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Sleep disturbances in chronic liver disease
Bradley Busebee1, Kymberly D Watt1, Kara Dupuy-McCauley2
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Summary
Sleep disturbances are prevalent in chronic liver disease (CLD), affecting patient quality of life. This review explores the causes, specific sleep issues, and management strategies for CLD-related sleep problems.
Area of Science:
- Hepatology
- Sleep Medicine
- Internal Medicine
Background:
- Sleep disturbances are frequent in chronic liver disease (CLD), negatively impacting patient outcomes and quality of life.
- The characteristics of sleep issues in CLD differ based on the liver disease's cause and severity.
- The pathophysiology linking CLD and sleep-wake dysfunction is complex and not fully understood.
Purpose of the Study:
- To review the pathophysiologic mechanisms underlying sleep disturbances in CLD.
- To describe the specific sleep-wake dysfunctions associated with different types of CLD.
- To outline current clinical management strategies for sleep problems in CLD patients.
Main Methods:
- Literature review of studies on sleep disturbances in chronic liver disease.
- Analysis of pathophysiologic processes affecting sleep in CLD.
- Synthesis of information on disease-specific sleep issues and management.
Main Results:
- CLD is linked to altered thermoregulation, inflammation, and physical activity, which can disrupt sleep.
- Complications like hepatic encephalopathy (HE) directly impact sleep patterns in CLD patients.
- Varied sleep disturbances, including insomnia and excessive daytime sleepiness, are observed in CLD.
Conclusions:
- Understanding the pathophysiology is crucial for managing CLD-associated sleep disturbances.
- Tailored management strategies are needed based on the specific CLD etiology and sleep issues.
- Further research is warranted to elucidate the complex relationship between CLD and sleep.
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