Relationship of muscle cramps to quality of life and sleep disturbance in patients with chronic liver diseases: A nationwide study

Iwasa, Motoh; Karino, Yoshiyasu; Kawaguchi, Takumi; Nakanishi, Hiroyuki; Miyaaki, Hisamitsu; Shiraki, Makoto; Nakajima, Tomoaki; Sawada, Yasuhiko; Yoshiji, Hitoshi; Okita, Kiwamu; Koike, Kazuhiko

doi:10.1111/liv.13745

Cited by 30 publications

(39 citation statements)

References 23 publications

(33 reference statements)

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“…Patients with CLD often describe sleep problems and the mechanisms of sleep disorders in such patients have not been fully investigated, however, they seem to be temporally linked to CLD itself [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Sleep disorder, which involves difficulties in falling asleep, intermittent awakening during the night and shortened total sleep duration, is a burden and negatively affects the quality of life, mood changes, and possibly fatigue, and all of them can result in adverse consequences [ 19 , 20 ]. Sleep disorders can negatively affect the immune system and are commonly linked to neurocognitive disorders in patients with CLD, independently of liver fibrosis severity [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Frailty and Sleep Disorder in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2020

Life

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We aimed to investigate the association in frailty and sleep disorder as assessed by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in patients with chronic liver diseases (CLDs, n = 317, 141 males). Frailty was determined using the following five phenotypes: unintentional body weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity. Sleep disorder was defined as patients with PSQI-J score 6 or greater. Robust (phenotype, 0), prefrail (1 or 2 phenotypes) and frailty (3 phenotypes or greater) were observed in 101 (31.9%), 174 (54.9%) and 42 (13.2%), respectively. The median (interquartile range (IQR)) PSQI-J score was 4 (3, 7). Sleep disorder was found in 115 patients (36.3%). The median (IQR) PSQI-J scores in patients of the robust, prefrail, and frail groups were 3 (2, 5), 5 (3, 7), and 8 (4.75, 10.25), respectively (P < 0.0001 between any two groups and overall P < 0.0001). The ratios of sleep disorder in patients with robust, prefrail and frailty were 15.8% (16/101), 39.1% (68/174), and 73.8% (31/42), respectively (overall P < 0.0001). In conclusion, CLD patients with frailty can involve poorer sleep quality. As sleep disorder in CLDs is potentially remediable, future frailty-preventive strategies must take sleep complaints into account.

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Section: Introductionmentioning

confidence: 99%

Frailty and Sleep Disorder in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2020

Life

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“…Sleep is essential for mental and physical health and there is growing interest in sleep worldwide. Liver cirrhosis (LC) patients frequently describe sleep problems and non-LC patients with chronic liver diseases (CLDs) are not exceptions [1,2,3,4,5,6,7,8,9,10,11]. The mechanisms of sleep disturbance in CLD patients are not well elucidated; however, they appear temporally to be associated with CLD itself [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Sarcopenia on Sleep Disturbance in Patients with Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2018

JCM

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We sought to investigate the influence of sarcopenia as defined by muscle strength and skeletal muscle mass (SMM) on sleep disturbance as evaluated by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in chronic liver diseases (CLDs) (n = 419). Muscle strength and muscle mass were determined by grip strength (GS) and SMM using bioimpedance analysis. Patients were classified into four types: type A (n = 61); decreased GS and decreased SMM; type B (n = 45); decreased GS and non-decreased SMM; type C (n = 102); non-decreased GS and decreased SMM; and type D (n = 211); non-decreased GS and non-decreased SMM. Factors associated with PSQI-J score 6 or more were examined. PSQI-J score 0–5 (normal) was found in 253 (60.4%); 6–8 (mild) in 97 (23.2%); 9–11 (moderate) in 45 (10.7%) and 12 or more (severe) in 24 (5.7%). Univariate analysis identified three factors to be significantly associated with PSQI-J score 6 or more: presence of liver cirrhosis (LC) (P = 0.0132); our classification of type A; B; C and D (P < 0.0001) and serum albumin level (P = 0.0041). Multivariate analysis showed that type A (P = 0.0021) and type B (P = 0.0220) were significant independent factors. In conclusion, sarcopenia in CLDs appears to be closely associated with sleep disturbance mainly due to muscle strength decline.

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“…Some previous studies showed that the prevalence of sleep-wake disturbance was higher in LC patients than in controls (2,3,14). The causes of sleep-wake disturbance are related to hepatic encephalopathy, muscle cramps, melatonin metabolism disturbance, restless legs syndrome, and glucose level uctuation (2,3,(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 97%

“…A large Japanese cohort study showed that muscle cramps in uence the sleep quality in 37.4% of patients with chronic liver disease (15). Nakanishi et al described that an 8-week L-carnitine treatment improved the muscle cramps of patients with LC (9).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Carnitine on the Quality of Life and Sleep-Wake Disturbance in Patients With Liver Cirrhosis

Miyaaki

Haraguchi

Miuma

et al. 2020

Preprint

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Background: Some patients with liver cirrhosis have sleep-wake disturbance and reduced quality of life (QOL). However, the effects of L-carnitine on QOL and sleep-wake disturbance have not been extensively studied. Thus, we aimed to examine the effects of L-carnitine on the sleep quality and QOL in cirrhotic patients.Methods: We investigated 19 cirrhotic patients (age: 65.0±10.2 years, male:female=10:9, Child-Pugh score: 6.5±1.8) treated with 1500-mg L-carnitine at Nagasaki University Hospital and its associated hospitals. We used questionnaires to evaluate the patients’ sleep-wake disturbance and QOL at the time of entry and 8 weeks. Results: Cirrhosis-related symptom scores (CSSs), Pittsburgh Sleep Quality Index (PSQI) and General Health (GH) of QOL score improved with L-carnitine treatment (CSS: from 11.5±9.4 to 9.4±3.7, p=0.015; PSQI: from 9.6±5.8 to 7.4±3.3, p=0.035; GH: from 33.5±8.2 to 38.3±9.8, p=0.05). L-carnitine treatment reduced PSQI in 12 out of 14 patients with sleep disturbance (PSQI>5). CSS was improved in 12 cases (63%), and PSQI was improved in 13 cases (68%). However, L-carnitine treatment did not improve daytime hypersomnolence, as evaluated by the Epworth Sleepiness Scale. None of patients had any adverse events related to the L-carnitine treatment.Conclusions: L-carnitine is a safe and useful treatment for cirrhotic patients with reduced sleep quality and QOL.

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Relationship of muscle cramps to quality of life and sleep disturbance in patients with chronic liver diseases: A nationwide study

Abstract: Muscle cramps occurred with great frequency and were associated with various factors such as age, sex, hepatitis C virus and liver function. Many patients experience poor QOL (26.3%) due to muscle cramps, and therapeutic interventions are therefore needed.

Cited by 30 publications

References 23 publications

Frailty and Sleep Disorder in Chronic Liver Diseases

Frailty and Sleep Disorder in Chronic Liver Diseases

Effect of Sarcopenia on Sleep Disturbance in Patients with Chronic Liver Diseases

The Effect of Carnitine on the Quality of Life and Sleep-Wake Disturbance in Patients With Liver Cirrhosis

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