistant epilepsy. The improvement in sleep quality, with increased REM sleep, seems to contribute to the improvement in QOL.