Prevalence of sleep disturbances in patients with liver cirrhosis

Latha K¹,
Kanmani Karthikeyan²,
Viji Devanand³,
Gokulnathan V 4

¹Associate Professor,
²Assistant Professor,
³Professor & Head
4Post Graduate
Department of Physiology,
Stanley Medical College,
Chennai – 600 001,
Tamil Nadu, India

  • Background: Disturbed sleep is frequently reported by patients with cirrhosis attending outpatient clinics, but its prevalence, determinants, and consequences are not well understood.
  • Aim: To prospectively assess the prevalence of disturbed sleepin patients with cirrhosis.
  • Materials and Methods: Consecutive patients with cirrhosis attending the liver clinics between June 2021 and December 2021 were invited to participate. They completed the questionnaire to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness using the Epworth sleepiness scale (ESS). Poor sleep according to the PSQI instrument is defined as PSQI>5. Daytime sleepiness is said to be present for the ESS score>8. The characteristics of sleep in cirrhotic patients were assessed using a sleep questionnaire. The results were compared with those of healthy subjects. The presence of subclinical hepatic encephalopathy and individual’s affective state were also analyzed.
  • Results: The questionnaire indicated an elevated number of cirrhotic patients (80%) who complained of unsatisfactory sleep compared with healthy subjects (10%, P value < 0.01). The sleep disturbance in cirrhosis was not associated with clinical parameters nor with cognitive impairment.
  • Conclusion: Disturbed sleep is highly prevalent in ambulatory cirrhotic patients, and it is independently associated with poor quality of life. Further studies are needed for better understanding of the pathogenesis of poor sleep and its management strategies in this population.

Keywords: cirrhosis, Pittsburgh sleep quality index, sleep disturbance