Sleep‐wake abnormalities in patients with cirrhosis
Sara Montagnese, Cristiano De Pittà, Michele De Rui, Michela Corrias, Matteo Turco, Carlo Merkel, Piero Amodio, Rodolfo Costa, Debra J. Skene, Angelo Gatta – 6 June 2013 – A considerable proportion of patients with cirrhosis exhibit insomnia, delayed sleep habits, and excessive daytime sleepiness. These have been variously attributed to hepatic encephalopathy and impaired hepatic melatonin metabolism, but the understanding of their pathophysiology remains limited and their treatment problematic. Sleep is regulated by the interaction of a homeostatic and a circadian process.