Factors Related to Sleeping Disorder Due to Pruritus in Patients with Chronic Liver Disease

Abstract

Objective This study evaluated cases of pruritus, which is known to be associated with sleep disorder, in chronic liver disease (CLD) patients. Methods Questionnaires were given to 339 enrolled CLD outpatients in winter (November 2019 to March 2020) and again in summer (April to October 2020) (median interval: 104 days). Relative changes in symptoms shown by a visual analogue scale (VAS) and Kawashima's pruritus score between winter and summer were evaluated in Study 1 (n=199), while Study 2 examined the clinical features of patients with sleep disorder based on the results of the second questionnaire (n=235, median age 70 years old; 141 men, liver cirrhosis 37%). Results Study 1. There was a significant relationship in VAS between daytime and nighttime for each season, as well as between winter and summer for each time period (p<0.001). A comparison of Kawashima's pruritus scores for the daytime and nighttime showed no significant seasonal differences (p=0.436 and 0.828, respectively). When Kawashima's score increased, so did the average VAS for both daytime (

Questionnaire‐based approach to sleep‐wake disturbance in patients with chronic liver disease

“…Regarding pruritus, Hiraoka et al. recently reported that intervention against pruritus is recommended in CLD patients with an elevated Kawashima's pruritus score (≥2), especially with a high FIB‐4 index 13 …”

“…12 Regarding pruritus, Hiraoka et al recently reported that intervention against pruritus is recommended in CLD patients with an elevated Kawashima's pruritus score (≥2), especially with a high FIB-4 index. 13 In order to optimize the treatment of sleep-wake disturbances in patients with CLD, it is essential to conduct multicenter collaborative studies and develop treatment guidelines led by relevant academic societies. In addition to preparing a high-quality questionnaire for proper evaluation of sleep-wake disturbance, the hepatologist must also pay attention to the patient's comorbidities such as muscle cramps, covert HE, sarcopenia, pruritus, and nocturia, and provide appropriate treatment.…”