Prevalence of and Factors Associated with Sleep-Wake Abnormalities in Patients with Cirrhosis.

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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.
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Authors Manoj Kumar, Sumeet Kainth, Sachin Kumar, Ankit Bhardwaj, Hemant KumarAggarwal, Rakhi Maiwall, Kapil D Jamwal, Saggere M Shasthry, Ankur Jindal, Ashok Choudhary, Lovkesh Anand, Ravinder M Dhamija, Guresh Chibbar, Barjesh Chander Sharma, Shiv K Sarin
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Journal Journal of clinical and experimental hepatology
Year Year not found
DOI
10.1016/j.jceh.2020.10.006
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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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