SNORE-HE Trial Opens: Melatonin vs Thiamine to Restore REM Sleep and Cognition in Hepatic Encephalopathy — What Clinicians Need to Know
247 Health News Editorial
·30 July 2026
·5 min read
·clinical-trialsThe SNORE-HE trial is now recruiting patients with cirrhosis and hepatic encephalopathy to investigate whether nightly melatonin 3 mg can restore REM sleep and improve cognitive function compared to thiamine. This double-blind crossover pilot study uses gold-standard polysomnography alongside continuous wearable monitoring to address a profoundly undertreated dimension of liver disease. Clinicians managing patients with covert or overt hepatic encephalopathy and sleep disturbance should be aware of this emerging evidence pathway.
Originally reported by ClinicalTrials.gov
References
- 1.Weill Medical College of Cornell University. (2025). Effect of supplemental nightly melatonin on REM and cognition in hepatic encephalopathy (SNORE-HE) trial (NCT07046429). ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT07046429
- 2.Montagnese, S., Middleton, B., Skene, D. J., & Morgan, M. Y. (2009). Night-time sleep disturbance does not correlate with neuropsychiatric impairment in patients with cirrhosis. Liver International, 29(9), 1372–1382. https://doi.org/10.1111/j.1478-3231.2009.02089.x
- 3.Vilstrup, H., Amodio, P., Bajaj, J., Cordoba, J., Ferenci, P., Mullen, K. D., Weissenborn, K., & Wong, P. (2014). Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology, 60(2), 715–735. https://doi.org/10.1002/hep.27210
- 4.Bajaj, J. S., Cordoba, J., Mullen, K. D., Amodio, P., Shawcross, D. L., Butterworth, R. F., & Morgan, M. Y. (2011). Review article: the design of clinical trials in hepatic encephalopathy — an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement. Alimentary Pharmacology & Therapeutics, 33(7), 739–747. https://doi.org/10.1111/j.1365-2036.2011.04590.x
- 5.de Franchis, R., Bosch, J., Garcia-Tsao, G., Reiberger, T., Ripoll, C., & Baveno VII Faculty. (2022). Baveno VII — Renewing consensus in portal hypertension. Journal of Hepatology, 76(4), 959–974. https://doi.org/10.1016/j.jhep.2021.12.022
- 6.Mostacci, B., Ferlisi, M., Baldi Antognini, A., Sama, C., Morelli, C., Mondini, S., & Cirignotta, F. (2008). Sleep disturbance and daytime sleepiness in patients with cirrhosis: a case control study. Neurological Sciences, 29(4), 237–240. https://doi.org/10.1007/s10072-008-0973-y
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247 Health News Editorial
247 Health News is a medical intelligence platform delivering evidence-based research appraisals, clinical trial monitoring, and health technology news for healthcare professionals.
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