Unrecognised sleep disturbances in patients with cirrhosis diagnosed with a portable electroencephalogram device

We aimed to compare sleep characteristics between patients with liver cirrhosis and healthy controls using a standardised protocol and portable electroencephalogram (EEG) devices.

We enrolled patients with early stage cirrhosis at low risk for sleep disorders (no apnoea, insomnia, alcohol use, pruritus or major portosystemic shunt; body mass index (BMI) ≤31 kg/m²). Using propensity score matching (age, sex, BMI), 18 patients with cirrhosis were compared with 18 healthy older adults from a 95-person cohort. Sleep was assessed at home using portable EEG devices measuring total sleep time, sleep latency, wake after sleep onset, sleep efficiency, sleep stages (N1-N3, rapid eye movement (REM)) and REM latency. Questionnaires were also administered.

Questionnaires indicated no major sleep complaints. However, EEG revealed longer sleep latency, increased wakefulness and lower sleep efficiency in cirrhosis. N1 sleep time and percentage were higher, REM sleep was reduced and REM latency was prolonged.

Traditional assessments rely on subjective reports, while polysomnography is often impractical. Our portable EEG approach revealed distinct disturbances-fragmented REM and delayed onset-undetectable by questionnaires alone.

Home EEG monitoring uncovered previously unrecognised sleep abnormalities in cirrhosis, suggesting utility for early detection and management.