Prevalence and evaluation of sleep disturbances in Mexican patients with hepatic cirrhosis through the application of the Pittsburgh sleep questionnaire

Introduction and Objectives

According to the literature, patients with cirrhosis have a high prevalence of sleep disturbances, which increase as the disease progresses. There are few studies conducted in this patient group, with a small number of samples, reflecting alterations in sleep quality and rest. The Pittsburgh Sleep Quality Index (PSQI) is a tool that allows us to evaluate sleep quality and the level of disturbances it may present. To assess the type and prevalence of sleep disturbances in a Mexican group of patients with cirrhosis through the application of the Pittsburgh questionnaire.

Materials and Patients

A prospective, cross-sectional, and epidemiological study was conducted with 300 individuals, of whom 266 did not have hepatic diseases and 74 were diagnosed with cirrhosis.

The Pittsburgh questionnaire was administered to them, which consists of 7 components that generate a total score. Total scores were interpreted as follows: 1-4 without sleep disturbances, 5-7 with mild disturbance, 8-14 with moderate disturbance, and 15 or more indicating severe disturbance.

Results were compared using Odds Ratio (OR) to assess the effect.

Results

Of the individuals evaluated, 74 (24.66%) were diagnosed with cirrhosis, with 42 women (56%) and 32 men (43.24%). The remaining 226 participants (75.33%) did not have liver diseases, with 150 women (66.3%) and 75 men (33.1%). When comparing the total scores, it was observed that 57 people without sleep disturbances, 18 (31.57%) were in the cirrhosis group, while 39 (68.42%) were not. Additionally, of the 102 individuals with mild alterations, 20 (19.60%) were in the cirrhosis group and 82 (80.39%) were not. Of the 131 individuals with moderate alterations, 32 (24.42%) had cirrhosis and 99 (75.57%) did not. Finally, of the 10 individuals with severe alterations, 4 (40%) had cirrhosis and 6 (60%) did not. The calculation of the Odds Ratio was 1.09, indicating that patients with cirrhosis had a similar risk of sleep disturbances as those without cirrhosis.

Conclusions

In our study, it seems to demonstrate that contrary to previous reports in the literature, no difference was found in the prevalence of sleep disturbances between our population without cirrhosis and patients with cirrhosis.

This study is the first to apply this validated and translated questionnaire in Spanish to a Mexican population of patients with cirrhosis and healthy individuals to evaluate their sleep quality and the first to have a significant sample.

Ethical statement: Patients’ identity was protected. Consentment was obtained directly from patients.

Declaration of interests: None

Funding: CEIHET - Center for the Study and Research of Hepatic and Toxicological Diseases.