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Cited by 273Sleep and related disordersLiver Disease and TransplantationCircadian rhythm and melatonin

High prevalence of sleep disturbance in cirrhosis

Córdoba, Juan, Cabrera, Juan, Lataif, Louis, Penev, Plamen, Zee, Phyllis, Blei, Andrés T.·1998·Hepatology
DOI 10.1002/hep.510270204
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Abstract

Sleep disturbance is a classic sign of hepatic encephalopathy. However, there are limited data regarding its prevalence in cirrhotic patients without overt hepatic encephalopathy. We assessed the characteristics of sleep in cirrhosis using a sleep questionnaire (n = 44) and actigraphy (n = 20). The results were compared with those of subjects with chronic renal failure and those of healthy controls. Presence of subclinical hepatic encephalopathy, chronotypology profile, and individual’s affective state were also analyzed. The questionnaire indicated an elevated number of cirrhotic patients (47.7%) and patients with chronic renal failure (38.6%) who complained of unsatisfactory sleep compared with healthy controls (4.5%, P < .01). Actigraphy corroborated the deterioration of sleep parameters in cirrhotic patients with unsatisfactory sleep. The sleep disturbance in cirrhosis was not associated with clinical parameters nor with cognitive impairment. Cirrhotic subjects and patients with chronic renal failure with unsatisfactory sleep showed higher scores for depression and anxiety, raising the possibility that the effects of chronic disease may underlie the pathogenesis of sleep disturbance. However, in contrast to chronic renal failure, unsatisfactory sleep in cirrhosis was associated with delayed bedtime, delayed wake-up time, and evening chronotypology. In conclusion, a sleep disturbance is frequent in cirrhotic patients without hepatic encephalopathy and may be related to abnormalities of the circadian timekeeping system.

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Crossref · 10.1002/hep.510270204

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  • The distal-proximal temperature gradient indicative of heat dissipation is blunted, which contributes to the highly prevalent sleep disruptions reported for cirrhotic patients.

    “Consequently, the distal-proximal temperature gradient indicative of heat dissipation is blunted, which contributes to the highly prevalent sleep disruptions reported for cirrhotic patients29, among other proposed mechanisms such as displaced melatonin secretion30.”

    From Diurnal rhythms of wrist temperature are associated with future disease risk in the UK Biobank (2023) · cites this paper as [29]

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Authors
Córdoba, J., Cabrera, J., Lataif, L., Penev, P., Zee, P., & Blei, A. T.
Affiliations
Northwestern University (US)
ORCID
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1998-02
Volume
27
Issue
2
Pages
339-345
ISSN
0270-9139 (ISSN-L)
DOI
10.1002/hep.510270204
OpenAlex
W2081088012
Cited by
273
References
40
Citations by year
2026: 6 · 2025: 6 · 2024: 8 · 2023: 2 · 2022: 10 · 2021: 13 · 2020: 9 · 2019: 7 · 2018: 11 · 2017: 14 · 2016: 12 · 2015: 9 · 2014: 21 · 2013: 11 · 2012: 14
FWCI
12.60
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 6421 d)
Locations
  • Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • Acceda (Universidad de Las Palmas de Gran Canaria) (submittedVersion)
Funders
  • Merit Review from the Veterans Administration Research Service and the Blowitz-Ridgeway Foundation
  • Dr. Juan Cabrera was supported by a grant from the Spanish Government and by Fundación Universitaria de Las Palmas (FIS 95/5375)
  • Dr. Juan Córdoba was supported by a grant from Generalitat de Catalunya (CIRIT)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
sleep disorders, liver cirrhosis, hepatic encephalopathy, chronic kidney disease, actigraphy, chronotype, circadian rhythm, depression, anxiety, bedtime timing
MeSH terms
Activity Cycles, Adult, Aged, Anxiety, Depression, Female, Humans, Kidney Failure, Chronic, Liver Cirrhosis, Male, Middle Aged, Prospective Studies, Quality of Life, Sleep Wake Disorders

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