Evidence map›Paper›PMID 34276152›Full record

ArticleJournal of clinical and experimental hepatology

Prevalence of and Factors Associated with Sleep-Wake Abnormalities in Patients with Cirrhosis.

Manoj Kumar, Sumeet Kainth, Sachin Kumar, Ankit Bhardwaj, Hemant KumarAggarwal, Rakhi Maiwall, Kapil D Jamwal, Saggere M Shasthry, Ankur Jindal, Ashok Choudhary and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 16 citations in OpenAlex.

  1. The Beauty Sleep to Keep a Healthy Liver.International journal of molecular sciences · 2025
    Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Manoj KumarDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Sumeet KainthDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Sachin KumarDepartment of Pulmonary Medicine, New Delhi, India.
Ankit BhardwajDepartment of Clinical Research, New Delhi, India.
Hemant KumarAggarwalDepartment of Pulmonary Medicine, New Delhi, India.
Rakhi MaiwallDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Kapil D JamwalDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Saggere M ShasthryDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Ankur JindalDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Ashok ChoudharyDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Lovkesh AnandDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Ravinder M DhamijaDepartment of Neurology, New Delhi, India.
Guresh ChibbarDepartment of Biostatistics, Institute of Liver & Biliary Sciences, New Delhi, India.
Barjesh Chander SharmaDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Shiv K SarinDepartment of Hepatology and Liver Transplantation, New Delhi, India.
Dr. Ram Manohar Lohia Institute of Medical Sciences · INInstitute of Liver and Biliary Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsSleep-wake abnormalities [poor nighttime sleep and excessive daytime sleepiness (EDS)] are common in patients with cirrhosis. The aim of this study was to assess the prevalence of sleep-wake abnormalities and clinical factors associated with these abnormalities in a group of patients with cirrhosis.

methods1098 patients with cirrhosis [Child Turcotte Pugh (CTP) class A, 22.2%; CTP class B, 29.2% and CTP class C, 48.6%], with either no ascites or mild ascites controlled on diuretics, and no history of or current overt hepatic encephalopathy were included in the study.

resultsPoor nighttime sleep and EDS were found in 569 (51.8%) and 489 (44.5%) patients respectively. On multivariate analysis, factors associated with poor nighttime sleep were CTP class C (vs. class A), presence of minimal hepatic encephalopathy (MHE), intermediate or evening type of diurnal preference category (vs. morning type), high risk for obstructive sleep apnea (OSA), diuretic use, presence of major depression, and presence of generalized anxiety disorder (GAD). Factors associated with EDS on multivariate analysis were CTP class B and C (vs. class A), intermediate or evening type of diurnal preference category (vs. morning type), high risk for OSA, presence of major depression, and presence of GAD.

conclusionsSleep-wake abnormalities are common in patients with cirrhosis. CTP status, diurnal preference chronotype, risk of OSA, major depression and GAD are associated with both poor nighttime sleep and EDS. MHE and diuretic use are associated with poor nighttime sleep, but not with EDS.

Indexed as

ACLF, Acute on chronic liver failureBQ, Berlin questionnaireCFF, Critical flicker frequencycirrhosisCLDQ, Chronic liver disease questionnaireCSM, Composite scale of morningnessCTP, Child Turcotte PughEDS, Excessive daytime sleepinessESS, Epworth sleepiness scaleGAD, generalized anxiety disorderHE, Hepatic encephalopathyHRQOL, Health related quality of lifeinsomniaMHE, Minimal hepatic encephalopathyNASH, Non-alcoholic steatohepatitisOSA, Obstructive sleep apneaPHQ, Patient health questionnairePSQI, Pittsburgh sleep quality indexsleep disturbancessleep-wake abnormalities

Identifiers

PMID34276152
PMCPMC8267360
OpenAlexW3094145143

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.