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Fatigue in primary biliary cirrhosis is associated with excessive daytime somnolence
Author(s) -
Newton Julia L.,
Gibson G. John,
Tomlinson Mark,
Wilton Katharine,
Jones David
Publication year - 2006
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21230
Subject(s) - somnolence , epworth sleepiness scale , medicine , excessive daytime sleepiness , daytime , pittsburgh sleep quality index , primary biliary cirrhosis , sleep disorder , physical therapy , polysomnography , insomnia , sleep quality , adverse effect , psychiatry , apnea , atmospheric sciences , geology
A significant proportion of patients with primary biliary cirrhosis (PBC) suffer from severe fatigue. The aim of this study was to characterize patterns of daytime sleep in patients with PBC (using both objective and subjective assessment approaches) and to study the association between sleep abnormality and fatigue severity. Fatigue severity was assessed in 48 female subjects with PBC (using a disease‐specific quality of life instrument (the PBC‐40) and a generic fatigue measure (Fatigue Impact Scale [FIS]) as well as 48 case‐matched normal controls. All participants also completed the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS, which assesses daytime hypersomnolence). Objective sleep assessment was performed using accelerometry over 7 days. Global sleep quality assessed by the PSQI was significantly lower in the PBC group compared to controls ( P < .0001). ESS scores were significantly higher in patients with PBC than controls ( P = .0001), suggesting significantly greater daytime somnolence in the patients with PBC. Objective sleep assessment confirmed that subjects with PBC were sleeping on average almost twice as long as controls during the daytime. Both degree of daytime somnolence (ESS) and actual daytime sleep activity (accelerometry) correlated strongly with fatigue severity in the patient group ( r 2 = 0.5, P < .0001 and r 2 = 0.2, P < .01, respectively). In conclusion, Sleep abnormality, in the form of excessive daytime somnolence, is present in a significant proportion of patients with PBC, with the degree of daytime somnolence correlating strongly with the degree of fatigue. Existing agents effective at reducing daytime somnolence (such as modafinil) hold potential for the treatment of fatigue in PBC. (H EPATOLOGY 2006;44:91–98.)