title: Active at night, sleepy all day--sleep disturbances in patients with hepatitis C virus infection.
abstract: OBJECTIVE
  More than 50% of patients with chronic hepatitis C with only mild liver disease complain about chronic fatigue, daytime sleepiness and poor sleep quality. The aim of the present study was to characterize and objectify the sleep disturbances in hepatitis C virus-infected patients.
  
  
  METHODS
  Twenty-five women who had been infected with hepatitis C virus contaminated anti-D immunoglobulin in 1978/79 and 22 age-matched female healthy controls underwent actigraphy over a period of 5 days to measure motor activity and thereby sleep-wake-rhythm and in addition completed questionnaires for depression, health-related quality of life, fatigue and sleep, and a sleep diary. Liver cirrhosis, a history of neurological or psychiatric disease, history of intravenous drug abuse, shift work, or current medication with effect upon the central nervous system were exclusion criteria.
  
  
  RESULTS
  The patients achieved higher scores for depression, fatigue and sleep disturbances and lower quality of life scores than the healthy controls. Actigraphy showed higher nocturnal activity and worse sleep efficiency in the patients, while the 24-h activity level did not differ between groups. Fatigue and quality of life scores correlated with bad sleep quality and daytime sleepiness.
  
  
  CONCLUSIONS
  Our data indicate that chronic fatigue is associated with bad sleep quality and increased nocturnal activity in HCV-infected patients suggesting an alteration of sleep architecture behind fatigue in HCV-associated encephalopathy.
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Meike
authors.initials: M
authors.lastname: Heeren
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Faina
authors.initials: F
authors.lastname: Sojref
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Ramona
authors.initials: R
authors.lastname: Schuppner
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Worthmann
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Pflugrad
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Anita B
authors.initials: AB
authors.lastname: Tryc
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pasedag
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany. Electronic address: Weissenborn.Karin@mh-hannover.de.
authors.forename: Karin
authors.initials: K
authors.lastname: Weissenborn
mesh_terms: D056044:Actigraphy; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D020178:Sleep Disorders, Circadian Rhythm / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Actigraphy; Fatigue; Hepatitis C; Sleep disturbances