Formentin Chiara, Garrido Maria, Montagnese Sara
1Department of Medicine, University of Padua, Via Giustiniani, 2, 35128 Padua, Italy.
Department of Physiology, Neuroimmunophysiology and Chrononutrition Research Group, Faculty of Science, Avda. Elvas s/n, 06006 Badajoz, Spain.
Curr Hepatol Rep. 2018;17(1):52-69. doi: 10.1007/s11901-018-0390-1. Epub 2018 Feb 13.
This review presents an in-depth overview of the sleep-wake phenotype of patients with cirrhosis, together with available pharmacological and non-pharmacological treatment strategies. A set of simple, practical recommendations is also provided.
The understanding of the pathophysiology of sleep disorders in this patient population has improved over the past decade, especially in relation to the interplay between homeostatic and circadian sleep regulation. In addition, new tools have been utilised for both screening and in-depth investigation of the sleep-wake profile of these patients. Finally, a number of studies have evaluated the efficacy of novel treatment strategies, often with encouraging results.
Since sleep disturbances are common in patients with cirrhosis, more so than in patients with other chronic diseases of similar severity, their assessment should become routine hepatological practice, along with the initiation of adequate treatment.
本综述深入概述了肝硬化患者的睡眠-觉醒表型,以及现有的药物和非药物治疗策略。还提供了一套简单实用的建议。
在过去十年中,对这一患者群体睡眠障碍病理生理学的理解有所改善,特别是在稳态睡眠调节和昼夜节律睡眠调节之间的相互作用方面。此外,新工具已被用于这些患者睡眠-觉醒特征的筛查和深入研究。最后,一些研究评估了新型治疗策略的疗效,结果往往令人鼓舞。
由于睡眠障碍在肝硬化患者中很常见,比其他严重程度相似的慢性疾病患者更为常见,因此对其评估应成为常规肝病诊疗实践的一部分,并应开始进行适当治疗。