Genco Gençdal1, Gamze Türker2, Işıl Yazıcı Gençdal3, Burçak Ekinci4, Şencan Acar5, Ayhan Dinçkan6, Murat Akyıldız7. 1. Department of Gastroenterology, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey. 2. Department of Chest Disease, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey. 3. Department of Neurology, Dr. Sadi Konuk Bakırköy Training and Research Hospital, İstanbul, Turkey. 4. Department of Neurology, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey. 5. Department of Internal Medicine, Memorial Ataşehir Hospital, Organ Transplantation Center, İstanbul, Turkey. 6. Department of General Surgery, Yeni Yüzyıl University, GOP Hospital, Organ Transplantation Center, İstanbul, Turkey. 7. Department of Gastroenterology, Memorial Ataşehir Hospital, Organ Transplantation Center, İstanbul, Turkey.
Abstract
BACKGROUND/AIMS: Sleep disorders (SDs) are frequently seen in patients with liver cirrhosis. Polysomnography (PSG), actigraphy, and electroencephalogram (EEG) are the common objective methods to diagnose SDs. The most commonly used subjective methods are the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). We aimed to evaluate the effect of liver transplantation (LTx) on SDs using a combination of objective (PSG and EEG) and subjective (PSQI and ESS) methods. MATERIALS AND METHODS: A total of 18 patients with cirrhosis on an LTx waiting list were included in this study. Patient clinical status and biochemical parameters were evaluated. All patients completed the validated Turkish forms of the PSQI and ESS before and 9 months after LTx. All patients underwent EEG and PSG before and 9 months after LTx. RESULTS: In total, 18 patients with liver cirrhosis (men: 12; 66.7%, mean age: 53.22±10.43 years) were included in this study. Pretransplant mean PSQI and ESS scores were 8.4±3.11 and 7.28±3.89, respectively; 9-month posttransplant mean PSQI and ESS scores were 4.5±2.8 and 4.72±2.91 (p<0.01), respectively. Before transplantation, metabolic encephalopathy was detected in 6 patients by EEG, whereas metabolic encephalopathy was detected in only 1 patient posttransplant. Posttransplantation PSG sleep duration (all stages) increased relative to pretransplant PSG values. Sleep latency and rapid eye movement latency were found to be reduced compared to the pretransplant values. CONCLUSION: This pilot study compared SDs in patients with pre- and post-LTx by combining the subjective and objective methods. Significant SD improvements were found at the 9th month.
BACKGROUND/AIMS: Sleep disorders (SDs) are frequently seen in patients with liver cirrhosis. Polysomnography (PSG), actigraphy, and electroencephalogram (EEG) are the common objective methods to diagnose SDs. The most commonly used subjective methods are the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). We aimed to evaluate the effect of liver transplantation (LTx) on SDs using a combination of objective (PSG and EEG) and subjective (PSQI and ESS) methods. MATERIALS AND METHODS: A total of 18 patients with cirrhosis on an LTx waiting list were included in this study. Patient clinical status and biochemical parameters were evaluated. All patients completed the validated Turkish forms of the PSQI and ESS before and 9 months after LTx. All patients underwent EEG and PSG before and 9 months after LTx. RESULTS: In total, 18 patients with liver cirrhosis (men: 12; 66.7%, mean age: 53.22±10.43 years) were included in this study. Pretransplant mean PSQI and ESS scores were 8.4±3.11 and 7.28±3.89, respectively; 9-month posttransplant mean PSQI and ESS scores were 4.5±2.8 and 4.72±2.91 (p<0.01), respectively. Before transplantation, metabolic encephalopathy was detected in 6 patients by EEG, whereas metabolic encephalopathy was detected in only 1 patient posttransplant. Posttransplantation PSG sleep duration (all stages) increased relative to pretransplant PSG values. Sleep latency and rapid eye movement latency were found to be reduced compared to the pretransplant values. CONCLUSION: This pilot study compared SDs in patients with pre- and post-LTx by combining the subjective and objective methods. Significant SD improvements were found at the 9th month.
Authors: Hendrik Vilstrup; Piero Amodio; Jasmohan Bajaj; Juan Cordoba; Peter Ferenci; Kevin D Mullen; Karin Weissenborn; Philip Wong Journal: Hepatology Date: 2014-07-08 Impact factor: 17.425
Authors: Elisabeth Hertenstein; Agata Gabryelska; Kai Spiegelhalder; Christoph Nissen; Anna F Johann; Roza Umarova; Dieter Riemann; Chiara Baglioni; Bernd Feige Journal: J Clin Sleep Med Date: 2018-04-15 Impact factor: 4.062
Authors: Richard B Berry; Rohit Budhiraja; Daniel J Gottlieb; David Gozal; Conrad Iber; Vishesh K Kapur; Carole L Marcus; Reena Mehra; Sairam Parthasarathy; Stuart F Quan; Susan Redline; Kingman P Strohl; Sally L Davidson Ward; Michelle M Tangredi Journal: J Clin Sleep Med Date: 2012-10-15 Impact factor: 4.062