Symptoms of Daytime Sleepiness and Sleep Apnea in Liver Cirrhosis Patients

Abdullah, Al Enezi; Al-Jahdali, Fares; Ahmed, Anwar; Shirbini, Nahid; Alharbi, Ahoud; Baharoon, Salim; Ali, Yosra; Abdulrahman, Aljumah; Khan, M.; Khaleid, Abdullah; Al‐Jahdali, Hamdan

doi:10.5604/01.3001.0010.0304

Cited by 20 publications

(18 citation statements)

References 52 publications

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“…Because obesity in particular is a major risk factor for SDB [ 9 ]. The most frequently reported patterns of SDB among our cohort were OSA and AHI, and this is consistent with most of the reports in the literature [ 10 ].…”

Section: Discussionsupporting

confidence: 92%

“…The question arises here why SDB was studied among cirrhotics, and the answer comprises two facts. First, cirrhotics had a variable degree of SDB, as confirmed in this study and in other studies [ 10 , 18 ], and this influence their quality of life. Obstructive sleep apnea syndrome was reported as a complication of liver cirrhosis with ascites.…”

Section: Discussionsupporting

confidence: 85%

“…This agrees with Al Enezi et al . [ 10 ], who found that 29.5% of patients with cirrhosis had EDS. In fact, different studies have reported variable prevalence rates of EDS among cirrhotics ranging from 18.5% to 38% [ 11 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…This agrees with Al Enezi et al . [ 10 ], who found that patients with cirrhosis frequently have high risk of OSA especially among cirrhotic patients after HCV and diabetes.…”

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: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…This agrees with Al Enezi et al . [ 10 ], who found that patients with cirrhosis frequently have high risk of OSA especially among cirrhotic patients after HCV and diabetes.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Elgammal

Zaher

Elkomy

et al. 2020

ceh

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“…A total of 39 studies assessing symptom prevalence were included (see Supplementary Material). 20–58 The majority reported data from North America (16) and Europe (14), although Asia (8) and Africa (1) were also covered. Most were cross-sectional studies conducted while patients were outpatients or stable after hospitalization.…”

Section: Symptom Prevalence Of Patients With End-stage Liver Diseasementioning

confidence: 99%

Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis

et al. 2018

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Background:End-stage liver disease is a common cause of morbidity and mortality worldwide, yet little is known about its symptomatology and impact on health-related quality of life.Aim:To describe symptom prevalence and health-related quality of life of patients with end-stage liver disease to improve care.Design:Systematic review.Data sources:We searched eight electronic databases from January 1980 to June 2018 for studies investigating symptom prevalence or health-related quality of life of adult patients with end-stage liver disease. No language restrictions were applied. Meta-analyses were performed where appropriate.Results:We included 80 studies: 35 assessing symptom prevalence, 41 assessing health-related quality of life, and 4 both. The instruments assessing symptoms varied across studies. The most frequently reported symptoms were as follows: pain (prevalence range 30%–79%), breathlessness (20%–88%), muscle cramps (56%–68%), sleep disturbance (insomnia 26%–77%, daytime sleepiness 29.5%–71%), and psychological symptoms (depression 4.5%–64%, anxiety 14%–45%). Erectile dysfunction was prevalent (53%–93%) in men. The health-related quality of life of patients with end-stage liver disease was significantly impaired when compared to healthy controls or patients with chronic liver disease. Compared with compensated cirrhosis, decompensation led to significant worsening of both components of the 36-Item Short Form Survey although to a larger degree for the Physical Component Summary score (decrease from average 6.4 (95% confidence interval: 4.0–8.8); p < 0.001) than for the Mental Component Summary score (4.5 (95% confidence interval: 2.4–6.6); p < 0.001).Conclusion:The symptom prevalence of patients with end-stage liver disease resembled that of patients with other advanced conditions. Given the diversity of symptoms and significantly impaired health-related quality of life, multidisciplinary approach and timely intervention are crucial.

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Sleep disturbances in patients with cirrhosis: Pursuing just right

Hui,

Chen,

Sun

2023

Portal Hypertension & Cirrhosis

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Liver cirrhosis represents the end‐stage of chronic liver disease and is related to high morbidity and mortality. To date, there is no standard curative method for liver cirrhosis, but there is treatment for common complications. Therefore, improving the health‐related quality of life (HRQoL) of patients with cirrhosis has become a potential therapeutic intervention by limiting its symptoms and complications. Sleep is a complex and rhythmic physiological process and is crucial to human health. Sleep disturbances are commonly encountered in patients with cirrhosis and adversely affect their HRQoL. Recently, sleep disturbances in patients with cirrhosis have received growing attention owing to their reciprocal effects. To better understand the effect of sleep disturbances on patients with cirrhosis, this review provides a comprehensive summary of the epidemiology and underlying mechanisms of sleep disturbances in cirrhosis. We also elaborate on the mutual relationships between sleep disturbances and other complications, such as muscle cramps, malnutrition, frailty, sarcopenia, HRQoL, and hepatic encephalopathy, in the context of cirrhosis. Finally, we discuss the potential management to improve poor sleep quality in patients with cirrhosis.

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Symptoms of Daytime Sleepiness and Sleep Apnea in Liver Cirrhosis Patients

Abstract: The risk of OSA and EDS is high among liver cirrhosis patients. Those patients with cirrhosis secondary to Hepatitis C are at higher risk of EDS and OSA. Both EDS and OSA affect patients designated as CPS Class A more frequently than patients designated as CPS Class B.

Cited by 20 publications

References 52 publications

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

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

Symptom prevalence and quality of life of patients with end-stage liver disease: A systematic review and meta-analysis

Sleep disturbances in patients with cirrhosis: Pursuing just right

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