Studies Say Poor Sleep Can Cause Fatty Liver Disease

Janet Tiberian Author
By Janet Tiberian, MA, MPH, CHES
November 17, 2022
older woman laying in bed gripping sides of head

Getting consistent, good quality sleep is crucial for your health. Sleep deprivation raises your risk for:

  • Obesity
  • Type 2 diabetes
  • Heart health
  • Brain health.

Recent studies suggest liver health should be added to this list. Poor sleep is a potential contributor to chronic liver disease, particularly fatty liver disease, according to a study published in The Lancet.

The liver has many functions, one of which is fat metabolism. The liver breaks down fat cells to yield energy. It also produces lipoproteins to carry fatty acids from the liver to body tissues, leaving the liver with very little fat to store. 

However, fat can accumulate if you consume too much alcohol or too many calories or have a condition such as:

  • Obesity 
  • Insulin resistance or type 2 diabetes
  • High bad cholesterol, high triglyceride levels or low good cholesterol
  • Polycystic ovarian syndrome (PCOS)
  • Sleep apnea
  • Underactive thyroid or pituitary gland
  • Metabolic syndrome

It can also accumulate if you are malnourished or lose weight rapidly. Excess fat acts like a toxin to liver cells, raising inflammation, promoting insulin resistance and lowering adiponectin -- a hormone that helps improve insulin sensitivity and lower inflammation. Too much fat in the liver leads to hepatic stenosis -- more commonly known as fatty liver disease -- the leading chronic liver disease worldwide, affecting about 25 percent of adults. 

There are two basic types of fatty liver disease: alcohol-related fatty liver disease and non-alcoholic fatty liver disease. Cleveland Clinic lists symptoms as:

  • Abdominal pain, nausea, loss of appetite, feeling of fullness
  • Weight loss
  • Yellowing of the skin and white of eyes (jaundice)
  • Swollen abdomen and legs (edema)
  • Extreme fatigue, mental confusion
  • Weakness

For many people fatty liver disease is manageable. Treatments usually involve:

  • Losing weight
  • Avoiding alcohol
  • Taking medications and/or vitamin E supplement

However, untreated or unmanageable fatty liver disease can lead to complications such as:

  • An enlarged liver
  • Alcoholic hepatitis
  • Cirrhosis
  • Fibrosis
  • Liver cancer
  • Cardiovascular disease

 As a result, people with fatty liver disease generally have a shorter lifespan. Data collected from a large number of Swedish patients with fatty liver disease lived 2.8 years less than their expected survival, according to a study published in Hepatology.  

“Many factors are involved in the development of liver disease. For years, a high-fat diet, high alcohol intake, obesity and type 2 diabetes were considered the leading risk factors,” says Bernard Kaminetsky, MD, medical director, MDVIP. “However, poor sleep habits are emerging as a serious risk factor.”

Chinese researchers analyzed self-reported sleep behavior from more than 5,000 Chinese adults with fatty liver disease. They found that increased risk of fatty liver disease were significantly associated with:

  • Late bedtime
  • Snoring
  • Daytime napping for more than 30 minutes

In contrast, they found that moderately improving sleep habits can reduce the risk for fatty liver disease by 29 percent, according to a study published in the Journal of Clinical Endocrinology & Metabolism.

Large-scale study conducted in Korea found that over time poor quality sleep and decreased sleep duration raised the risk for non-alcoholic fatty liver disease.

“A lack of sleep doesn’t just put a person at risk for fatty liver disease – there’s also a risk for other liver diseases such as cirrhosis,” Kaminetsky says.

Liver and Sleep Quality

Our bodies operate on an internal, 24-hour clock, referred to a circadian rhythm. This clock helps keep our natural processes like breathing, digesting food and sleeping run at various points throughout a 24-hour period. Circadian rhythms are connected to and affect the sleep-wake cycle. 

The liver works in a similar manner. It has its own internal clock that helps it maintain its processes such as:

  • Regulating hormones
  • Metabolizing nutrients
  • Detoxifying the body
  • Processing insulin

 Sleep deprivation compromises the liver’s ability to perform these functions, altering fat content and raising the risk for disease, especially when it’s over exposed to damaging elements such as:

  • Toxins, including environmental and alcohol 
  • Harmful herbs, supplements and over-the-counter medications 
  • Simple carbohydrates, e.g., sugar and refined grains

Maintaining a healthy liver is complicated, says Kaminetsky. “Work closely your primary care physician to make sure you’re living a liver-friendly lifestyle, which includes:

  • Adhering to a healthy diet
  • Managing weight
  • Limiting alcohol
  • Monitoring over-the-counter medication usage
  • Maintaining healthy blood sugar and blood fat levels
  • Getting enough sleep

If you don’t have a primary care physician, consider partnering with an MDVIP-affiliated physician. Physicians in MDVIP-affiliated practices can help you adopt a healthier lifestyle. Find an MDVIP affiliate near you and begin your partnership in health »

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About the Author
Janet Tiberian Author
Janet Tiberian, MA, MPH, CHES

Janet Tiberian is MDVIP's health educator. She has more than 25 years experience in chronic disease prevention and therapeutic exercise.

View All Posts By Janet Tiberian, MA, MPH, CHES
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