ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2015
Effects of obstructive sleep apnea on sleep quality, cognition, and driving performance in patients with cirrhosis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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18 citing papers in PubMed, 42 citations in OpenAlex.
- Sleep irregularity is associated with reduced wellbeing in patients with cirrhosis.JHEP reports : innovation in hepatology · 2026Article
- A novel sweat sensor detects inflammatory differential rhythmicity patterns in inpatients and outpatients with cirrhosis.NPJ digital medicine · 2024Article
- Non-alcoholic fatty liver disease and sleep disorders.World journal of hepatology · 2024Review
- AASLD Practice Guidance: Palliative care and symptom-based management in decompensated cirrhosis.Hepatology (Baltimore, Md.) · 2022Article
- The Usefulness of the Athens Insomnia Scale for Evaluating Sleep Disturbance in Patients with Chronic Liver Disease Comparing with Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale.Medicina (Kaunas, Lithuania) · 2022Article
- Elevated thyroid-stimulating hormone levels are associated with poor sleep: a cross-sectional and longitudinal study.Endocrine · 2022Article
- Poor quality sleep is associated with greater carotid intima media thickness among otherwise healthy resident doctors.Frontiers in epidemiology · 2022Article
- Lack of direct association between viral hepatitis and sleep disturbances.Frontiers in medicine · 2022Article
- Effect of continuous positive air pressure on cognitive impairment associated with obstructive sleep apnea.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2021Article
- Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease.Brain sciences · 2021Review
- How frequent is sleep-disordered breathing among Egyptian cirrhotic adults?Clinical and experimental hepatology · 2020Article
- Understanding the impact of neurologic complications in patients with cirrhosis.SAGE open medicine · 2019Review
- Assessment and Management of Sleep Disturbance in Cirrhosis.Current hepatology reports · 2018Review
- Sleep disturbances in patients with liver cirrhosis: prevalence, impact, and management challenges.Nature and science of sleep · 2018Review
- Symptom Domain Groups of the Patient-Reported Outcomes Measurement Information System Tools Independently Predict Hospitalizations and Re-hospitalizations in Cirrhosis.Digestive diseases and sciences · 2017Article
- Managing Sleep Disturbances in Cirrhosis.Scientifica · 2016Review
- Management of fatigue and sleep disorders in patients with chronic liver disease.Clinical liver diseaseArticle
- Prevalence of and Factors Associated with Sleep-Wake Abnormalities in Patients with Cirrhosis.Journal of clinical and experimental hepatologyArticle
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18 authors at 2 institutions in 1 country.
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Abstract
BACKGROUND &
aimsIn patients with cirrhosis, sleep disturbances are assumed to result from hepatic encephalopathy (HE). The effects of obstructive sleep apnea (OSA) on cognition, sleep parameters, or driving in patients with cirrhosis are unclear.
methodsWe performed a cross-sectional and prospective study of 118 subjects. Subjects were assigned to 1 of 4 groups: those with OSA and cirrhosis (without hepatic encephalopathy or ascites, n = 34), those with cirrhosis only (n = 30), those with OSA only (n = 29), and those without OSA or cirrhosis (controls, n = 25). None of the OSA patients were receiving continuous positive airway pressure (CPAP) therapy. Subjects underwent cognitive testing (paper-pencil tests for psychomotor speed and attention, as well as executive function tests), sleep assessment (daytime sleepiness and night-time sleep quality), and a monotonous driving simulation (worsening lane deviations over time indicated poor performance). We also tested patients with OSA, with cirrhosis (n = 10) and without cirrhosis (n = 7), before and after CPAP therapy.
resultsDaytime sleepiness and sleep quality were worse in subjects in the OSA groups (with or without cirrhosis) than subjects with cirrhosis alone or controls. Of subjects with only OSA, 36% had impaired psychomotor speed and attention, compared with more than 60% of subjects in both cirrhosis groups. In contrast, executive function was uniformly worse in subjects with OSA, with or without cirrhosis, than groups without OSA. Simulator performance (lane deviations) worsened over time in both OSA groups. CPAP therapy significantly increased executive function and sleep quality, and reduced simulator lane deviations and sleepiness, in OSA subjects with and without cirrhosis. After CPAP therapy, performance on the paper-pencil test improved significantly only in subjects with OSA without cirrhosis.
conclusionsOSA should be considered in evaluating sleep impairment in patients with cirrhosis. In patients with cirrhosis and OSA, psychomotor speed and attention issues likely are related to cirrhosis, whereas executive function and simulator performance are affected by OSA. CPAP therapy improves executive function and simulator performance in patients with OSA, regardless of cirrhosis.
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