Relationship between sleep disordered breathing patterns and Liver decompensation among cirrhotic patients

Mohamed Abdallah, Nahla Elgammal, Tarik Zaher, Howida Elkomy, Mohamed Emara


Background and study aim: Liver cirrhosis is associated with different complications. There is growing evidence in the international literature about the association of liver cirrhosis with different patterns of sleep-disordered breathing (SDB). The relation between SDB and severity of liver cirrhosis is less understood. This study aimed at studying the relationship between degree of liver decompensation graded as Child class and SDB patterns in a cohort of Egyptian cirrhotic patients.

Patients and methods: Forty-eight post-viral cirrhotic patients were recruited. They were divided into three groups according to their Child class; Child A (N=16), Child B (N=16) and Child C (N=16) groups. All patients were evaluated by through history taking, complete physical examination, and laboratory investigations. Evaluation of sleep disorders was carried out by questionnaires (Epworth sleepiness scale and Berlin questionnaire) and polysomnography.

Results: Excessive daytime sleepiness and obstructive sleep apnea (OSA) were frequently reported among cirrhotic patients. Excessive daytime sleepiness was significantly (P ˂0.001) present in 50% of Child C group in comparison to 31.2% of Child B and 18.8% of Child A groups. In fact, not only the frequency of OSA is higher in Child class C patients but also the severity. The frequency of severe OSA was 31.8%, 12.5% and 0% among patients with Child class C, B and A respectively.

Conclusions: Patients with liver cirrhosis had different patterns of SDB detected by both sleep questionnaires and polysomnography. Not only the frequency of SDB but also the severity is increased with advanced stage of liver diseases.


Liver cirrhosis; Sleep disordered breathing; Obstructive sleep apnea; Epworth sleepiness scale; Polysomnography


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