Night-time sleep disturbance does not correlate with neuropsychiatric impairment in patients with cirrhosis

作者：Montagnese Sara; Middleton Benita; Skene Debra J; Morgan Marsha Y^*

来源：Liver International, 2009, 29(9): 1372-1382.

DOI：10.1111/j.1478-3231.2009.02089.x

• cirrhosis
• diurnal preference
• health-related quality of life
• hepatic encephalopathy
• sleep disturbance
• somnolence

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%; chi(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.

• 出版日期2009-10