الفهرس 
SLEEP DISTURBANCES AMONG ELDERLYOnly 14 pages are availabe for public view
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Abstract
Sleep is an important aspect in life that affects physical
health، quality of life and overall well-being in diseased as well
as healthy populations. Sleep and circadian rhythm
disturbances are prevalent in chronic liver disease patients with
or without previous history of hepatic encephalopathy and
include a wide range of problems.
The aim of this work is to study the relationship between
chronic liver diseases and sleep disturbances among elderly
patients.
The study enrolled 100 male and female elderly, divided
equally to cases and controls. Cases are then divided into 2
groups; child A and child B. The three groups were matched for
age and sex. All participants underwent medical history and
clinical assessment, Sleep disturbances were detected using the
Pittsburgh sleep quality index using Arabic version, assessment
of mood by the geriatric depression scale (GDS)، assessment of
physical function using activities of daily living (ADL) and
instrumental activities of daily living (IADL),and assessment of
nutrition done using Mini Nutritional Assessment(MNA).
Our study concluded that sleep disturbance is more
frequent among participants with chronic liver disease than the
control (44% of cases with hepatic disease had sleep
disturbances in comparison to only 14% of controls) Sleep disturbances did not increase with the increase of
chronic liver disease severity. when comparing the two groups
of cases together (Child A and Child B), there was no
significant difference .
The most affected component of Pittsburgh sleep quality
index in comparison to control individual are sleep quality,
sleep latency, sleep efficiency and daytime dysfunction.
Sleep medications use (component 6 in PSQI) showed no
significant relation among groups that might be due to fear of
use sleep medications in elderly hepatic patients.
The presence of ascites affected the sleep quality, sleep
duration and daytime dysfunction in cases. But it did not affect
sleep latency, sleep efficiency, sleep disturbances and
medication use in cases.
Beta blockers and caffeine could not be excluded due to
its prevalent use. Our results showed significant relationship
between beta blocker use and total Pittsburgh score in cases.
where 60% of participants receiving beta blocker have PSQI
total score of more than 5. Also the results showed that caffeine
use has no significant relationship between the study groups as
regard the total Pittsburgh sleep quality index score or any
significance when compared to each Pittsburgh sleep quality
index component.
As regards nutritional assessment, the cases showed
more risk for malnutrition and malnourishment when compared to controls. These results were also compared to total
Pittsburgh sleep quality index score, and showed a significant
relationship between total Pittsburgh sleep quality index score
and the presence of malnutrition in the cases group.