title: The effects of poor sleep quality on cognitive function of patients with cirrhosis.
abstract: OBJECTIVE
  This study was conducted to assess the ill-defined relationship between sleep quality and multiple, specific domains of cognitive function in patients with cirrhosis.
  
  
  METHODS
  A comprehensive battery of neuropsychological tests (divided into six neurocognitive domains) and a standardized, validated measure of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were administered to patients with cirrhosis and without evidence of overt hepatic encephalopathy, recruited from liver transplant and advanced liver disease clinics (n = 34). An inflammatory bowel disease (IBD) control group (n = 23) was similarly recruited and evaluated to control for the secondary effect of a chronic illness on cognition. PSQI global and component scores were used to predict cognitive function in each neurocognitive domain, using linear regression.
  
  
  RESULTS
  Global PSQI scores were significantly higher (indicating poorer sleep quality) in the cirrhosis group (median [range] = 10 [1-19]) than in IBD controls = 5 (1-14); p = 0.002). After controlling for age and education, short duration of sleep was associated with impaired memory for patients with cirrhosis; the use of soporific agents was associated with poor visual-perceptual function in patients with IBD.
  
  
  CONCLUSIONS
  Poor sleep was associated with worsening of the already impaired cognitive function of patients with cirrhosis.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine University of Illinois at Chicago, Chicago, IL.
authors.forename: Charmaine A
authors.initials: CA
authors.lastname: Stewart
authors.forename: Robert R
authors.initials: RR
authors.lastname: Auger
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Robert
authors.initials: R
authors.lastname: Auger
authors.affiliation: Division of Biostatistics, Department of Health Sciences Research.
authors.forename: Felicity T B
authors.initials: FT
authors.lastname: Enders
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Donna
authors.initials: D
authors.lastname: Felmlee-Devine
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN.
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003072:Cognition Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires
keywords: Minimal hepatic encephalopathy; cognitive impairment and cirrhosis; hepatic encephalopathy; poor sleep quality in cirrhosis