Objective:

The purpose of this study is to examine sleep parameters of cirrhosis patients who
have daytime sleepiness and evaluate their correlation in terms of minimal hepatic encephalopathy (MHE).

Background:

Thirty cirrhosis patients were included in our study who were 18-75 years old, followed up in Marmara University Medical Faculty Hospital between December 2021-March 2022, and had Epworth sleepiness scale (ESS) ≥ 9. PSG data of 15 age-matched patients assigned as the control group, and cirrhosis patients were compared with control group.

Design/Methods:

Cirrhosis patients who have excessive daytime sleepiness (EDS) were classified as A and B in accordance with Child-Pugh score and they were evaluated with MSLT in the morning following one night PSG examination. At the same time, each patient was divided into 2 groups in terms of MHE by applying a PHES test battery.

Results:

The mean age of cases were 57,63±10,07 (min:36- max:72) years and 17 of 30 patients (56,7%) were male. It was found that 70% cryptogenic, 20% HBV, 6.7% HCV, and 3.3% was developed on the background of alcohol etiology. The mean ESS was 12,17±3,10. There was a significant decrease in N2 (p<0,007) and increase in N3 stage (p<0,002) in cirrhosis patients. Total sleep time (TST) and sleep efficiency (SE%) were significantly lower in cirrhosis patients than healthy population ( p<0,015 and  p<0,030 respectively).  Patients fell asleep at 2 or more naps (97%) and 48.3%  had a sleep latency of 8 or less (p<0.007). SOREMs were observed in 17% of the patients. 

Conclusions:

EDS has objectively demonstrated with MSLT in our study, there was no difference in cirrhosis stages and MHE patients. It is believed that EDS may be a predictor for MHE patients and that EDS is the complaint that occurs earlier than the development of overt HE.