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ORIGINAL RESEARCH article

Front. Netw. Physiol.
Sec. Networks in Sleep and Circadian Systems
Volume 4 - 2024 | doi: 10.3389/fnetp.2024.1458665

Significant nocturnal wakefulness after sleep onset in metabolic dysfunction-associated steatotic liver disease

Provisionally accepted
Sofia Schaeffer Sofia Schaeffer 1,2*Andrijana Bogdanovic Andrijana Bogdanovic 1Talitha Hildebrandt Talitha Hildebrandt 1Emilio Flint Emilio Flint 1Anne Geng Anne Geng 1Sylvia Pecenko Sylvia Pecenko 1Paul Lussier Paul Lussier 1Michael A. Strumberger Michael A. Strumberger 3Martin Meyer Martin Meyer 3Jakob Weber Jakob Weber 4Markus H. Heim Markus H. Heim 1,2Christian Cajochen Christian Cajochen 3Christine Bernsmeier Christine Bernsmeier 1,2
  • 1 Department of Biomedicine, Faculty of Medicine, University of Basel, Basel, Basel-Stadt, Switzerland
  • 2 University Centre for Gastrointestinal and Liver Diseases, Basel, Switzerland
  • 3 Centre for Chronobiology, University Psychiatric Clinic Basel, Basel, Switzerland
  • 4 Other, 4108 Witterswil, Switzerland

The final, formatted version of the article will be published soon.

    Metabolic dysfunction-associated steatotic liver disease (MASLD) is a multisystemic disease with a multifactorial pathogenesis involving dietary, environmental, and genetic factors. Previous mouse models suggested that circadian misalignment may additionally influence its development as it influences metabolism in diverse organs including the liver. Further, data from sleep questionnaires proved sleep-wake disruption in patients with MASLD. We objectively assessed sleep-wake rhythms in patients with biopsy-proven MASLD (n=35) and healthy controls (HC, n=16) using actigraphy 24/7 for four weeks. With the aim to re-align sleep rhythms a single standardized sleep hygiene education session was performed after two weeks. Actigraphy data revealed that MASLD patients had more awakenings per night (MASLD vs. HC 8.5 vs. 5.5, p=0.0036), longer wakefulness after sleep onset (MASLD vs. HC 45.4 min vs. 21.3 min, p=0.0004), and decreased sleep efficiency (MASLD vs. HC 86.5% vs. 92.8%, p=0.0008) compared with HC despite comparable sleep duration. Patients with MASLD self-reported shorter sleep duration (MASLD vs. HC 6h vs. 6 h 45 min, p=0.01) and prolonged sleep latency contributing to poorer sleep quality. Standardized sleep hygiene education did not produce significant changes in sleep parameters. Our findings indicate fragmented nocturnal sleep in patients with MASLD, characterized by increased wakefulness and reduced sleep efficiency, perceived subjectively as shortened sleep duration and delayed onset. A single sleep hygiene education session did not improve sleep parameters.

    Keywords: MASLD, Circadian misalignment, Circadian Rhythm, Actigraphy, Sleep hygiene education

    Received: 02 Jul 2024; Accepted: 30 Sep 2024.

    Copyright: © 2024 Schaeffer, Bogdanovic, Hildebrandt, Flint, Geng, Pecenko, Lussier, Strumberger, Meyer, Weber, Heim, Cajochen and Bernsmeier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sofia Schaeffer, Department of Biomedicine, Faculty of Medicine, University of Basel, Basel, 4031, Basel-Stadt, Switzerland

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