Sleep-Wake profiles in patients with primary biliary cirrhosis.

Liver Int 2013 Feb 22;33(2):203-9. Epub 2012 Nov 22.

Department of Medicine, University of Padova, Padova, Italy.

Background: Impaired sleep quality and daytime sleepiness have been described in patients with primary biliary cirrhosis (PBC). However, no information is available on their sleep timing/diurnal preference.

Aims: To evaluate such variables and determine their relationship with sleep quality, fatigue, pruritus and quality of life.

Methods: Seventy-four patients with PBC (58 ± 12 years), 79 healthy volunteers (56 ± 8 years) and 60 patients with cirrhosis (58 ± 12 years) underwent formal assessment of sleep quality/timing, diurnal preference and daytime sleepiness. Patients with PBC also underwent assessment of fatigue, quality of life and the daytime course of sleepiness/pruritus.

Results: Sleep timing was significantly delayed in both patients with PBC and with cirrhosis, compared to healthy volunteers (sleep onset time: 23:18 ± 01:00 vs. 23:30 ± 01:00 vs. 22:54 ± 00:54 hours, respectively; P < 0.05). In patients with PBC, delayed sleep timing was associated with impaired sleep quality (P < 0.05). Sleepiness showed a physiological daily rhythm, with early afternoon/evening peaks. Pruritus was absent in the morning and increased over the afternoon/evening hours. Both the daytime course of pruritus and sleepiness changed in relation to diurnal preference. Patients with PBC and significant pruritus (upper quartile) had prolonged sleep latency (39 ± 37 vs. 21 ± 23 min, P = 0.05) and earlier wake-up times (5.9 ± 0.8 vs. 6.7 ± 0.9 min, P < 0.05). Significant correlations were observed between sleep timing and quality of life.

Conclusions: Patients with PBC exhibited a delay in sleep timing that was associated with impaired sleep quality/quality of life. In addition, an interplay was observed between diurnal preference and the daytime course of pruritus/sleepiness.

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http://dx.doi.org/10.1111/liv.12026DOI Listing
February 2013
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(Supplied by CrossRef)

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Thorpy et al.
Am J Manag Care 2007
Fatigue in primary biliary cirrhosis
Cauch-Dudek et al.
Gut 1998
Primary biliary cirrhosis
Scheuer et al.
Proc R Soc Med 1967

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