Sleep Deprivation And Fasting Protocol
Mice were visually monitored continuously for signs of sleep for 6 h from 0800 to 1400 on the day of the experiment. To avoid any stress, handling or touching of mice was minimized. For mice of the sleep deprivation group, they were physically handled or gently touched once they started to close their eyes and recline. On the other hand, mice of the control group were allowed to sleep undisrupted. Unless otherwise stated, the procedure of sleep deprivation was applied only once per animal in this study. Mice of both groups were fasted during the 6-h sleep deprivation period and also maintained in small individual plastic cages to limit their physical activity during the sleep deprivation period. Tissue and blood sampling, intraperitoneal glucose tolerance test , and pyruvate challenge test were performed immediately after the 6-h sleep deprivation period. For the chronic assessment, 6 h of sleep deprivation was conducted daily over 5 consecutive days under the same laboratory conditions, and then ipGTT was performed at the end of the 5-day sleep deprivation period. For the recovery sleep assessment, after a single 6-h sleep deprivation period, the mice of the recovery group were released into the usual plastic cage and stayed ad libitum overnight. After an overnight, they slept in the small plastic cage while fasting for 6 h, and then ipGTT or tissue sampling was performed.
Impact Of Sleep Disturbances In Liver Cirrhosis
Sleep disturbances have been shown to negatively impact QoL in cirrhotic patients and have been measured in the majority of studies by the SF-36,,, or the Chronic Liver Disease Questionnaire., For example, QoL in patients with liver cirrhosis is worse than QoL in healthy controls, for both the Physical Component Summary and the Mental Component Summary. Samanta et al, in a study comparing 100 cirrhotic patients with minimal HE or no HE, showed that minimal HE was associated with poor sleep and EDS, but also that sleep disturbances aggravate neuropsychiatric impairment. Sleep disturbances have also been shown to negatively impact psychological distress and depression.
Managing Sleep Disturbances In Cirrhosis
1Department of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University, 1001 Boulevard Decarie, Montreal, QC, Canada
Sleep disturbances, particularly daytime sleepiness and insomnia, are common problems reported by patients suffering from liver cirrhosis. Poor sleep negatively impacts patients quality of life and cognitive functions and increases mortality. Although sleep disturbances can be an early sign of hepatic encephalopathy , many patients without HE still complain of poor quality sleep. The pathophysiology of these disturbances is not fully understood but is believed to be linked to impaired hepatic melatonin metabolism. This paper provides an overview for the clinician of common comorbidities contributing to poor sleep in patients with liver disease, mainly restless leg syndrome and obstructive sleep apnea. It discusses nondrug and pharmacologic treatment options in these patients, such as the use of light therapy and histamine blockers.
2. Material and Methods
Internet data bases used were PubMed and Google Scholar. The following search words were used: Sleep disturbance Cirrhosis. The information of 55 references was cited in this review article.
3. Review of Literature and Discussion
3.2. Common Comorbidities
3.3. Nonpharmacological Treatments
3.4. Pharmacological Treatments
The authors declare that they have no competing interests.
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My Tips On How To Rest So You Can Digest
Whether or not you suffer from a digestive disorder like GERD, IBD or leaky gut, its always important to consider your digestive health when organising your bedtime routine. Certain habits or sleeping positions can have a big impact on your digestive system so below Ive listed a few of my top tips so you can avoid upsetting your digestive system at night.
Management Of Sleep Disturbance In Cld
Limited interventions have been investigated specifically targeting sleep disturbance in CLD. Lactulose is widely used to treat HE. A randomized study demonstrated a significant improvement in subjective sleep quality after three months of lactulose in cirrhotic patients with minimal HE . An observational study investigating three-month lactulose therapy in minimal HE patients revealed improvements in PSQI, Epworth Sleepiness Scale and polysomnographic measures of sleep quality . Rifaximin, an antibiotic used for refractory HE has been demonstrated to improve the amount of time spent in REM sleep, without changes to EDS or subjective sleep quality . A randomized trial investigating the effect of short-term hydroxyzine in patients with cirrhosis demonstrated an improvement in sleep efficiency and a subjective improvement in sleep quality . A randomized study investigating a months treatment of zolpidem in patients with cirrhosis revealed improvements in total sleep time, sleep efficiency, sleep latency and the number of arousals and subjective sleep quality , without any changes to sleep architecture . Interestingly, given the close association between melatonin rhythm and sleep disturbance in CLD, the administration of melatonin has not been specifically investigated. Light therapy has been investigated as a means to correct circadian rhythm, but despite positive case report evidence , a randomized trial failed to demonstrate any benefit .
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Does The Size Of Your Waist Matter
Excess abdominal fat is associated with fatty liver disease and other health risks such as diabetes. Waist measurementswhich differ according to genderare used to identify the health risks associated with excess abdominal fat.
- For men, health risks increase if your waist circumference is more than 102 cm
- For women, health risks increase if your waist circumference is more than 88 cm
It is important to measure your waist circumference in a consistent way. The best way to do this is:
- Wrap a measuring tape around yourself at a level 2 cm higher than your belly button.
