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Hyperammonemia Disrupts Sleep in Patients With Cirrhosis

Induced higher ammonia levels in blood leads to increase in sleepiness, alteration of sleep patterns

FRIDAY, March 16 (HealthDay News) -- For patients with cirrhosis, hyperammonemia induced by an amino acid challenge (AAC) leads to an increase in daytime subjective sleepiness and changes in sleep patterns, according to a study published in the March issue of Hepatology.

Alessia Bersagliere, of the University of Zurich, and associates studied the clinical, psychometric, and wake-sleep electroencephalogram (EEG) effects of AAC-induced hyperammonemia in 10 patients with cirrhosis and 10 healthy volunteers. Participants underwent sleep quality/timing monitoring, neuropsychiatric assessment, hourly ammonia/subjective sleepiness assessment, and sleep EEG recordings.

The researchers found that, following the AAC, both healthy volunteers and patients had an increase in ammonia concentrations and subjective sleepiness. In 20 percent of patients and no healthy controls, there was a worsening of neuropsychiatric performance following AAC. In healthy volunteers, the length of non-rapid eye movement sleep increased and the sleep EEG beta power decreased. In patients with cirrhosis, the sleep EEG delta power decreased following AAC.

"AAC led to a significant increase in daytime subjective sleepiness and changes in the EEG architecture of a subsequent sleep episode in patients with cirrhosis, pointing to a reduced ability to produce restorative sleep," the authors write.

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