Prevalence of and Factors Associated with Sleep-Wake Abnormalities in Patients with Cirrhosis

Overview

Journal J Clin Exp Hepatol

Publisher Elsevier

Specialty Gastroenterology

Date 2021 Jul 19

PMID 34276152

Citations 6

Authors

Manoj Kumar

Sumeet Kainth

Sachin Kumar

Ankit Bhardwaj

Hemant KumarAggarwal

Rakhi Maiwall

Kapil D Jamwal

Saggere M Shasthry

Ankur Jindal

Ashok Choudhary

Lovkesh Anand

Ravinder M Dhamija

Guresh Chibbar

Barjesh Chander Sharma

Shiv K Sarin

Affiliations

Soon will be listed here.

Abstract

Background & Aims: Sleep-wake abnormalities [poor nighttime sleep and excessive daytime sleepiness (EDS)] are common in patients with cirrhosis. The aim of this study was to assess the prevalence of sleep-wake abnormalities and clinical factors associated with these abnormalities in a group of patients with cirrhosis.

Methods: 1098 patients with cirrhosis [Child Turcotte Pugh (CTP) class A, 22.2%; CTP class B, 29.2% and CTP class C, 48.6%], with either no ascites or mild ascites controlled on diuretics, and no history of or current overt hepatic encephalopathy were included in the study.

Results: Poor nighttime sleep and EDS were found in 569 (51.8%) and 489 (44.5%) patients respectively. On multivariate analysis, factors associated with poor nighttime sleep were CTP class C (vs. class A), presence of minimal hepatic encephalopathy (MHE), intermediate or evening type of diurnal preference category (vs. morning type), high risk for obstructive sleep apnea (OSA), diuretic use, presence of major depression, and presence of generalized anxiety disorder (GAD). Factors associated with EDS on multivariate analysis were CTP class B and C (vs. class A), intermediate or evening type of diurnal preference category (vs. morning type), high risk for OSA, presence of major depression, and presence of GAD.

Conclusions: Sleep-wake abnormalities are common in patients with cirrhosis. CTP status, diurnal preference chronotype, risk of OSA, major depression and GAD are associated with both poor nighttime sleep and EDS. MHE and diuretic use are associated with poor nighttime sleep, but not with EDS.

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