The Association Between Sleep Disturbance and Liver Stiffness in Patients with Non-alcoholic Fatty Liver Disease

Abazar Parsi, Eskandar Hajiani, Ahmad fakhri, Mohamad hossein Haghighizadeh, Mohsen Taghizadeh, Mohammad Javad Rezaei



Non-alcoholic fatty liver disease (NAFLD) is a common disorder leading to severe medical conditions such as liver failure or malignancy. Given the potential relation between sleep disturbance and NAFLD, we aimed to investigate the association between the deterioration of sleep and liver stiffness with NAFLD.

Materials and Methods:

In this cross-sectional study, 134 patients who were proven to have NAFLD were included. Liver stiffness was determined by transient elastography, and sleep patterns were evaluated using Pittsburg Sleep Quality Index (PSQI).


 The results showed that sleep disorder was more prevalent in women (p = 0.007), and they had higher liver stiffness than men (p = 0.001). Habitual Sleep Efficiency: The adequate sleep time was worsened in patients with more severe liver stiffness (p = 0.037). Also, Subjective Sleep Quality that is the self-estimation of patients about sleep quality, was reversely related to liver stiffness (p = 0.003). Categorized liver stiffness groups had a negative association between sleep quality and liver stiffness (p = 0.001), but there was no significant association between liver stiffness and sleep latency, sleep duration, and daytime dysfunction or using sleeping pills.


 The present study indicates that bad sleep habits and poor sleep quality correlate with increased liver stiffness in patients with NAFLD, suggesting that patients' lifestyle modification can improve the quality of their lives and prevent more severe disorders caused by sleep dysfunction.


Sleep disruption, Liver stiffness, NFLAD, Pittsburgh Sleep Quality Index

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