Sleep in ambulatory patients with stable cirrhosis of the liver

Saleh, Khaled; Javaheri, Shahrokh

doi:10.1016/j.sleep.2017.08.022

Cited by 8 publications

(3 citation statements)

References 28 publications

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“…This association has been recently confirmed by a study on 341 patients with viral liver cirrhosis, reporting a significant elevation of the Pittsburgh Sleep Quality Index [125]. Abnormal polysomnographic findings are also present [126]. Sleep disturbances have been attributed to hepatic encephalopathy (HE).…”

Section: Liver Diseasesmentioning

confidence: 84%

Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition

Vernia¹,

Ruscio²,

Ciccone³

et al. 2021

Int. J. Med. Sci.

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Section: Liver Diseasesmentioning

confidence: 84%

Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition

Vernia¹,

Ruscio²,

Ciccone³

et al. 2021

Int. J. Med. Sci.

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“…Some studies have shown that the decline in serum bilirubin is a risk factor for depression [26], but there is strong evidence that a rise in bilirubin level is a risk factor for depression [24]. Meanwhile, Saleh et al found that the most important factor affecting sleep disturbance in cirrhosis patients is the increase in serum bilirubin [27]. In a present study, multivariate analysis showed a weak correlation of TBil levels with subclinical and clinical depression, and a weak correlation with clinical insomnia.…”

Section: Discussionmentioning

confidence: 99%

Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B

Huang

Zhang

et al. 2019

Med Sci Monit

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Background Depression and insomnia in chronic hepatitis B (CHB) patients affect the quality of life, disease diagnosis, and mortality. CHB patients are more likely to have psychological disorders, but the underlying mechanisms have not been elucidated. This study investigated the incidence of depression in patients with CHB and sought to identify risk factors for depression and insomnia in these patients, focusing on changes in liver function and thyroid hormone levels. Material/Methods This cross-sectional cohort study used the Hamilton Depression Scale and Athens Insomnia Scale to assess the depressive and insomnia states, respectively, of 209 CHB patients. Liver function, thyroid hormone levels, hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B virus-deoxyribonucleic acid load were evaluated. Liver cirrhosis was assessed by imaging (color Doppler ultrasound and computed tomography). A multivariate logistic regression model was used to analyze the correlation among various factors and depression and insomnia. Results Subclinical and clinical depressive states were found in 23.9% and 5.3% and subclinical and clinical insomnia in 11% and 35.4% of patients, respectively. Depression and insomnia severity were significantly correlated with low FT3 (<3.5 mol/L). The odds ratios of low FT3 for subclinical and clinical depression and clinical insomnia were 3.07 (95% confidence interval (CI), 1.248–7.568), 7.85 (95% CI, 1.839–33.547), and 3.91 (95% CI, 1.417–10.789), respectively. Conclusions CHB patients are prone to depression and insomnia. FT3 reduction may be a risk factor for depression and insomnia. In clinical settings, more attention needs to be paid to the mental state of patients with FT3 reduction.

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“…Nocturnal actigraphy and polysomnography studies have demonstrated short sleeping time (<6 hours per night), reduced sleep efficiency, increased sleep latency, increased rapid eye movement (REM) latency and reduced REM sleep, frequent nocturnal awakening, and excessive daytime sleepiness (EDS) (5,6). Excessive periodic limb movements during sleep have also been reported (7); 25-40% of cirrhotic patients reported insomnia, with increased prevalence of insomnia with worsening severity of cirrhosis. In addition, patients reporting insomnia also reported higher EDS (8,9).…”

Section: Sleep Disturbance In Cldmentioning

confidence: 99%

Sleep disorder in patients with chronic liver disease: a narrative review

Shah¹,

Malhotra²,

Kaltsakas³

2020

J Thorac Dis

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Sleep disturbance is a common feature of chronic liver disease (CLD) with impact on healthrelated quality of life; 60-80% of patients with CLD report subjective poor sleep; frequent presentations of sleep disturbance include insomnia, reduced sleep efficiency, increased sleep latency, reduced time in rapid eye movement (REM) sleep, restless leg syndrome and excessive daytime sleepiness (EDS). Key contributors to sleep disturbance include hepatic encephalopathy (HE) and circadian rhythm imbalance due to altered melatonin metabolism. Specific conditions causing CLD, such as non-alcoholic fatty liver disease (NAFLD), chronic viral hepatitis and primary biliary cholangitis (PBC) result in different types of sleep disturbance, and the treatment of these conditions can often also lead to sleep disturbance. There are currently limited management options for sleep disturbance in CLD. Obstructive sleep apnoea (OSA) is a common condition that causes chronic intermittent hypoxia due to airway collapse during sleep. This chronic intermittent hypoxia appears to contribute to the development of NAFLD. The presence of reactive oxygen species and the overexpression of hypoxia inducible factor 1-alpha secondary to hypoxia may be responsible for the second 'hit' of the 'two-hit' hypothesis of NAFLD. Treatment of the intermittent hypoxia with continuous positive airway pressure therapy has limited efficacy against liver dysfunction. There remain many outstanding areas of investigation in the management of sleep disturbance in CLD, and of liver dysfunction in OSA.

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Sleep in ambulatory patients with stable cirrhosis of the liver

Cited by 8 publications

References 28 publications

Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition

Sleep disorders related to nutrition and digestive diseases: a neglected clinical condition

Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B

Sleep disorder in patients with chronic liver disease: a narrative review

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