title: Sleep apnoea syndrome and early stage cirrhosis: a pilot study.
abstract: OBJECTIVE
  Hepatic encephalopathy in patients with end-stage liver cirrhosis is associated with alterations in sleep patterns. Cirrhosis may also affect pulmonary function and it might be involved in the development of obstructive sleep apnoea syndrome (OSAS) in patients with ascites. We carried out a study to evaluate the presence of OSAS in cirrhotic patients without evidence of ascites (early stage cirrhosis).
  
  
  METHODS
  We investigated 20 patients with Child A or B cirrhosis (19 and one, respectively) and 10 non-cirrhotic patients with chronic viral hepatitis (disease control group). All subjects were interviewed and underwent a thorough physical examination, a full polysomnographic study and a pulmonary function testing by spirometry. Serum samples were also obtained in order to determine the liver function tests.
  
  
  RESULTS
  The presence of OSAS and inverted sleep patterns was similar in cirrhotic patients and disease controls. However, significant correlations were revealed between age and hypopnoeas per hour of sleep; age and the Apneas/Hypopneas Index (AHI); age and FEV1/FVC; gamma-glutamyl transpeptidase and FEV1/FVC; and total bilirubin and total sleep time.
  
  
  CONCLUSIONS
  Early stage cirrhosis is not associated with sleep disorders and OSAS. However, total bilirubin levels might be a useful laboratory marker for early assessment of disturbance in sleep patterns and therefore of subclinical hepatic encephalopathy in Child A cirrhosis.
authors.affiliation: Department of Respiratory Medicine, University Hospital of Larissa, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Nikaina
authors.forename: Chaido
authors.initials: C
authors.lastname: Pastaka
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Zachou
authors.forename: Georgios N
authors.initials: GN
authors.lastname: Dalekos
authors.forename: Kostantinos
authors.initials: K
authors.lastname: Gourgoulianis
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001663:Bilirubin / Q000097:blood; D005260:Female; D005541:Forced Expiratory Volume; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017286:Polysomnography; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000209:etiology*; D014797:Vital Capacity
chemical_list: D001663:Bilirubin