Fatigue in primary biliary cirrhosis is associated with excessive daytime somnolence

Newton, Julia L.; Gibson, Gretchen; Tomlinson, Mark; Wilton, Katharine; Jones, David

doi:10.1002/hep.21230

Cited by 155 publications

(128 citation statements)

References 26 publications

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“…Taken together, these findings suggest that, whereas fatigue is a highly significant Control values are for an age-and sex-matched control population not preselected for symptom severity who completed a version of the PBC-40 (the PBC-40c) which was validated for completion by non-PBC patients for the purposes of this study and which was found to demonstrate construct validity (Supporting Table 1). In addition to the potentially generic symptom domains demonstrated in this figure, the impact of pruritus and general PBC symptoms was unsurprisingly greater in PBC patients than in matched controls (pruritus: PBC-40 pruritus domain score median 4 [interquartile range 0-9 in PBC patients versus 2 [0-3] in controls, P < 0.0001; general PBC symptoms 16 [12][13][14][15][16][17][18][19][20] versus 10 [8-13], P < 0.0001). Dotted lines for each symptom domain represent the cutoff for clinically significant symptoms (defined as mean value for normal subjects 12 SD).…”

Section: Resultsmentioning

confidence: 97%

“…A score or 10 or over is regarded as indicating clinically significant daytime somnolence warranting intervention. 19 Orthostatic Grading Scale (OGS). Previous small studies have identified an increased prevalence of vasomotor autonomic symptoms in PBC (at early disease stages in addition to the well-recognized prevalence in cirrhotic disease).…”

Section: Study Design and Subjectsmentioning

confidence: 99%

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Impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study

et al. 2013

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,4 and the UK-PBC Consortium Primary biliary cirrhosis (PBC) has a complex clinical phenotype, with debate about the extent and specificity of frequently described systemic symptoms such as fatigue. The aim of this study was to use a national patient cohort of 2,353 patients recruited from all clinical centers in the UK to explore the impact of disease on perceived life quality. Clinical data regarding diagnosis, therapy, and biochemical status were collected and have been reported previously. Detailed symptom phenotyping using recognized and validated symptom assessment tools including the PBC-40 was also undertaken and is reported here. Perception of poor quality of life and impaired health status was common in PBC patients (35% and 46%, respectively) and more common than in an age-matched and sex-matched community control group (6% and 15%, P < 0.0001 for both). Fatigue and symptoms of social dysfunction were associated with impaired perceived quality of life using multivariate analysis. Fatigue was the symptom with the greatest impact. Depression was a significant factor, but appeared to be a manifestation of complex symptom burden rather than a primary event. Fatigue had its greatest impact on perceived quality of life when accompanied by symptoms of social dysfunction, suggesting that maintenance of social networks is critical for minimizing the impact of fatigue. Conclusion: The symptom burden in PBC, which is unrelated to disease severity or ursodeoxycholic acid response, is significant and complex and results in significant quality of life deficit. The complexity of symptom burden, and its lack of relation to disease severity and treatment response, suggest that specific approaches to symptom management are warranted that address both symptom biology and social impact. (HEPATOLOGY 2013;58:273-283)

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Section: Resultsmentioning

confidence: 97%

Section: Study Design and Subjectsmentioning

confidence: 99%

Impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study

et al. 2013

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“…Sleep disturbance and excessive daytime somnolence are common in patients with cirrhosis [1,2,3,4]. In addition, a disturbance of sleep is recognized as one of the early signs of hepatic encephalopathy [5,6,7].…”

Section: Introductionmentioning

confidence: 99%

Sleep disturbance and daytime sleepiness in patients with cirrhosis: a case control study

et al. 2008

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Abstract:Objective: Sleep disturbance and excessive daytime sleepiness have been reported in patients with hepatic cirrhosis. The objective of this study was to evaluate daytime somnolence and sleep complaints in a group of 178 patients with cirrhosis compared to a control group.Method: Sleep features and excessive daytime sleepiness were evaluated by the Basic Nordic Sleep Questionnaire (BNSQ) and the Epworth Sleepiness Scale (ESS). We collected clinical and laboratory data, neurological assessment and EEG recording in cirrhotic patients. Results:Patients with cirrhosis complained of more daytime sleepiness (p<0.005), sleeping badly at least three times a week (p<0.005), difficulties falling asleep (p<0.01) and frequent nocturnal awakening (p<0.005) than controls. We found a poor correlation between sleep disorders and clinical or laboratory parameters. Conclusion: Our results confirm previous literature reports suggesting a high prevalence of sleep disturbance in patients with cirrhosis.Insomnia and daytime sleepiness are the main complaints. Sleep disorders are probably a multifactorial phenomenon.

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“…5 Extreme fatigue might also be associated with excessive daytime somnolence. 6 Our patient complained of impaired quality of everyday life.…”

Section: Discussionmentioning

confidence: 87%

Primary Biliary Cirrhosis in a Male: A Case Report and Review of Literature

et al. 2015

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Fatigue in primary biliary cirrhosis is associated with excessive daytime somnolence

Cited by 155 publications

References 26 publications

Impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study

Impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study

Sleep disturbance and daytime sleepiness in patients with cirrhosis: a case control study

Primary Biliary Cirrhosis in a Male: A Case Report and Review of Literature

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