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Sleep disturbances in patients of liver cirrhosis with minimal hepatic encephalopathy before and after lactulose therapy.
Singh, Jatinderpal; Sharma, Barjesh Chander; Puri, Vinod; Sachdeva, Sanjeev; Srivastava, Siddharth.
Afiliación
  • Singh J; Department of Gastroenterology, G. B. Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, 110002, India.
  • Sharma BC; Department of Gastroenterology, G. B. Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, 110002, India. drbcsharma@hotmail.com.
  • Puri V; Department of Neurology, G. B. Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, 110002, India.
  • Sachdeva S; Department of Gastroenterology, G. B. Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, 110002, India.
  • Srivastava S; Department of Gastroenterology, G. B. Pant Institute of Postgraduate Medical Education and Research, JLN Marg, New Delhi, 110002, India.
Metab Brain Dis ; 32(2): 595-605, 2017 04.
Article en En | MEDLINE | ID: mdl-28070704
Sleep disturbances are common in patients of cirrhosis with minimal hepatic encephalopathy (MHE) and affect health related quality of life (HRQOL). No study has evaluated effect of lactulose on sleep disturbances and correlation with HRQOL in patients with MHE. We assessed sleep disturbances in cirrhosis with MHE and effect of lactulose on sleep disturbances and HRQOL. One hundred patients of cirrhosis [MHE; (n = 50, age 45.3 ± 11.2 years, 45 males) no-MHE (n = 50, age 46.3 ± 10.4 years, 44 males)] were included. MHE was diagnosed with psychometric hepatic encephalopathy score (PHES) ≤ -5. All patients underwent laboratory parameters including arterial ammonia and critical flicker frequency (CFF) Sleep disturbances were measured with Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and polysomnography. HRQOL was measured with SF-36(v2) questionnaire. Patients with MHE were given lactulose therapy for 3 months and all the parameters were repeated. Poor quality of sleep and excessive day time sleepiness were more common in patients with MHE, compared to without MHE. With lactulose therapy there was improvement in MHE in 21 patients and arterial ammonia levels (93.74 ± 14.8 vs. 71.44 ± 18.8 µmol/L: p < 0.001), CFF (34.83 ± 3.54 vs. 39.44 ± 4.95 Hz: p < 0.001), PHES (-7.64 ± 2.1 vs. -5.58 ± 2.09: p < 0.001), PSQI (8.6 ± 3.3 vs. 5.2 ± 1.5: p < 0.001), ESS (12.52 ± 3.01 vs. 9.24 ± 2.27: p < 0.001) and HRQOL (p = 0.01). Excessive day time sleepiness and impaired sleep quality are common in patients with MHE and correlate with neuropsychiatric impairment. Improvement in MHE with lactulose also leads to improvement in sleep disturbances and HRQOL.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos del Sueño-Vigilia / Encefalopatía Hepática / Lactulosa / Cirrosis Hepática Tipo de estudio: Etiology_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Metab Brain Dis Asunto de la revista: CEREBRO / METABOLISMO Año: 2017 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos del Sueño-Vigilia / Encefalopatía Hepática / Lactulosa / Cirrosis Hepática Tipo de estudio: Etiology_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Metab Brain Dis Asunto de la revista: CEREBRO / METABOLISMO Año: 2017 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos