Cirrhosis and SLeep Disturbances

[I fightis thetitis]

Hi Hep fighetrs,

I recently began to experience awful sleep patterns. Recent Labs and Ultras all good.
My specific prob is I wake up after 2 hours sleep, then take at least an hour, sometimes more to get back to sleep. This continues and no REM sleep occurs.  It is almost like a series of small naps.
Next day I'm a zombie and need extra caffeine to power through. Sometimes I can go 3 or 4 hours of straight zzz but that is rare.

I googled and there seems to be a connection. I wanted to check with those on the forum who have cirrhosis and experiencing sleep probs. Or if you have cirrohosis and sleeping well whats your process? Thank you!

Best always,

Greg

[Lynn K]

Hi Ifight

Yes sleep disturbances like sleep reversal can be a symptom of more advanced cirrhosis. Here is a link on the subject

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868900/

"Sleep disturbances, particularly daytime sleepiness and insomnia, are common problems reported by patients suffering from liver cirrhosis. Poor sleep negatively impacts patients' quality of life and cognitive functions and increases mortality. Although sleep disturbances can be an early sign of hepatic encephalopathy (HE), many patients without HE still complain of poor quality sleep."

"Despite the fact that disturbance in sleep rhythm is one of the earliest signs of covert hepatic encephalopathy, there has been no correlation found between the degree of sleep disturbance and the presence of hepatic encephalopathy. There may, however, be a relationship between daytime sleepiness and the development of HE."

One thing I do know is that you need to be very careful with sleep meds and you should discuss this with your doctor

[MommaT]

hi Greg!
I get no sleep post Epclusa and I am Compensated Cirrhosis. I am going for a Sleep Study soon. I am so irritable with this! I have always had to some degree can go to sleep but wake up 3-4am which I can deal with. But now it is the sleep for 2-3 hours and wake up 1am and cannot fall back. Then end up mini nap all day cycle!
'
This is from either from Epclusa or the Cirrhosis. My sister has sleep apnea and I do wake up with my heart pounding or a bad feeling. This could be from my maybe stopping breathing! There is an in home test you wear like a Halter Moniter so that I like! I will keep you posted!

Tess

[dragonslayer]

While many people with cirrhosis report such sleep disturbances, in general, sleep disturbances, even of the kind mentioned here, are not the sole providence cirrhosis.   Ive had insomnia for decades often mimicking those disturbance types common to cirrhosis, yet Ive never had cirrhosis  nor even fibrosis beyond stage 0-1.   

Many of the HCV symptoms and side effects including those reported during treatment may be the result of the disease and the treatment, but they also may not be.  We're all looking for reasons and explanations to support the way we feel, but its very hard to know, often, what those causes really are.. I think this applies in spades to sleep disorders.

Lynn is very right that sleep meds, whether over the counter or prescription based,  all have big down sides.  Benadryl causes dementia, Ambien is addictive, etc, etc.. Unfortunately, there's no free ride when it comes to sleep meds...  As bad as they can be, sleeplessness carries a plethora of its own dangers....  Choosing the right solution is often a balance of many approaches.. Ive yet to find a doctor with a method that works, but that doesnt mean one doesnt exist.. Common sense and a conservative approach is probably the best way to tackle this.

[Lynn K]

Specifically if the sleep problems are due to cirrhosis sleep meds can trigger an episode of HE.

So if the cause is cirrhosis sleep disturbances can be a symptom of early HE  which is why I suggest you discuss this with your doctor. But as Dragonslayer says there are many possible explanations for sleep problems unrelated to liver disease

[elias]

Hi there..

Nice to hear from you MommaT..

I'm EOT 24 from Epclusa. Still suffering much from insomnia. Never sleep straight through the night. Happy if i can get 4 hours straight. So it's sleep in spurts mostly. Much depends on what i'm supposed to do next day. If any anxiety connected to it, I might even get no sleep. Poor sleep intensifies aches n pains as many probably realize.

It has been getting very very slowly better over the past few months. hard to say for sure as of now

Only thing which helps so far is low dose benzo. Doc wont script anymore out of fear of it being habit-forming. I made mistake of telling him I'd rather be on lifelong low dose benzo than suffer as I do now. This only made him more vigilant, so it backfired.

Melatonin made me too out of it next day. But i'll soon start the much lower dosage recommended here. by Dragonslayer and Mw.

I should had that I've had disordered sleep all my life.  along with many unexplained symptoms But then again I've also had HCV since age 12. it is possible that aggravation of sleep was result of learning I had the HCV and not the Epclusa. The circumstances of my contracting it are bizarre and resulted from repetitive child abuse which had never been addressed..

All in all, I'm afraid I'm in worse shape now than i was before I treated the HCV

PS: I do not have cirrhosis. Mistakenly posted this on wrong thread. But perhaps its similar pattern after all

[andrew j]

Time seems to be the essential factor in post - Tx recovery - and taking it quietly, if you can.

As for the other issues - I guess it's a matter of finding the right support and resources.

I'm a big counseling and psychotherapy fan myself.
I seem to have needed it (or to have otherwise found it beneficial), off and on throughout my adult life.

Here in New Zealand, it's possible to find good practitioners through public and community channels, if cost is an issue.

Some have expertise in abuse, and trauma.

Don't know if this is of any help?

You will know the terrain better than I do.

Thanks for sharing.
It must have taken some guts.

Best wishes,
A.