Severe, unrecognized sleep disturbances in patients with cirrhosis diagnosed with a portable electroencephalogram device

GoalsWe aimed to examine patients with liver cirrhosis and compare their sleep characteristics with those of healthy controls using innovative new electroencephalogram models. BackgroundSleep disturbance is a common disorder in patients with cirrhosis. Many previous studies have been conducted on the topic using questionnaire methods. However, polysomnographic quantitative assessments remain challenging because they are complicated and difficult to implement at the clinical research level. StudyWe recruited patients with early liver disease with a low probability of causing sleep disturbances, body mass index (BMI) [≤]31 kg/m2, history of alcohol use, itching, and no severe encephalopathy. Using propensity score matching among 20 patients with liver cirrhosis and 95 healthy older adults, the sleep structure of 18 patients with cirrhosis was analyzed and compared with that of 18 healthy adults matched for age, sex, and BMI. Sleep structure in both the groups was assessed using data obtained from a portable electroencephalogram (EEG) device, including total sleep time, sleep latency, wakefulness after sleep onset, sleep efficiency, sleep stages, and rapid eye movement (REM) latency. Sleep stages included REM and non-rapid eye movement (non-REM) stages (stages N1, N2, and N3). Self-report questionnaires were administered to the participants to confirm subjective and objective sleep statuses. ResultsQuestionnaire responses revealed that neither group reported any severe sleep disturbances. Regarding sleep structure assessment using a portable EEG device, patients with cirrhosis exhibited longer sleep latency, suboptimal wakefulness after sleep onset, and poorer sleep efficiency than healthy controls. In patients with cirrhosis, the total time and percentage of N1 sleep were longer; total time and percentage of REM sleep were shorter; and REM latency was prolonged. ConclusionsA high frequency of severely unrecognized sleep disturbances was observed in patients with cirrhosis using home portable polysomnography.