This prospective registry study (2018–2024) evaluated the prevalence of sleep disorders in 104 adult PBC patients and their association with symptoms (fatigue, pruritus), laboratory markers, and UDCA treatment response, using the PBC-40 and CLDQ questionnaires.
33% of PBC patients reported sleep disorders. Those affected had higher ALP (p=0.003) and AST (p=0.018), more fatigue (p=0.016), worse self-rated health (p<0.001), and were far less likely to meet Paris II UDCA response criteria (44% vs. 94%, p<0.001). On multivariable analysis, higher ALP, UDCA non-response, and poorer self-rated health were independently associated with sleep disorders.
Single-center registry with a relatively small sample (n=104), limiting generalizability. Sleep disorders were patient-reported via questionnaires rather than confirmed by polysomnography or formal sleep study. Confounders such as comorbid depression or obstructive sleep apnea were not clearly accounted for.
Routinely screen PBC patients for sleep complaints — especially those with elevated ALP or poor UDCA response — as sleep disorders may signal a higher overall disease burden. Addressing sleep disturbances alongside standard treatment monitoring could improve patient-reported outcomes.
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