Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov 15;8(11):21541-8.
eCollection 2015.

Changes in sleep architecture and quality in minimal hepatic encephalopathy patients and relationship to psychological dysfunction

Changyun Liu  1 , Jianguang Zhou  1 , Xuedong Yang  1 , Jiao Lv  1 , Yunxing Shi  1 , Xiaohong Zeng  1
Affiliations

Changes in sleep architecture and quality in minimal hepatic encephalopathy patients and relationship to psychological dysfunction

Changyun Liu et al. Int J Clin Exp Med. .

Abstract

Objectives: We examined changes in sleep quality and architecture in patients with minimal hepatic encephalopathy (MHE) and the impacts of sleep disruption on patient physical and psychological health.

Methods: Ninety-eight MHE patients were examined by polysomnography (PSG) and the Pittsburg sleep quality inventory (PSQI). In addition, patients completed the SAS, SDS, and SCL-90 to examine the relationship between sleep quality and psychological health.

Results: Mean relative durations of Stage 1 and Stage 2, sleep latency, microarousal frequency, and total sleep time (TST) were all lower in MHE patients compared to healthy controls (P<0.05 for all). Similarly, SWS and REM stage durations, REM latency, sleep maintenance rate, and sleep efficiency were lower than controls (P<0.01 for all). Mean PSQI scores were lower in MHE patients. Total SAS, SDS, and SCL-90 scores, as well as all SCL-90 subscores, were significantly higher in the MHE group (P<0.05), indicating significant psychological dysfunction. Longer SWS, longer REM, and lower microarousal frequency were associated with improved sleep quality (P<0.05), while shorter SWS and REM led to dyssomnia and daytime functional disturbance (P<0.05, P<0.01). Longer REM latency and higher microarousal frequency were associated with higher PSQI scores (P<0.05, P<0.01), while longer SWS, longer REM, and higher sleep maintenance rate were associated with lower PSQI scores (P<0.05, P<0.01). Finally, total PSQI score and sleep efficiency subscore were positively correlated with total SCL-90 and most SCL-90 subscores (P<0.05).

Conclusions: MHE patients suffer from multiple subjective dyssomnias and changes in sleep architecture that are strongly correlated with psychological dysfunction.

Keywords: Minimal hepatic encephalopathy sleep architecture; pittsburgh sleep quality index; psychological symptoms.

PubMed Disclaimer

References

    1. Zamora Nava LE, Torre Delgadillo A. Minimal hepatic encephalopathy. Ann Hepatol. 2011;10(Suppl 2):S50–54. - PubMed
    1. Jia L. Update of mild hepatic encephalopathy in China. World Chinese J of Digestology. 2004;12:1261–62.
    1. Maldonado-Garza HJ, Vázquez-Elizondo G, Gaytán-Torres JO, Flores-Rendón AR, Cárdenas-Sandoval MG, Bosques-Padilla FJ. Prevalence of minimal hepatic encephalopathy in cirrhotic patients. Ann Hepatol. 2011;10(Suppl 2):S40–44. - PubMed
    1. McNamara P, Pace-Schott EF, Johnson P, Harris E, Auerbach S. Sleep architecture and sleep-related mentation in securely and insecurely attached people. Attach Hum Dev. 2011;13:141–54. - PMC - PubMed
    1. Bajaj JS, Saeian K, Schubert CM, Franco R, Franco J, Heuman DM. Disruption of sleeparchitecture in minimal hepatic encephalopathy and ghrelin secretion. Aliment Pharmacol Ther. 2011;34:103–105. - PubMed