Abstract
The present study aims to assess the sleep characteristics and health-related quality of life (HRQOL) among patients with chronic liver diseases (CLDs), as well as the relationship between them. We conducted a prospective cross-sectional study, over a period of eight months, on patients with CLDs. Sleep was assessed by subjective tools (self-reported validated questionnaires), semi-objective methods (actigraphy), and HRQOL by using the 36-Item Short Form Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ). The results indicated that 48.21% of patients with CLDs had a mean Pittsburgh Sleep Quality Index (PSQI) score higher than five, suggestive of poor sleep; 39.29% of patients had a mean Epworth Sleepiness Scale (ESS) score ≥11, indicative of daytime sleepiness. Actigraphy monitoring showed that patients with cirrhosis had significantly more delayed bedtime hours and get-up hours, more awakenings, and more reduced sleep efficacy when compared to pre-cirrhotics. The CLDQ and SF-36 questionnaire scores were significantly lower in cirrhotics compared to pre-cirrhotics within each domain. Moreover, we identified significant correlations between the variables from each questionnaire, referring to HRQOL and sleep parameters. In conclusion, sleep disturbances are commonly encountered among patients with CLDs and are associated with impaired HRQOL. This is the first study in Romania that assesses sleep by actigraphy in a cohort of patients with different stages of CLD.
Highlights
Introduction published maps and institutional affilQuality of life (QOL) represents an important endpoint in healthcare and has been extensively studied in the past decades, especially among patients with chronic diseases [1,2].Health-related QOL (HRQOL) is a complex concept that was described in various ways,“generally considered to reflect the impact of disease and treatment on disability and daily functioning“ (Mayo’s dictionary, 2016) [3].Sleep health is less frequently defined in the literature compared to health-related quality of life (HRQOL), and it is mostly expressed in association with its outcomes
Convenience sampling was applied as we recruited patients with chronic liver diseases (CLDs) who presented for regular follow-ups, or patients who presented for decompensation of their liver disease, taking into consideration the including and excluding criteria which are mentioned below
There were 11 patients with mixed etiology, both viral and alcoholic, and 7 patients who had been diagnosed with non-alcoholic fatty liver disease (NAFLD)
Summary
Introduction published maps and institutional affilQuality of life (QOL) represents an important endpoint in healthcare and has been extensively studied in the past decades, especially among patients with chronic diseases [1,2].Health-related QOL (HRQOL) is a complex concept that was described in various ways,“generally considered to reflect the impact of disease and treatment on disability and daily functioning“ (Mayo’s dictionary, 2016) [3].Sleep health is less frequently defined in the literature compared to HRQOL, and it is mostly expressed in association with its outcomes. Quality of life (QOL) represents an important endpoint in healthcare and has been extensively studied in the past decades, especially among patients with chronic diseases [1,2]. Health-related QOL (HRQOL) is a complex concept that was described in various ways,. “generally considered to reflect the impact of disease and treatment on disability and daily functioning“ (Mayo’s dictionary, 2016) [3]. Sleep health is less frequently defined in the literature compared to HRQOL, and it is mostly expressed in association with its outcomes. There are five main indicators of sleep health, measured either by self-reported and/or objective methods [4,5]: iations.
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