Sleep disturbances in patients with liver cirrhosis: prevalence, impact, and management challenges

Bruyneel, Marie; Sersté, Thomas

doi:10.2147/nss.s186665

Cited by 37 publications

(35 citation statements)

References 54 publications

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“…Subjective tools, such as questionnaires, e.g. ESS and Berlin questionnaires, can be used to collect information on sleep quality and daytime complaints while objective methods such as PSG allow more precise assessment [ 14 ], and this was obvious in the current study; by questionnaire SBD is 33.3% while by PSG the prevalence is higher at 56.2%. This is due to the fact that patients, especially insomniacs, tend to underestimate their sleep quality.…”

Section: Discussionmentioning

confidence: 96%

“…First, the number of patients recruited is small. Second, the study lacks both in depth analysis of the prior episodes of HE and testing for minimal HE, because HE by itself is associated with sleep disorders among cirrhotics [ 14 ] and one study concluded that prior HE may synergize with OSA in worsening sleep patterns in cirrhotics [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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How frequent is sleep-disordered breathing among Egyptian cirrhotic adults?

Elgammal

Zaher

Elkomy

et al. 2020

ceh

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Aim of the study: Liver cirrhosis is an irreversible destructive liver disease that is associated with a wide range of complications. Among the recognized comorbidities of liver cirrhosis are sleep-disordered breathing (SDB), which is being more and more often described among cirrhotics. This study aimed to detect the prevalence of SDB among Egyptian post-viral cirrhotic adults. Material and methods: This study enrolled 48 post-viral cirrhotic patients and 16 apparently healthy control subjects. All patients and controls were evaluated by thorough history taking, full clinical examination, laboratory investigations, the Epworth Sleepiness Scale questionnaire, the Berlin Questionnaire and polysomnography. Results: Patients and controls were comparable as regards baseline demographics. Patients with liver cirrhosis had higher frequency of SDB compared to controls (56.2% vs. 12.5%, p = 0.002). The most frequently encountered SBD patterns among cirrhotics were obstructive sleep apnea and apnea hypopnea index. Moreover, SDB was more severe among cirrhotics (25% were mild, 16.6% were moderate and 14.6% were severe obstructive sleep apnea-OSA) compared to the healthy controls (all were mild). Conclusions: It seems that post-viral cirrhotic patients had a wide range of SDB with variable degrees of severity compared to the healthy controls.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

How frequent is sleep-disordered breathing among Egyptian cirrhotic adults?

Elgammal

Zaher

Elkomy

et al. 2020

ceh

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“…Liver physiology and pathophysiology are subjected to a tight circadian regulation, mostly influenced by feeding time [ 294 ]. Circadian disturbances, such as alterations in the sleep–wake cycle and disrupted patterns of hormones secretion are common risk factors associated with liver cirrhosis, a previous step to develop liver cancer (LC) [ 295 ]. Hepatocellular carcinoma is the most abundant type of LC and the fourth leading cause of cancer death worldwide according to the World Health Organization (WHO) [ 296 ].…”

Section: Melatonin: Reported Actions In Breast Prostate Liver Amentioning

confidence: 99%

Melatonin and Cancer: A Polyhedral Network Where the Source Matters

Bonmatí-Carrión

Tomás-Loba

2021

Antioxidants

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Melatonin is one of the most phylogenetically conserved signals in biology. Although its original function was probably related to its antioxidant capacity, this indoleamine has been “adopted” by multicellular organisms as the “darkness signal” when secreted in a circadian manner and is acutely suppressed by light at night by the pineal gland. However, melatonin is also produced by other tissues, which constitute its extrapineal sources. Apart from its undisputed chronobiotic function, melatonin exerts antioxidant, immunomodulatory, pro-apoptotic, antiproliferative, and anti-angiogenic effects, with all these properties making it a powerful antitumor agent. Indeed, this activity has been demonstrated to be mediated by interfering with various cancer hallmarks, and different epidemiological studies have also linked light at night (melatonin suppression) with a higher incidence of different types of cancer. In 2007, the World Health Organization classified night shift work as a probable carcinogen due to circadian disruption, where melatonin plays a central role. Our aim is to review, from a global perspective, the role of melatonin both from pineal and extrapineal origin, as well as their possible interplay, as an intrinsic factor in the incidence, development, and progression of cancer. Particular emphasis will be placed not only on those mechanisms related to melatonin’s antioxidant nature but also on the recently described novel roles of melatonin in microbiota and epigenetic regulation.

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“…Traditionally, hepatic encephalopathy (HE) has been incriminated as the main cause for sleep disorders, but recent studies [ 2 , 3 , 4 , 5 , 6 ] have reported sleep abnormalities in patients without neurocognitive disorders attributable to HE. Among the possible incriminated mechanisms have been mentioned imbalances of melatonin metabolism, imbalances of thermoregulation, and increased level of serum ammonia that crosses the blood-brain barrier.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease

et al. 2021

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The impact of sleep disorders (SDs) on patients with chronic liver diseases (CLD) is tremendous. SDs are frequently encountered among these patients and interfere with their quality of life. This review aims to present the data available so far about the prevalence, phenotypes, and proposed pathophysiological mechanisms of SDs in CLD. Moreover, we proposed to search the literature regarding the most reliable methods to assess SDs and the possible therapeutic options in patients with CLD. The main results of this review show that when it comes to prevalence, the percentages reported vary widely between studies performed among populations from the USA or Europe and those coming from Asian countries. Furthermore, it has been proven that SDs may also be present in the absence of neurocognitive disorders attributable to hepatic encephalopathy (HE), which contradicts traditional suppositions where SDs were considered part of the clinical scenario of HE. Currently, there are no specific recommendations or protocols to assess SDs in CLD patients and data about the therapeutic management are limited. Taking into consideration their impact, a protocol for diagnosing and managing SDs should be developed and included in the daily practice of hepatologists.

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Sleep disturbances in patients with liver cirrhosis: prevalence, impact, and management challenges

Cited by 37 publications

References 54 publications

How frequent is sleep-disordered breathing among Egyptian cirrhotic adults?

How frequent is sleep-disordered breathing among Egyptian cirrhotic adults?

Melatonin and Cancer: A Polyhedral Network Where the Source Matters

Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease

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