Unrecognised sleep disturbances in patients with cirrhosis diagnosed with a portable electroencephalogram device

Sep 30, 2026

Objectives: Compare sleep characteristics between liver cirrhosis patients and healthy controls using a standardised protocol and portable EEG devices. Methods: Patients with early-stage cirrhosis and low sleep-disorder risk were propensity-score matched to older healthy adults; home portable EEG assessed total sleep time, latency, wake after sleep onset, efficiency, sleep stages (N1–N3, REM) and REM latency, alongside questionnaires. Results: Questionnaires showed no major complaints, but EEG demonstrated longer latency, more wakefulness, reduced efficiency, increased N1, reduced REM and prolonged REM latency. Conclusion: Home EEG monitoring identified previously unrecognised sleep abnormalities and supports early detection and management.

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CategoryHealthcare

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Open access Original research Unrecognised sleep disturbances inpatients with cirrhosis diagnosed with a portable electroencephalogram device Atsushi Uchiyama,1 Hiroteru Kamimura ,1 Suguru Miida,1 Hiroki Maruyama,1 Takafumi Tonouchi,1 Jaehoon Seol,2 Toshio Kokubo,2 Tomohiro Okura,2 Yusuke Watanabe,1 Naruhiro Kimura,1 Hiroyuki Abe,1 Akira Sakamaki,1 Takeshi Yokoo,1 Shuji Terai1 To cite: Uchiyama A, Kamimura H, Miida S, et al. Unrecognised sleep disturbances in patients with cirrhosis diagnosed with a portable electroencephalogram device. BMJ Health Care Inform 2026;33:e101526 . doi:10 . 1136/ bmjhci-2025-101526 ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjhci-2025-101526](bmjhci-2025-101526)) . Received 31 March 2025 Accepted 27 December 2025 © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. 1Niigata Daigaku, Niigata, Japan 2Tsukuba Daigaku, Tsukuba, Japan Correspondence to Dr Hiroteru Kamimura; [hiroteruk@med.niigata-u.ac.jp](hiroteruk@med.niigata-u.ac.jp) ABSTRACT Objectives We aimed to compare sleep characteristics between patients with liver cirrhosis and healthy controls using a standardised protocol and portable electroencephalogram (EEG) devices. Methods We enrolled patients with early stage cirrhosis at low risk for sleep disorders (no apnoea, insomnia, alcohol use, pruritus or major portosystemic shunt; body mass index (BMI) ≤31 kg/m²) . Using propensity score matching (age, sex, BMI), 18 patients with cirrhosis were compared with 18 healthy older adults from a 95-person cohort. Sleep was assessed at home using portable EEG devices measuring total sleep time, sleep latency, wake after sleep onset, sleep efficiency, sleep stages (N1–N3, rapid eye movement (REM)) and REM latency. Questionnaires were also administered. Results Questionnaires indicated no major sleep complaints. However, EEG revealed longer sleep latency, increased wakefulness and lower sleep efficiency in cirrhosis. N1 sleep time and percentage were higher, REM sleep was reduced and REM latency was prolonged. Discussion Traditional assessments rely on subjective reports, while polysomnography is often impractical. Our portable EEG approach revealed distinct disturbances—fragmented REM and delayed onset—undetectable by questionnaires alone. Conclusion Home EEG monitoring uncovered previously unrecognised sleep abnormalities in cirrhosis, suggesting utility for early detection and management. INTRODUCTION Cirrhosis has become increasingly prevalent globally, partly due to population growth and ageing. Deaths due to cirrhosis accounted for 2.4% of global deaths in 2017, compared with 1.9% in 1990. Sleep-wake disturbance is common in patients with cirrhosis; 50%–80% of them experience disturbances five times higher than healthy individuals do. However, polysomnography, the gold standard for assessing sleep architecture, is extremely difficult to conduct in research due to instrumental complexity and insurance coverage; WHAT IS ALREADY KNOWN ON THIS TOPIC | ⇒ Sleep disturbances are common in patients with liver cirrhosis.
⇒ To date, prior studies have relied almost exclusively on subjective questionnaires, and objective polysomnographic assessments are rarely performed because of their complexity and limited feasibility in clinical research.
WHAT THIS STUDY ADDS | | --- | | ⇒ Using a portable electroencephalogram (EEG) device with matched healthy controls, we objectively identified previously unrecognised alterations in sleep architecture—marked by increased sleep latency, reduced sleep efficiency, prolonged rapid eye movement latency and shifts in stage distribution—inpatients with cirrhosis.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY | ⇒ Our findings demons

FAQs

What was the study’s primary objective?

To compare sleep characteristics between patients with liver cirrhosis and healthy controls using a standardised protocol and portable electroencephalogram (EEG) devices.

How were sleep outcomes measured in this study?

Sleep was assessed at home with portable EEG measuring total sleep time, sleep latency, wake after sleep onset, sleep efficiency, sleep stages (N1–N3 and REM) and REM latency, along with questionnaires.

What did questionnaires and EEG show differently?

Questionnaires indicated no major sleep complaints, while EEG revealed longer sleep latency, increased wakefulness, lower sleep efficiency, higher N1, reduced REM, and prolonged REM latency in cirrhosis patients.

Sep 30, 2026

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