Introduction: a disturbance of sleep is recognized as one of early signs of hepatic encephalopathy, Nevertheless, specific enquiry about sleep behaviour is rarely included in the clinical assessment of patients with cirrhosis, most likely reflecting the fact that the currently available sleep–wake evaluation tools are time consuming and laborious to use .Subjective sleep disturbance is usually assessed with retrospective questionnaires and sleep diaries, For this reason, Pittsburgh sleep quality index (PSQI) was developed which is easy for subjects to use and for clinicians and researchers to interpret”, The Sleep Timing and Sleep Quality Screening questionnaire (STSQS) is a simplified tool and, if validated in patients with cirrhosis, would allow their sleep problems to be formally documented and then, perhaps, better addressed
Aim of the study: to assess the validity of a simple sleep timing and sleep quality screening questionnaire (STSQS) in patients with liver cirrhosis against the Pittsburgh Sleep Quality Index (PSQI) questionnaire which is an established sleep quality questionnaire
Patients and methods: The study is done on 60 patients diagnosed as cirrhotic by compatible clinical history and imaging studies, divided as 20 patients Child’s class A, 20 patients Child’s class B, 20 patients Child’s class C and 20 healthy volunteers. All subjected to full history taking, clinical examination, routine laboratory examination, liver function tests and abdominal ultrasonography, The Pittsburgh Sleep Quality Index (PSQI) questionnaire, The Sleep Timing and Sleep Quality Screening questionnaire (STSQS)
Results: This study included 60 patients diagnosed to have liver cirrhosis without clinical evidence of hepatic encephalopathy (group 1) (43 men: 17 women) of mean age 57 (39-78) with an etiology of cirrhosis which was chronic hepatitis C in all patients. This group is further subdivided into A, B, C groups with 20 patients in each group according to Child-paugh classification A, B and C respectively. The reference population comprised 20 healthy volunteers (group 2) (12 men: 8 women) of mean age 46 (28-46) years.
The prevalence of sleep disturbance in the patients with cirrhosis was high with almost 77% classified as ‘poor sleepers’ using the PSQI, also, Sleep timing was generally delayed in the patients compared to healthy volunteers. the STSQS proved to be successful in estimating sleep quality and is correlated significantly with results obtained using the more complex PSQI questionnaire and it can separate individuals classified as ‘poor’ or ‘good sleepers’ on the basis of the PSQI score.
Conclusion: The STSQS provided useful estimates of sleep quality and sleep timing in both healthy volunteers and in patients with cirrhosis.