Cut the Carbs to Stay Awake
People with narcolepsy, a debilitating nervous-system disorder that causes excessive daytime sleepiness, may benefit from eating a low-carbohydrate diet, according to a study in Neurology (2004;62:2300–02).
People with narcolepsy may have “sleep attacks” that cause them to involuntarily fall asleep during activities. They may also have episodes of paralysis or muscle weakness (such as jaw drop, slurred speech, and buckling of the knees), paralysis while sleeping, and vivid dreams and sounds when they first fall asleep. Symptoms usually start between the ages of 15 and 30 years. While the cause is not fully understood, results of new research suggest that a deficiency of a chemical called hypocretin may be associated with the disease. Hypocretin is a chemical messenger (neurotransmitter) produced in the brain that plays a role in the regulation of sleep and appetite. People with narcolepsy have 85 to 95% fewer hypocretin-producing cells than do people without the disorder. Stimulant medications such as dextroamphetamine (Dexedrine™) and methylphenidate (Ritalin™) are used to decrease sleepiness in people with narcolepsy. Although they provide some benefit, these drugs may cause insomnia, high blood pressure, and headaches. A newer drug called modafinil (Provigil™) increases alertness with fewer side effects than other stimulant medications. Imipramine (Tofranil™) and fluoxetine (Prozac™) are antidepressants used to treat muscle weakness and paralysis, vivid dreams, and sleep paralysis. These medications are helpful for some people, but may be associated with side effects such as anxiety, fatigue, and sexual dysfunction.
Eating carbohydrates is thought to aggravate sleepiness in narcoleptics, though the role of diet in the management of narcolepsy has not been fully investigated. The new study examined the effect of a low-carbohydrate, high-protein, high-fat diet on daytime sleepiness in people with narcolepsy. For eight weeks, the eight participants were instructed to follow the dietary guidelines in the book Dr. Atkins’ New Diet Revolution, which included consuming less than 20 grams of carbohydrates per day. Narcolepsy symptoms were assessed by the participants using self-administered rating scales at the start of the study and at weeks two, four, and eight. Blood pressure and blood fats were measured at the beginning and end of the study.
The total score on the Narcolepsy Symptoms Severity Questionnaire improved by 18% over the eight-week study period. Specifically, the amount of sleepiness, number of sleep attacks, and frequency of sleep paralysis improved significantly. Blood pressure and blood fat levels were not adversely affected by the diet, and only a few minor side effects were experienced, such as headaches and leg cramps.
In addition to its beneficial effect on narcolepsy, the Atkins diet has also recently been found to help some people with epilepsy. The long-term safety of this type of diet, however, has not been proven and there is concern that it could promote the development of osteoporosis, kidney stones, or other problems. People interested in following a very-low-carbohydrate diet should be supervised by a doctor.
Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She is a co-founder and practicing physician at South County Naturopaths, Inc., in Wakefield, RI. Dr. Beauchamp teaches holistic medicine classes and provides consultations focusing on detoxification and whole-foods nutrition.
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