Night Sleep Organization in Patients with Severe Hepatic Failure

20 subjects with severe hepatic failure have been studied by means of all night polygraphic sleep recordings. Base night recordings have been made, as well as registrations after treatment with drugs that are known to improve the clinical conditions of these patients, especially concerning the psychic performances. Base night recordings show sleep disruption, with a large amount of wakefulness at the beginning of the registrations and during the night itself; sleep stages are strongly reduced, especially REM sleep. After L-dopa treatment, these negative patterns are furthermore enhanced and the percentage incidence of the REM stage is very low; nevertheless, this behaviour goes side by side with a light improvement in psychological performances. On the contrary, therapy with lactulose seems to improve the neuropsychiatric state and the sleep organization; as a matter of fact, wakefulness is lower in the night records after lactulose treatment, whilst the percentage incidence of sleep stages tends back toward normality; REM sleep has clearly risen.