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Night‐time sleep disturbance does not correlate with neuropsychiatric impairment in patients with cirrhosis
Author(s) -
Montagnese Sara,
Middleton Benita,
Skene Debra J.,
Morgan Marsha Y.
Publication year - 2009
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2009.02089.x
Subject(s) - cirrhosis , hepatic encephalopathy , medicine , pittsburgh sleep quality index , epworth sleepiness scale , sleep disorder , sleep (system call) , encephalopathy , gastroenterology , quality of life (healthcare) , sleep quality , psychiatry , polysomnography , insomnia , apnea , operating system , nursing , computer science
Background: Sleep–wake disturbances are common in patients with cirrhosis and are generally attributed to the presence of hepatic encephalopathy. Aim: To determine the relationship between sleep and neuropsychiatric disturbances in patients with cirrhosis. Methods: The study population comprised 87 patients, classified as neuropsychiatrically unimpaired or as having minimal/overt hepatic encephalopathy. Nineteen healthy volunteers served as controls. Validated questionnaires were used to assess sleep quality [Pittsburgh sleep quality index (PSQI)], day‐time sleepiness [Epworth sleepiness scale (ESS)] and diurnal preference. Health‐related quality of life (H‐RQoL) was assessed using the 36‐item short form health profile (SF‐36v1) and the chronic liver disease questionnaire. Results: Patients slept significantly less well than the healthy volunteers (PSQI score: 8.4 ± 4.9 vs. 4.6 ± 2.5, P <0.01) and had more pronounced day‐time sleepiness (abnormal ESS: 21 vs. 0%; χ 2 =3.8, P =0.05). No significant relationships were observed between sleep indices and the presence/degree of hepatic encephalopathy. H‐RQoL was significantly impaired in the patients (SF‐36v1 physical score: 36 ± 15 vs. 50 ± 10, P <0.001; SF‐36v1 mental score: 46 ± 11 vs. 50 ± 10, P <0.01); night‐time sleep disturbance was an independent predictor of poor H‐RQoL ( P <0.01). Conclusions: Sleep–wake abnormalities are common in patients with cirrhosis; they significantly affect H‐RQoL but are not related to the presence of hepatic encephalopathy.