Relationship between sleep patterns and incident liver related events: retrospective analysis of prospectively...

Unhealthy sleep patterns have been associated with an increased risk of liver-related events, including the development of advanced liver disease. While prior studies linked sleep patterns to cirrhosis and mortality, the relationship between sleep behaviors and overall liver-related events (LRE) remains underexplored. This study examines the association between healthy sleep patterns (HSP) and the incidence of LRE, including cirrhosis and liver cancer.

This prospective cohort study included 356,501 European participants from the UK Biobank. A healthy sleep pattern was assessed using five key parameters: sleep duration, chronotype, insomnia, daytime sleepiness, and snoring. Associations between the healthy sleep score (HSS) and the risk of LRE, cirrhosis, and liver cancer were evaluated using Cox proportional hazards models.

Over a median follow-up of 12.8 years, 2441 incident liver-related events (LRE), 2197 cirrhosis cases, and 661 liver cancer cases were documented. After multivariable adjustment, a healthy sleep score (HSS) of 5 was significantly associated with a 44% reduction in LRE risk (HR=0.56; 95% CI: 0.46-0.70), a 46% reduction in cirrhosis risk (HR=0.54; 95% CI: 0.43-0.67), and a 45% reduction in liver cancer risk (HR=0.55; 95% CI: 0.37-0.80), compared to HSS 0-1. The inverse association between HSS and LRE was more pronounced among younger participants, individuals with prolonged sedentary behavior, and those with diabetes mellitus (P < 0.05).

Adherence to a healthy sleep pattern is independently associated with a reduced risk of liver-related events, cirrhosis, and liver cancer. This association is especially pronounced in younger adults, individuals with prolonged sedentary behavior (>4 h/day), and patients with diabetes.