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• W79350960 abstract "Patients with liver cirrhosis (LC) have a variety of symptoms; some of them have sleep disturbance. The mechanism of sleep disturbance in these patients is still unclear. Sleep disturbance is one of the symptoms of overt hepatic encephalopathy but has also been reported for patients without encephalopathy. Recently, attention is being paid to the ratio of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) in liver disease patients. Abnormalities in BCAA and AAA levels in LC are expressed as molar BCAA/AAA ratio or BCAA/tyrosine ratio. The plasma BCAA concentration may influence brain function and affect appetite, physical and mental fatigue, mental performance, and physical endurance. The increased influx of AAAs into the brain would increase the biological availability of precursors for neurotransmitters. BCAA-enriched snacks are useful for cirrhotic patients who do not have overt encephalopathy but experience sleep disturbance. BCAA supplementation improved sleep disturbance, and amino acid supplementation without BCAA induced sleep disturbance. It has been considered that sleep disturbance is an early sign of hepatic encephalopathy and symptom of minimal hepatic encephalopathy, which is characterized by cognition dysfunction without overt encephalopathy. Melatonin, a brain hormone and common pacemaker of circadian rhythm, and its metabolite are involved in hepatic metabolism; thus, the reason for sleep disturbance (e.g. delayed sleep phase) might be that peak melatonin levels are significantly delayed in cirrhotic patients. Neurosteroids, which are suggested to be related with hepatic encephalopathy, are known to induce significant alterations of the sleep/wake cycle. BCAAs can act as psychotropic drugs that directly act on the central nervous system. Restless legs syndrome and obstructive sleep apnoea syndrome are known as causes of sleep disturbance in chronic liver disease patients. The cause of sleep disturbance and the relationship between prognosis of LC and sleep disturbance will be the subject of future research." @default.
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• W79350960 date "2013-01-01" @default.
• W79350960 modified "2023-09-23" @default.
• W79350960 title "Branched-chain amino acid-enriched snacks for sleep disturbance" @default.
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• W79350960 doi "https://doi.org/10.3920/978-90-8686-763-9_31" @default.
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