Study Finds Ketogenic Diet and Exercise as Effective Primary Treatments for Narcolepsy

A ketogenic diet and regular physical exercise appear to be effective first-line treatments for narcolepsy, new research suggested.

Results of a randomized, controlled trial on the impact of physical exercise and a ketogenic diet on narcolepsy showed both exercise and the diet improved excessive daytime sleepiness (EDS) in narcolepsy type 1.

The results were presented at the Congress of the European Academy of Neurology (EAN) 2024.

Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and sudden, uncontrollable episodes of falling asleep during the day. It often includes symptoms like cataplexy (sudden loss of muscle tone), sleep paralysis, and hallucinations. The condition results from the brain's inability to regulate sleep-wake cycles properly.

In the study involving 60 adult patients with type 1 narcolepsy (NT1), participants were divided into three groups: regular physical activity, a ketogenic diet, and a control group for 10 weeks. Participants had a BMI > 20 and did not have severe cardiovascular disease or be on certain medications.

The primary outcome measured was excessive daytime sleepiness (EDS) using the Epworth Sleepiness Scale (ESS), with secondary outcomes including sleep quality, quality of life, well-being, cataplexy frequency, and fatigue.

The exercise group performed power walking and logged daily steps and training minutes. The ketogenic diet group received nutritional counselling and monitored ketone levels, weight, and waist circumference.

Results showed significant improvements in excessive daytime sleepiness and sleep quality in the exercise group. The ketogenic group also saw improvements in sleep quality, though not significantly, while the control group showed no changes. There were no adverse effects from the interventions.

“European guidelines on narcolepsy, particularly from patient feedback, emphasize the need for non-pharmacological treatments. However, specific recommendations on physical activity or nutrition are lacking. In the study, both physical activity and a ketogenic diet significantly improved excessive daytime sleepiness (EDS) to levels comparable with drug treatments. These interventions also reduced fatigue and enhanced both physical and mental quality of life. The ketogenic diet additionally resulted in significant weight loss. Both interventions are widely accessible, cost-effective, and showed no adverse effects,” said study investigator Frederike Tepel.

Reference: Frederike Tepel, Centre for Narcolepsy and Hypersomnia, Witten/Herdecke University, Witten, Germany; Ketogenic Diet, Exercise Effective First-line Treatments for Narcolepsy; Congress of the European Academy of Neurology (EAN) 2024