Department of Psychobiology, Federal University of São Paulo, São Paulo 04024-002, Brazil.
World J Gastroenterol. 2013 Jun 14;19(22):3433-8. doi: 10.3748/wjg.v19.i22.3433.
To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results.
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.
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).
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.
研究肝硬化患者的睡眠状况和参数，并评估肝功能严重程度在多导睡眠图结果中的作用。
这是一项病例对照研究。连续纳入诊断为肝硬化的患者。所有患者均进行临床检查和实验室肝功能检查，并使用Child-Pugh 评分评估疾病严重程度。对照组由年龄和性别匹配的健康志愿者组成。所有个体均回答了一份有关睡眠习惯、行为和抱怨的问卷，并接受了多导睡眠图检查。比较两组之间的睡眠参数，并在肝硬化组的 Child-Pugh 分类中进行单独分析。
共纳入 42 例肝硬化患者和 42 例对照。与对照组相比，肝硬化组的睡眠效率较低（平均值 ± 标准差：73.89% ± 14.99%对 84.43% ± 8.55%，P < 0.01），潜伏期较长（151.27 ± 93.24 分钟对 90.62 ± 54.74 分钟，P < 0.01），快速眼动（REM）睡眠比例较低（14.04% ± 5.64%对 20.71% ± 6.77%，P < 0.05），周期性肢体运动（PLM）频率较高（10.56 ± 2.85/小时对 2.79 ± 0.61/小时，P < 0.01）。Child A、B 和 C 肝硬化患者的睡眠参数比较显示，严重肝病（Child C 患者）的 REM 睡眠阶段发生率明显降低，与 Child A/B 患者相比（Child A 患者的 REM 睡眠阶段多导睡眠图百分比：16.1% ± 1.2%；Child B 患者：14.9% ± 1.2%；Child C 患者：8.6% ± 1.6%，P < 0.05）。
肝硬化与睡眠时间缩短、睡眠效率降低、潜伏期延长、REM 潜伏期延长和 REM 睡眠减少有关。此外，疾病严重程度影响睡眠参数。
