الفهرس | Only 14 pages are availabe for public view |
Abstract Sleep is an important aspect in life that affects physical health، quality of life and overall well-being in diseased as well as healthy populations. Sleep and circadian rhythm disturbances are prevalent in chronic liver disease patients with or without previous history of hepatic encephalopathy and include a wide range of problems. The aim of this work is to study the relationship between chronic liver diseases and sleep disturbances among elderly patients. The study enrolled 100 male and female elderly, divided equally to cases and controls. Cases are then divided into 2 groups; child A and child B. The three groups were matched for age and sex. All participants underwent medical history and clinical assessment, Sleep disturbances were detected using the Pittsburgh sleep quality index using Arabic version, assessment of mood by the geriatric depression scale (GDS)، assessment of physical function using activities of daily living (ADL) and instrumental activities of daily living (IADL),and assessment of nutrition done using Mini Nutritional Assessment(MNA). Our study concluded that sleep disturbance is more frequent among participants with chronic liver disease than the control (44% of cases with hepatic disease had sleep disturbances in comparison to only 14% of controls) Sleep disturbances did not increase with the increase of chronic liver disease severity. when comparing the two groups of cases together (Child A and Child B), there was no significant difference . The most affected component of Pittsburgh sleep quality index in comparison to control individual are sleep quality, sleep latency, sleep efficiency and daytime dysfunction. Sleep medications use (component 6 in PSQI) showed no significant relation among groups that might be due to fear of use sleep medications in elderly hepatic patients. The presence of ascites affected the sleep quality, sleep duration and daytime dysfunction in cases. But it did not affect sleep latency, sleep efficiency, sleep disturbances and medication use in cases. Beta blockers and caffeine could not be excluded due to its prevalent use. Our results showed significant relationship between beta blocker use and total Pittsburgh score in cases. where 60% of participants receiving beta blocker have PSQI total score of more than 5. Also the results showed that caffeine use has no significant relationship between the study groups as regard the total Pittsburgh sleep quality index score or any significance when compared to each Pittsburgh sleep quality index component. As regards nutritional assessment, the cases showed more risk for malnutrition and malnourishment when compared to controls. These results were also compared to total Pittsburgh sleep quality index score, and showed a significant relationship between total Pittsburgh sleep quality index score and the presence of malnutrition in the cases group. |