Sleep problems

Most people with liver disease find their sleep is affected. You might get insomnia (not being able to fall asleep or stay asleep), or notice that your sleep doesn’t refresh you like it used to. It might take longer to fall asleep after you turn off the light, or you might develop restless legs.

This can all leave you feeling sleepy and lethargic during the day. It can affect your mood and concentration, or make you irritable.

Why you get sleeping problems

It’s thought that when your liver stops working properly, your body doesn’t deal with melatonin so well. Melatonin is a hormone needed for sleep. Another cause might be changes to your body temperature or glucose levels caused by the liver disease.

Many people with liver disease have other chronic conditions such as obstructive sleep apnoea (OSA), which can affect sleep and make you feel very sleepy during the day. Mental health problems that are common in people with liver disease can also make it hard to sleep.

Sleep problems can also be caused by hepatic encephalopathy, which is a serious condition in people who have cirrhosis.

Tips for managing sleeping problems

Sleep is really important for your overall health and wellbeing. If you are having trouble with sleep, here are some things you can do.

  • Create a routine – get up and go to bed at the same time every day and eat regular meals
  • Make sure your bedroom is suitable for sleep: make it as dark as possible, not too hot or too cold, and make sure your pillow and mattress are comfy. Wear ear plugs if noise is keeping you awake
  • Do something relaxing before bedtime – have a bath, listen to music, meditate
  • Use a relaxation app or relaxation exercises to de-stress
  • Drink a warm, milky drink before bed
  • Exercise as much as you can, but not too late in the day
  • Try not to nap too late in the day
  • Avoid caffeine or alcohol
  • Read a book in bed rather than a screen
  • If you really can’t sleep, get up rather than letting yourself get anxious. Relax then try again in about 20 minutes.

When to see your doctor

If lack of sleep is bothering you, it’s worth talking to your doctor. They may send you to see a sleep specialist or psychologist.

If your sleep problems are caused by hepatic encephalopathy, it’s very important to see a doctor and get treated as soon as possible.

If you snore or have interruptions in breathing while you sleep, you may have OSA. Talk to your doctor about whether you might benefit from a formal sleep study. If you have OSA, your doctor may recommend a machine called a CPAP machine that keeps your airways open while you sleep.

References

Shah NM, Malhotra AM, Kaltsakas G. Sleep disorder in patients with chronic liver disease: a narrative review. J Thorac Dis. 2020 Oct;12(Suppl 2):S248-S260. doi: 10.21037/jtd-cus-2020-012
Health Direct. Insomnia

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