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Abstract：
OBJECTIVE: To study sleep aspects and parameters in cirrhotic patients and assess the role of liver dysfunction severity in polysomnographic results.
METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of age- and gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classes of Child-Pugh classification in the cirrhotic group.
RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05).
CONCLUSIONS: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
METHODS: This was a case-control study. Patients with a diagnosis of liver cirrhosis were consecutively enrolled in the study. Clinical examinations and laboratory liver tests were performed in all patients, and disease severity was assessed using the Child-Pugh score. The control group consisted of age- and gender-matched healthy volunteers. All individuals answered a questionnaire about habits, behaviors, and complaints related to sleep and were submitted to polysomnography. Sleep parameters were compared between the two groups, and separate analyses were performed among classes of Child-Pugh classification in the cirrhotic group.
RESULTS: Forty-two cirrhotic patients and forty-two controls were enrolled. Compared to the control group, the cirrhotic group exhibited lower sleep efficiency (mean ± SD: 73.89% ± 14.99% vs 84.43% ± 8.55%, P < 0.01), increased latency (151.27 ± 93.24 min vs 90.62 ± 54.74 min, P < 0.01) and a lower percentage of rapid eye movement (REM) sleep (14.04% ± 5.64% vs 20.71% ± 6.77%, P < 0.05) as well as a higher frequency of periodic limb movements (10.56 ± 2.85/h vs 2.79 ± 0.61/h, P < 0.01). The comparison of sleep parameters among Child A, B and C cirrhotic patients revealed a significant reduction of REM sleep stage occurrence in individuals with severe liver disease (Child C patients) compared to Child A/B patients (polysomnography percentage of REM sleep stage of patients Child A: 16.1% ± 1.2%; Child B: 14.9% ± 1.2%; Child C: 8.6% ± 1.6%, P < 0.05).
CONCLUSIONS: Cirrhosis was associated with shorter sleep time, reduced sleep efficiency, increased sleep latency, increased REM latency and reduced REM sleep. Additionally, disease severity influences sleep parameters.
摘要：
目的：研究肝硬化患者的睡眠方面和参数，并评估肝功能障碍严重程度在多导睡眠图检查结果中的作用。
方法：这是一项病例对照研究。诊断为肝硬化的患者被连续纳入研究。所有患者均进行了临床检查和实验室肝脏检查，使用Child-Pugh评分评估疾病严重程度。对照组由年龄和性别匹配的健康志愿者组成。所有的人都回答了一份关于习惯的问卷，行为,和与睡眠有关的投诉，并提交多导睡眠图。比较两组患者的睡眠参数,并对肝硬化组的Child-Pugh分类进行了单独分析。
结果：纳入42例肝硬化患者和42例对照。与对照组相比,肝硬化组睡眠效率较低(平均值±SD:73.89%±14.99%vs84.43%±8.55%,P<0.01),潜伏期增加（151.27±93.24分钟vs90.62±54.74分钟，P<0.01）和较低的快速眼动（REM）睡眠百分比（14.04％±5.64％vs20.71％±6.77％，P<0.05）以及较高的周期性肢体运动频率（10.56±2.85/hvs2.79±0.61/h，P<0.01)。儿童A之间睡眠参数的比较，与儿童A/B患者相比，B和C肝硬化患者显示严重肝病患者（ChildC患者）的REM睡眠阶段发生率显着降低（患者ChildA的REM睡眠阶段的多导睡眠图百分比：16.1％±1.2％；儿童B：14.9％±1.2％；儿童C：8.6％±1.6％，P<0.05)。
结论：肝硬化与较短的睡眠时间有关，降低睡眠效率，睡眠潜伏期增加，增加REM延迟和减少REM睡眠。此外,疾病严重程度影响睡眠参数。
方法：这是一项病例对照研究。诊断为肝硬化的患者被连续纳入研究。所有患者均进行了临床检查和实验室肝脏检查，使用Child-Pugh评分评估疾病严重程度。对照组由年龄和性别匹配的健康志愿者组成。所有的人都回答了一份关于习惯的问卷，行为,和与睡眠有关的投诉，并提交多导睡眠图。比较两组患者的睡眠参数,并对肝硬化组的Child-Pugh分类进行了单独分析。
结果：纳入42例肝硬化患者和42例对照。与对照组相比,肝硬化组睡眠效率较低(平均值±SD:73.89%±14.99%vs84.43%±8.55%,P<0.01),潜伏期增加（151.27±93.24分钟vs90.62±54.74分钟，P<0.01）和较低的快速眼动（REM）睡眠百分比（14.04％±5.64％vs20.71％±6.77％，P<0.05）以及较高的周期性肢体运动频率（10.56±2.85/hvs2.79±0.61/h，P<0.01)。儿童A之间睡眠参数的比较，与儿童A/B患者相比，B和C肝硬化患者显示严重肝病患者（ChildC患者）的REM睡眠阶段发生率显着降低（患者ChildA的REM睡眠阶段的多导睡眠图百分比：16.1％±1.2％；儿童B：14.9％±1.2％；儿童C：8.6％±1.6％，P<0.05)。
结论：肝硬化与较短的睡眠时间有关，降低睡眠效率，睡眠潜伏期增加，增加REM延迟和减少REM睡眠。此外,疾病严重程度影响睡眠参数。
