Non-alcoholic fatty liver disease and sleep quality: a single center cross-sectional survey study

Sleep-wake disorders are probably a part of Nonalcoholic Fatty Liver Disease (NAFLD) etiology. This study aimed to evaluate the relationship between NAFLD and the Pittsburgh Sleep Quality Index (PSQI) components. Sleep quality was assessed by the PSQI, which comprised seven components. Participants diagnosed with hepatic steatosis using ultrasonographic imaging and healthy volunteers were given the questionnaire. The percentage of subjects with poor sleep quality was noticeably higher in the NAFLD patients than in the non-NAFLD control group (OR: 4.58, 95% CI: 2.67-7.85) (p<0.001). Compared to the control group, the NAFLD group reported shorter sleep duration (p=0.044), a longer sleep onset delay (p<0.001), worse subjective sleep quality (p<0.001), a higher percentage of subjects with sleep disturbances (p<0.001), a higher percentage of subjects using hypnotic drugs (p=0.009), and a higher percentage of subjects with daytime dysfunction (p<0.001). When the subjects were split into two groups based on gender, global PSQI sleep quality and subjective sleep quality were significantly worse in both genders with NAFLD than in the non-NAFLD group (p<0.001). The sleep onset delay of the NAFLD group was substantially longer in males (p=0.002) and females (p<0.001) compared to controls. Sleep disturbances were significantly higher in both sexes with NAFLD compared to controls (p<0.001). The rate of those with daytime dysfunction in the NAFLD group was considerably higher in both genders compared to the non-NAFLD group (p=0.001). Only among the male patients in the NAFLD group the prevalence of hypnotic drug use was substantially greater (p=0.033) than in the non-NAFLD group. Poor sleep was associated with NAFLD in both genders.