Diurnal changes of critical flicker frequency in patients with liver cirrhosis and their relationship with sleep disturbances

Increased serum interleukin‐6, not minimal hepatic encephalopathy, predicts poor sleep quality in nonalcoholic cirrhotic patients

“…The pathogenesis of sleep disturbance in patients with cirrhosis remained unclear and may be multifactorial. Sleep dysfunction in cirrhotic patients has been attributed to abnormalities in circadian or homeostatic sleep regulation . Disruption of the diurnal rhythm of melatonin, dysregulated histamine neurotransmission and cirrhosis‐associated chronic itching could be factors leading to sleep disturbance in cirrhosis.…”

“…Strategies for the treatment of sleep disturbances in cirrhotic patients are essential, and the management of sleep problems in cirrhotic patients may be difficult. Benzodiazepines are potentially dangerous because of the increased risk of a hepatic coma, and recent guidelines have suggested that such drugs should be avoided in patients with cirrhosis . Treatment with a histamine H1 blocker has been shown to improve sleep behaviours in patients with cirrhosis; however, the therapy carries the risk of precipitating overt HE .…”

“…Sleep disturbance is common among patients with liver cirrhosis . The prevalence of sleep disturbance in cirrhotic patients is estimated to be between 26% and 70%, depending on the patient population and the heterogeneity of the assessment tools used in the study . Sleep disturbance has a considerable effect on health‐related quality of life and has been demonstrated to be related to poor survival rates among cirrhotic patients waiting for liver transplantation .…”

“…Despite the effects of sleep dysfunction, the underlying mechanisms for sleep disturbances in cirrhotic patients remain unclear. Abnormalities in circadian, ghrelin or homeostatic sleep regulation in cirrhotic patients have been proposed as potential mechanisms . Hepatic encephalopathy (HE) could also be an important factor contributing to sleep dysfunction in cirrhotic patients because sleep–wake inversion characterises cirrhotic patients with HE …”

The performance of critical flicker frequency on determining of neurocognitive function loss in severe obstructive sleep apnea syndrome

“…The CFF test has important advantages compared to other psychometric and neurophysiological tests used in the assessment of cognitive function loss. Some of these advantages include ease of implementation, low cost and characteristically not being affected by differences in patients’ ages, languages or levels of education (Gencdal et al ., ; Torlot et al ., ; Wunsch et al ., ). However, few studies have employed the CFF test for patients with OSAS (Schneider et al ., ; Schulz et al ., ).…”