Polysomnographic sleep aspects in liver cirrhosis: a case control study.
AIM
To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results.


METHODS
This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of age- and gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classes of Child-Pugh classification in the cirrhotic group.


RESULTS
Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05).


CONCLUSION
Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
['Teodoro|Vinicius Vasconcelos|VV|', 'Bragagnolo|Mauricio Augusto|MA|', 'Lucchesi|Ligia Mendonça|LM|', 'Cavignolli|Daniel|D|', 'de Mello|Marco Túlio|MT|', 'Kondo|Mario|M|', 'Tufik|Sergio|S|']
D000328:Adult D016022:Case-Control Studies D005260:Female D006801:Humans D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D017286:Polysomnography D011237:Predictive Value of Tests D012720:Severity of Illness Index D012890:Sleep D012893:Sleep Wake Disorders D011795:Surveys and Questionnaires
Sleep Liver cirrhosis Polysomnography Child-Pugh classification Apnea-hypopnea index Obstructive sleep apnea syndrome Periodic limb movements in sleep Rapid eye movement sleep