- The tape should be snug but not pressing into your bare skin.
- Relax, exhale, and read the measurement.
Things You Must Know If You Dont Have A Gallbladder
Removal of the gallbladder is one of the most common surgeries performed in the USA and Australia today. Gallstones are incredibly common and they occur in 10 to 15 percent of the population. The problem does tend to run in families. Women are more likely to experience gallbladder problems than men and this is partly due to the effects of the female hormone estrogen.
A gallbladder performs several important roles in your body:
- Enables fat digestion
- Enables absorption of fat soluble antioxidants and vitamins A, E, D and K
- Assists the removal of cholesterol from your body
- Assists the removal of toxins that have been broken down by the liver
Obviously you can survive without a gallbladder, but you are more prone to developing certain health problems. In particular you are at greater risk of developing a fatty liver, experiencing indigestion and developing deficiencies of essential fatty acids and fat soluble nutrients
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Mechanisms Of Sleep Deprivation
Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
Address for reprint requests and other correspondence: N. Kumashiro, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, Japan 143-8541 .
Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
What Is Insulin And What Does It Do
Insulin is a hormone a chemical naturally produced in the body. Hormones carry a message and tell body cells, organs, or our mind what to do. Insulin, in particular, orders cells in our body to take glucose from the blood and use it for energy. As the cells consume glucose, its levels in the blood remain healthy. Therefore, insulin is an important factor in our metabolism.
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Associations Between Lifestyle And Sleep Duration
Sleep duration affects multiple behaviors. Thus, we evaluated several lifestyle factors and sleep duration. Compared with subjects with a sleep duration of 6 to 7 h, the age-adjusted OR for subjects with a sleep duration 6 h was significantly higher for those who did not eat breakfast ), whereas that of subjects with a sleep duration > 7 to 8 h was significantly lower for those who did not eat breakfast ).
Age-adjusted odds ratios of lifestyle factors in relation to sleep durationa
Surrogate Measure Of Fatty Liver
Although ultrasonography is a first-line screening technique in clinical practice, ultrasonography is not included in the NHIS mass screening program. Therefore, biochemical data were used to identify NAFLD. These data were used to calculate the fatty liver index score according to the below formula . This score ranges from 0 to 100, with< 30 representing low risk of a fatty liver and60 representing high risk of a fatty liver.
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Sleep Apnea Worsens Fatty Liver Disease
A recent study reported that there may be a direct link between sleep apnea and NAFLD that goes above and beyond the obvious indirect link between obesity/ sleep apnea/ NAFLD. In this study, a cohort of 101 obese patients were studied. Obese patients afflicted with obstructive sleep apnea were found to be much more likely to have developed a more advanced form of NAFLD.
Researchers think that oxygen deprivation caused by the frequent failures to breathe during sleep may be causing cases of NAFLD to dramatically worsen.
What Is Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease is the most common cause of chronic liver failure in the United States. In a nutshell, excess fat accumulates in the liver. Over time, the liver enlarges and liver cells are replaced by scar tissue. This eventually leads to liver malfunction, cirrhosis, occasionally to liver cancer, and sometimes to end-stage liver failure. An estimated 25% of adults in the United States today have NAFLD.
The obvious reason why NAFLD is becoming more prevalent is the increase in the nations girththe development of NAFLD is strongly linked to being overweight. In particular, it is linked to being obese and/or to having metabolic syndrome or overt type II diabetes.
NAFLD is generally ignored by both medical doctors and the population. It doesnt have any overt symptoms until it is quite advanced. Any known treatments revolve around addressing the more obvious problems of obesity and metabolic syndrome, which can sometimes reverse or stop the progression of NAFLD. End-stage forms of NAFLD can only be treated by a liver transplant.
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Rodent Gene Expression Patterns Comparable To Humans With Hcc
When the researchers investigated global gene expression in the livers of jet-lagged mice, they found a pattern similar to that seen in humans with HCC.
This shows the direct effect that chronic jet lag has on gene expression, including genes involved in regulation of circadian rhythm , despite a lack of mutations in classic cancer genes.
Cholesterol and bile acid pathways, which are essential for normal liver function, were also disrupted. Nuclear receptor CAR, which is involved in sensing toxic compounds, was constitutively activated, while FXR, the bile acid receptor, was suppressed. This pattern is similar to HCC in humans.
To us, our results are consistent with what we already knew about these receptors, but they definitely show that chronic circadian disruption alone leads to malfunction of these receptors. Fu explains. And thus, maintaining internal physiological homeostasis is really important for liver tumor suppression.
The team concludes that HCC caused by disruption of normal liver function could be addressed by drugs which target these receptors.
This experiment allowed us to take several threads that were already there and put them together to come to this conclusion. We think most people would be surprised to hear that chronic jet lag was sufficient to induce liver cancer.
