Sleep Problems

Trouble sleeping is common in people with cirrhosis. Some people feel sleepy during the day, even after having enough sleep. Other people feel sleepy during the day and wide awake at night.

Sleep is important because it gives you energy to get through your day. When you have trouble sleeping for weeks at a time, it can make your health worse. Sleep is especially important if you are living with a chronic condition like cirrhosis.

Causes

Having trouble getting a restful sleep may be because of your cirrhosis, or because of other symptoms like itching, muscle cramps, pain, or trouble breathing.

Take this quiz to see if you may have sleep troubles: Epworth Sleepiness Scale

Treatment

Complementary treatments
  • Mind and body therapies like mindfulness, yoga and meditation can improve sleep.
  • Bright-light therapy can also be helpful. It includes getting bright light exposure in the early hours of the morning and avoiding bright light in the evenings (including mobile phones, tablets etc).
Medications

If you are still having trouble with sleep after trying the complementary treatments and self care tips on this page, talk to your healthcare team about whether sleep medicine may be right for you. If you have cirrhosis, you should be extra cautious with sleep medicines. You can find more information on medication safety here.

Self Care Tips:

  • Wake up at the same time every morning.
  • Exercise early in the day. Avoid exercising before bed as this may keep you up at night
  • Do not go to bed until you feel sleepy. If you have gone to bed and are unable to sleep, get out of bed and do something relaxing before returning to bed.
  • Develop a relaxing bedtime ritual, like taking a warm shower or reading something relaxing.
  • Don’t watch television or use mobile phones, tablets or computers in bed as these activate your brain. Keep your bedroom dark and cool at night.
  • Avoid napping during the day.
  • Avoid caffeine and nicotine in the evening.
  • Avoid alcohol.

Let your healthcare provider know if you:

  • have trouble with sleep even after following the self-care tips above
  • are needing sleep during the day
  • wake up always feeling tired

References:

The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.

References: 

  1. US Department of Veterans Affairs, Veterans Health Administration 
  2. Canadian Liver Foundation
  3. Davison SN on behalf of the Kidney Supportive Care Research Group. Conservative Kidney Management Pathway; Available from: https//:www.CKMcare.com.
  4. My Health Alberta
  5. Bruyneel M, Sersté T. Sleep disturbances in patients with liver cirrhosis: prevalence, impact, and management challenges. Nat Sci Sleep. 2018;10:369‐375. Published 2018 Nov 2. doi:10.2147/NSS.S186665
Last reviewed March 15, 2021
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