BACKGROUND: Sleep-wake disturbances are common in patients with cirrhosis and are generally attributed to the presence of hepatic encephalopathy. AIM: To determine the relationship between sleep and neuropsychiatric disturbances in patients with cirrhosis. METHODS: The study population comprised 87 patients, classified as neuropsychiatrically unimpaired or as having minimal/overt hepatic encephalopathy. Nineteen healthy volunteers served as controls. Validated questionnaires were used to assess sleep quality [Pittsburgh sleep quality index (PSQI)], day-time sleepiness [Epworth sleepiness scale (ESS)] and diurnal preference. Health-related quality of life (H-RQoL) was assessed using the 36-item short form health profile (SF-36v1) and the chronic liver disease questionnaire. RESULTS: Patients slept significantly less well than the healthy volunteers (PSQI score: 8.4 +/- 4.9 vs. 4.6 +/- 2.5, P<0.01) and had more pronounced day-time sleepiness (abnormal ESS: 21 vs. 0%; chi(2)=3.8, P=0.05). No significant relationships were observed between sleep indices and the presence/degree of hepatic encephalopathy. H-RQoL was significantly impaired in the patients (SF-36v1 physical score: 36 +/- 15 vs. 50 +/- 10, P<0.001; SF-36v1 mental score: 46 +/- 11 vs. 50 +/- 10, P<0.01); night-time sleep disturbance was an independent predictor of poor H-RQoL (P<0.01). CONCLUSIONS: Sleep-wake abnormalities are common in patients with cirrhosis; they significantly affect H-RQoL but are not related to the presence of hepatic encephalopathy.
BACKGROUND: Sleep-wake disturbances are common in patients with cirrhosis and are generally attributed to the presence of hepatic encephalopathy. AIM: To determine the relationship between sleep and neuropsychiatric disturbances in patients with cirrhosis. METHODS: The study population comprised 87 patients, classified as neuropsychiatrically unimpaired or as having minimal/overt hepatic encephalopathy. Nineteen healthy volunteers served as controls. Validated questionnaires were used to assess sleep quality [Pittsburgh sleep quality index (PSQI)], day-time sleepiness [Epworth sleepiness scale (ESS)] and diurnal preference. Health-related quality of life (H-RQoL) was assessed using the 36-item short form health profile (SF-36v1) and the chronic liver disease questionnaire. RESULTS:Patients slept significantly less well than the healthy volunteers (PSQI score: 8.4 +/- 4.9 vs. 4.6 +/- 2.5, P<0.01) and had more pronounced day-time sleepiness (abnormal ESS: 21 vs. 0%; chi(2)=3.8, P=0.05). No significant relationships were observed between sleep indices and the presence/degree of hepatic encephalopathy. H-RQoL was significantly impaired in the patients (SF-36v1 physical score: 36 +/- 15 vs. 50 +/- 10, P<0.001; SF-36v1 mental score: 46 +/- 11 vs. 50 +/- 10, P<0.01); night-time sleep disturbance was an independent predictor of poor H-RQoL (P<0.01). CONCLUSIONS:Sleep-wake abnormalities are common in patients with cirrhosis; they significantly affect H-RQoL but are not related to the presence of hepatic encephalopathy.
Authors: Charmaine A Stewart; Robert R Auger; Robert Auger; Felicity T B Enders; Donna Felmlee-Devine; Glenn E Smith Journal: J Clin Sleep Med Date: 2014-01-15 Impact factor: 4.062
Authors: Maria Garrido; Jelena Skorucak; Daniela Raduazzo; Matteo Turco; Giuseppe Spinelli; Paolo Angeli; Piero Amodio; Peter Achermann; Sara Montagnese Journal: Metab Brain Dis Date: 2016-05-19 Impact factor: 3.584