Hyperammonemia Takes Away Restorative Sleep in Cirrhosis Patients

Ammonia is a normal constituent of all body fluids. It is a substance that contains nitrogen and is a product of the catabolism of protein. Excess ammonia is excreted as urea, which is synthesized in the liver through the urea cycle. Sources of ammonia include bacterial hydrolysis of urea and other nitrogenous compounds in the intestine, amino acid transamination in skeletal muscle and the purine-nucleotide cycle and other metabolic processes in the kidneys and liver. Increased entry of ammonia to the brain is a primary cause of neurological disorders associated with hyperammonemia.

Hyperammonemia is a dangerous condition that may lead to encephalopathy and death. It may be primary or secondary. Primary hyperammonemia is caused by several inborn errors of metabolism that are characterized by reduced activity of any of the enzymes in the urea cycle. Secondary hyperammonemia is caused by inborn errors of intermediary metabolism characterized by reduced activity in enzymes that are not part of the urea cycle or dysfunction of cells that make major contributions to metabolism.

deep sleep
Our bodies need to sleep in order to perform rejuvenating functions like muscle growth, protein synthesis, tissue repair, and even learning new things. The sleep phases when our bodies and minds undergo the most renewal (Deep and REM sleep) are collectively referred as Restorative Sleep. Deep sleep occurs mostly within the first third of the night, while REM sleep occurs mostly within the final third of the night. This means that, in order to get the Restorative sleep your body needs to follow a healthy schedule. However, hyperammonemia significantly increases daytime sleepiness in patients with cirrhosis

Cirrhosis is scarring of the liver and poor liver function and it’s the final phase of chronic liver disease. Caused by chronic liver diseases, cirrhosis is the end result of chronic liver damage. Common causes of chronic liver disease include long-term alcohol abuse and hepatitis C infection (long-term infection). Symptoms may develop gradually, or there may be no symptoms at all. When symptoms do occur, they can include confusion or problems of thinking, impotence, loss of appetite, loss of interest in sex, nausea and vomiting, nosebleeds or bleeding gums, swelling or fluid buildup of the legs (edema) and in the abdomen (ascites), vomiting blood or blood in stools, pale or clay colored stools, small, red spider-like blood vessels on the skin, weakness, weight loss and jaundice. It is important that people with cirrhosis should be careful of hyperammonemia.

Hyperammonemia Takes Away Restorative Sleep in Cirrhosis Patients
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