You are right in what you say. Odd sleeping patterns seem to show up before the official diagnosis ofcirrhosis. My sister is the one with cirrhosis and she had a problem with sleep at least 10 yrs. before her official diagnosis. She has lived with the diagnosis of stage 4cirrhosis for over 5 yrs. now, but it is progressing to other organs and systems now. She has actually had cirrhosis in it's earlier stages for at least 15 yrs. before she was diagnosed with stage 4cirrhosis and liver failure (over 5 yrs. ago). She now has congested heart failure, renal problems and low platelet problems. All caused by the end stage ofcirrhosis.
She has had bouts of HE throughout these past 5 yrs., but she does not recognize it as such. And it keeps her from going to the hospital for treatment until it is almost too late many times. (She does not live close to me and is rather isolated at this stage of her life.) I do not know how much longer she has as she does not communicate well and my attempts to see her stress her out too much. Maybe part of her HE as well.