Prevalence of and Factors Associated with Sleep-Wake Abnormalities in Patients with Cirrhosis.
Abstract
Sleep-wake abnormalities [poor nighttime sleep and excessive daytime sleepiness (EDS)] are common in patients with cirrhosis. The aim of this study was to assess the prevalence of sleep-wake abnormalities and clinical factors associated with these abnormalities in a group of patients with cirrhosis.1098 patients with cirrhosis [Child Turcotte Pugh (CTP) class A, 22.2%; CTP class B, 29.2% and CTP class C, 48.6%], with either no ascites or mild ascites controlled on diuretics, and no history of or current overt hepatic encephalopathy were included in the study.Poor nighttime sleep and EDS were found in 569 (51.8%) and 489 (44.5%) patients respectively. On multivariate analysis, factors associated with poor nighttime sleep were CTP class C (vs. class A), presence of minimal hepatic encephalopathy (MHE), intermediate or evening type of diurnal preference category (vs. morning type), high risk for obstructive sleep apnea (OSA), diuretic use, presence of major depression, and presence of generalized anxiety disorder (GAD). Factors associated with EDS on multivariate analysis were CTP class B and C (vs. class A), intermediate or evening type of diurnal preference category (vs. morning type), high risk for OSA, presence of major depression, and presence of GAD.Sleep-wake abnormalities are common in patients with cirrhosis. CTP status, diurnal preference chronotype, risk of OSA, major depression and GAD are associated with both poor nighttime sleep and EDS. MHE and diuretic use are associated with poor nighttime sleep, but not with EDS.
Keywords
cirrhosis
insomnia
nash, non-alcoholic steatohepatitis
aclf, acute on chronic liver failure
bq, berlin questionnaire
cff, critical flicker frequency
cldq, chronic liver disease questionnaire
csm, composite scale of morningness
ctp, child turcotte pugh
eds, excessive daytime sleepiness
ess, epworth sleepiness scale
gad, generalized anxiety disorder
he, hepatic encephalopathy
hrqol, health related quality of life
mhe, minimal hepatic encephalopathy
osa, obstructive sleep apnea
phq, patient health questionnaire
psqi, pittsburgh sleep quality index
sleep disturbances
sleep-wake abnormalities
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268986
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0x95644003c57E6F55A65596E3D9Eac6813e3566dA
Article ID:
268986
Unique Identifier:
10.1016/j.jceh.2020.10.006
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Scimatic Chain (ID: 481)
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