title: Prevalence and predictors of sleep disturbance among liver diseases in long-term transplant survivors.
abstract: BACKGROUND
  Patients with cirrhosis are known to experience sleep disturbance, which negatively impacts health-related quality of life.
  
  
  OBJECTIVE
  To assess the prevalence and predictors of sleep disturbance before and after liver transplantation (LT).
  
  
  METHODS
  Both pre- and post-LT patients were administered the Basic Nordic Sleep Questionnaire. The primary outcome was overall sleep satisfaction; the secondary outcomes were sleep latency and sleep duration.
  
  
  RESULTS
  Eighty-three patients participated pre-LT and 273 post-LT. Overall, participants having completed both pre- and post-LT questionnaires reported satisfactory sleep 61% of the time before LT and 65% of the time after LT. However, on review of all questionnaires, patients with alcoholic liver disease (ETOH) experienced dramatically less sleep disturbance (OR 0.13 [95% CI 0.03 to 0.60]) post-LT, whereas those with hepatitis C remained without improvement (OR 0.90 [95% CI [0.38 to 2.15]). On logistic regression, patients with ETOH had statistically less sleep satisfaction pre-LT (OR 5.8 [95% CI 1.0 to 40.5]) and significantly better sleep satisfaction post-LT (OR 0.50 [95% CI 0.20 to 1.00]) compared with those with hepatitis C. In addition, both ETOH and other conditions had significantly better sleep latency than hepatitis C patients.
  
  
  CONCLUSIONS
  Sleep parameters for patients who undergo LT for hepatitis C do not improve following LT as much as they do in patients transplanted for ETOH. Following LT, patients transplanted for ETOH are significantly more satisfied with their sleep than those transplanted for hepatitis C. Physicians should address and manage sleep quality after LT, so as to ultimately improve quality of life.
authors.forename: Mamatha
authors.initials: M
authors.lastname: Bhat
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Wyse
authors.forename: Erica
authors.initials: E
authors.lastname: Moodie
authors.forename: Peter
authors.initials: P
authors.lastname: Ghali
authors.forename: Nir
authors.initials: N
authors.lastname: Hilzenrat
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
authors.forename: Marc
authors.initials: M
authors.lastname: Deschenes
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology* / Q000601:surgery; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome