Ketogenic Diet Improves Sleep Quality and Daytime Sleepiness in Chronic Migraine: A Pilot Study

The aim of this study is to assess the sleep quality and daytime sleepiness improvement in chronic migraineurs after 6 months of a 2:1 KD (ketogenic diet) and LGID (low-glycemic-index diet). Twenty-six patients underwent 2:1 KD (11 patients) and LGID (15 patients). PSQI (Pittsburgh sleep quality index) and ESS (Epworth sleepiness scale) were administered at the baseline and the 3-month and 6-month follow-up. MIDAS (Migraine Disability Assessment), HIT-6 (Headache Impact Test 6), migraine frequency (migraine days per month), migraine intensity, BMI (Body Mass Index), FM (Fat Mass), and FFM (Fat-Free Mass) were also assessed. PSQI (F = 7.250; = 0.004), ESS (F = 9.938; < 0.001), HIT-6 (F = 12.693; < 0.001), migraine frequency (F = 23.070; < 0.001), migraine intensity (F = 18.798; < 0.001), BMI (F = 38.191; < 0.001), and FM (F = 45.487; < 0.001) improved significantly. The MIDAS (F = 3.037; = 0.093) and the FMM (F = 1.741; = 0.197) did not improve significantly. The ESS ( = 0.712) and PSQI ( = 0.776) data at 3-month and 6-month follow-ups did not differ significantly, as well as for migraine frequency, migraine intensity, BMI, FM, and HIT-6. A mild correlation emerged between the mean FM and mean ESS reduction during the 6 months ( = 0.497, = 0.010). Six months of LGID and 2:1 KD can improve sleep quality and daytime sleepiness in patients with chronic migraine. The effectiveness on migraine, sleep quality, and daytime sleepiness does not differ significantly between the 3-month and 6-month follow-up periods.