You probably know the feeling of being tired during the day even after a long night in bed. Most of us blame a busy week or too much screen time. New research suggests that drowsiness may say something about an organ we rarely think about.
Adults who struggled to sleep, or felt drowsy almost every day, had notably higher rates of fatty liver disease. The finding was reported at the American College of Gastroenterology 2026 Annual Scientific Meeting in Nashville, held October 9 to 14.
People with near-daily daytime sleepiness had about 65% higher odds of the condition than people who felt alert during the day.
The study drew on 13,291 US adults from the National Health and Nutrition Examination Survey, from 2017 to 2023. Among those with trouble sleeping, 36.3% had fatty liver disease. Among those without sleep trouble, the rate was 29.6%.
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What the researchers actually measured
Researchers at Vassar Brothers Medical Center in New York, led by Bright Nwatamole, split sleep into quality and quantity. The number of hours themselves showed no clear link to the disease. The quality of sleep did.
Liver health was checked with a bedside scan called vibration-controlled transient elastography, which measures stiffness and fat in the liver. Sleep habits came from standard NHANES survey questions on trouble falling asleep, trouble staying asleep and daytime sleepiness.
After adjusting for demographics, the links held. The authors noted that current fatty liver guidelines do not ask doctors to screen for sleep quality in routine visits.
The pattern lines up with earlier work on sleep quality and overall disease risk, where how well a person sleeps has been tied more closely to risk than how long they sleep.
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Why it matters for a very common condition
Fatty liver disease is quiet. According to the Cleveland Clinic, the condition develops over several years and a person can have it without any symptoms. When symptoms do show, they are usually mild: an ache in the upper right abdomen, or extreme fatigue and weakness.
The full name is metabolic dysfunction-associated steatotic liver disease, or MASLD. It is the newer label for what used to be called non-alcoholic fatty liver disease. It develops when fat builds up in the liver and can quietly scar the organ over years.
The scale is large. Cleveland Clinic estimates that more than 30% of adults worldwide have the condition, and most do not know. We have previously covered the subtle warning signs doctors want people to watch for.
When drowsiness is worth bringing up
A single groggy afternoon is not a liver warning. Persistent trouble falling asleep, or feeling drowsy during the day most days of the week, is worth raising at a check-up.
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This is especially true for people with obesity, type 2 diabetes or high cholesterol, who already belong in the group that doctors monitor for liver disease.
The findings were presented as a conference poster and have not yet been published in a peer-reviewed journal. They show association, not cause. Sleep is a factor people can act on, however, and the researchers argue it may be an overlooked one in liver care.
For now, patients with heavy daytime drowsiness or ongoing sleep trouble can raise it as a specific concern at their next liver or metabolic appointment, alongside the usual risk factors.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.