RESUMEN
Obstructive sleep apnea syndrome has been recently described as a complication of ascites. This occurs due to elevated mechanical loads on the upper airway and defects in compensatory neuromuscular responses. Sleep disturbances, daytime hypersomnolence and neurocognitive dysfunction are common complications of cirrhosis and sleep apnea syndrome. The severity of these complications increases with the presence of both pathologies and improve markedly with the improvement of apnea after tapping of ascites. The aim of this study was to determine the type of apnea associated with ascites. The effect of apnea on the condition and the level of improvement in sleep disturbances and neurocognitive complications after tapping of ascites. The study was conducted on 40 patients with chronic liver disease, divided into 3 groups according to the extent of ascites. Group I with tense ascites [n=20], Group II with mild to moderate ascites [n=10], Group III without ascites [n=10]. Assessment was done through clinical examination, minimental state examination [MMSE], laboratory investigations, abdominal ultrasound and polysomnography. Sleep efficiency and neurocognitive functions as measured by MMSE were significantly affected with the increased degree of ascites. Apnea was found to be of the obstructive type. Apnea hypopnea index [AHI] was clearly higher in group I than groups II and III. MMSE and sleep efficiency showed a statistically significant correlation with the presence of significant apnea. AHI, sleep efficiency and MMSE improved markedly after tapping of ascites. Obstructive sleep apnea syndrome [OSAS] can be a complication of tense ascites. OSAS causes more deterioration of sleep efficiency and neurocognitive functions and these findings improved after tapping of ascites