Lack Of Sleep May Increase Risk Of Death
In the Ã¢â¬ÅWhitehall II Study,Ã¢â¬ï¿½ British researchers looked at how sleep patterns affected the mortality of more than 10,000 British civil servants over two decades. The results, published in 2007, showed that those who had cut their sleep from seven to five hours or fewer a night nearly doubled their risk of death from all causes. In particular, lack of sleep doubled the risk of death from cardiovascular disease.
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Sleep Loss Impairs Judgment Especially About Sleep
Lack of sleep can affect our interpretation of events. This hurts our ability to make sound judgments because we may not assess situations accurately and act on them wisely.
Sleep-deprived people seem to be especially prone to poor judgment when it comes to assessing what lack of sleep is doing to them. In our increasingly fast-paced world, functioning on less sleep has become a kind of badge of honor. But sleep specialists say if you think youÃ¢â¬â¢re doing fine on less sleep, youÃ¢â¬â¢re probably wrong. And if you work in a profession where itÃ¢â¬â¢s important to be able to judge your level of functioning, this can be a big problem.
Ã¢â¬ÅStudies show that over time, people who are getting six hours of sleep, instead of seven or eight, begin to feel that theyÃ¢â¬â¢ve adapted to that sleep deprivation — theyÃ¢â¬â¢ve gotten used to it,Ã¢â¬ï¿½ Gehrman says. Ã¢â¬ÅBut if you look at how they actually do on tests of mental alertness and performance, they continue to go downhill. So thereÃ¢â¬â¢s a point in sleep deprivation when we lose touch with how impaired we are.Ã¢â¬ï¿½
Improve Sleep And Lower Your Blood Pressure
Lack of sleep doesnt just cause hypertension there are many other poor sleep effects that you may experience. Poor sleep affects mental clarity, libido, energy, mental health, aging skin, weight and even judgment. With all these negative outcomes from poor sleep, its important to try to get as much high quality sleep as you can.
There are many ways you can improve your quality of sleep and ward off hypertension. For starters, examine any underlying causes that may be disrupting your sleep. Are you stressed? Do you suffer from sleep apnea? These are viable questions to ask to get to the root of your sleeping problems.
There are good strategies to improve your sleep and fight poor sleep effects, such as:
These tips can help you get back to high-quality sleep, which makes you feel energized and prevents the lack of sleep that causes hypertension.
You know sleep is important, so wouldnt you want to try to get the best possible nights rest naturally? Lack of sleep causing hypertension is a serious problem, so if youve been noticing that your eight hours a night has dropped down, or youre waking up exhausted, its time to make sleep a priority for the well-being of your heart.
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Relationship Between Sleepwake Disturbance And Risk Of Malnutrition In Hospitalized Patients With Cirrhosis
- 1Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
- 2Tianjin Medical University General Hospital, Tianjin Institute of Digestive Disease, Tianjin, China
- 3Department of Nutriology, Tianjin Third Central Hospital, Tianjin, China
- 4Department of Internal Medicine, Tianjin Hexi Hospital, Tianjin, China
- 5Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
- 6Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
What Can You Do To Support Your Liver
If youre looking to support your liver there are a number of steps you can take.
1 – Eat more liver-boosting foods! Id recommend checking out our nutritionist Emmas blog What are the best foods to eat for your liver? This blog contains plenty of suggestions for how to support your liver through your diet, listing a few liver-boosting foods and drinks. Its also important to bear in mind that certain foods can upset your liver the most obvious among these is alcohol but too much sugar and refined carbohydrates can also have an adverse effect by upsetting your blood glucose levels. Instead, use the mantra that fresh is best and focus on getting plenty of fruit, veg and lean protein into your diet!
2 Exercise: Exercise is a great way of staying fit, getting your heart pumping and even aiding your sleep patterns. When you exercise the blood gets pumped around your body faster, which as Ali points out, means that your liver is also getting a healthy supply of oxygen and nutrients while any waste gets filtered away allowing for a more effective and healthier liver! If youre looking to get started with some simple exercises, why not check out our Get Active Advisor Gillians blog, An easy 10 minute workout for beginners.
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Sleep And Cancer Treatment
A cancer patients sleep may influence their response to cancer treatment, and a deeper understanding of circadian rhythm may create possibilities for more effective cancer therapies.
Because the process of cell growth and division is affected by circadian rhythm, cancer cells may be more vulnerable or resistant to treatments depending on when treatment is given. Cancer drugs often target specific proteins, enzymes, or receptors on the surface of cells, and most of these are affected by circadian timing.
Though still developing, chronotherapy is a component of cancer treatment that works to optimize radiation therapy, chemotherapy, or immunotherapy based on a persons circadian rhythm. Some researchers hope that chronotherapy can enable treatments to kill more cancer cells while reducing damage to healthy tissue.
Entirely new drugs may also be developed that seize upon knowledge of circadian rhythm to fight cancer. For example, drugs have been identified that manipulate the on/off signals for cell growth that are part of circadian timing, and early-phase studies have shown positive results for several types of cancer.
Sleeping well may affect the way that cancer patients recover and respond to treatment. For example, poor sleep has been connected to higher levels of pain, longer hospital stays, and a greater chance of complications in women undergoing surgery for breast cancer.