Reviewer ’s report  
 
Title: Non-alcoholic Fatty Liver Disease among Patients wit h Sleep Disorders: A Nationwide 
Study of Taiwan  
 
Version: 0 Date: 17 May 2019  
 
Reviewer: Ludovico Abenavoli  
 
Reviewer's report:  
 
- Introduction section: i suggest to report taht NAFLD is the hepatic border of metabolic 
syndrome, and it is related to many metabolic changes (i.e. Abenavoli et al. World J 
Gastroenterol. 201 6). I suggest also to report the exact definition of sleep apnea  
 
- Methods section: the benzodiazepines are sedative hypnotic drugs, i.e., central nervous system 
depressant drugs, that may adversely affect the control of ventilation during sleep. Prescript ion 
of these drugs may worsen sleep -related breathing disorders, especially in patients with chronic 
obstructive pulmonary disease or cardiac failure. The most frequent users of sedative hypnotics 
are the polymorbid elderly with a secondary complaint of in somnia. Although the 
benzodiazepines may reduce sleep fragmentation, their long -term use may also cause health 
problems, such as complete obstructive sleep apnea in heavy snorers or short repetitive central 
sleep apnea in patients with recent myocardial in farction. In this way are benzodiazepines 
considered as a exclusion criteria?  
 
- Discussion section: considered that these two conditions are exceedingly common in the 
general population, on the basis of the founded data, i suggest to report the profile of the patients 
with sleep apnea in which is necessary to provide the screening for NAFLD.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are r equired in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, fees, funding, or salar y 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publicati on of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has  applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I decla re that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
NO 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is  accepted f or publication, my named report 
including any attachments I upload will be posted on the website  along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Non-alcoholic Fatty Liver Disease among Patients wit h Sleep Disorders: A Nationwide 
Study of Taiwan  
 
Version: 0 Date: 17 May 2019  
 
Reviewer: Ludovico Abenavoli  
 
Reviewer's report:  
 
- Introduction section: i suggest to report taht NAFLD is the hepatic border of metabolic 
syndrome, and it is related to many metabolic changes (i.e. Abenavoli et al. World J 
Gastroenterol. 201 6). I suggest also to report the exact definition of sleep apnea  
 
- Methods section: the benzodiazepines are sedative hypnotic drugs, i.e., central nervous system 
depressant drugs, that may adversely affect the control of ventilation during sleep. Prescript ion 
of these drugs may worsen sleep -related breathing disorders, especially in patients with chronic 
obstructive pulmonary disease or cardiac failure. The most frequent users of sedative hypnotics 
are the polymorbid elderly with a secondary complaint of in somnia. Although the 
benzodiazepines may reduce sleep fragmentation, their long -term use may also cause health 
problems, such as complete obstructive sleep apnea in heavy snorers or short repetitive central 
sleep apnea in patients with recent myocardial in farction. In this way are benzodiazepines 
considered as a exclusion criteria?  
 
- Discussion section: considered that these two conditions are exceedingly common in the 
general population, on the basis of the founded data, i suggest to report the profile of the patients 
with sleep apnea in which is necessary to provide the screening for NAFLD.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are r equired in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, fees, funding, or salar y 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publicati on of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has  applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I decla re that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
NO 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is  accepted f or publication, my named report 
including any attachments I upload will be posted on the website  along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Non-alcoholic Fatty Liver Disease among Patients wit h Sleep Disorders: A Nationwide 
Study of Taiwan  
 
Version: 0 Date: 17 May 2019  
 
Reviewer: Ludovico Abenavoli  
 
Reviewer's report:  
 
- Introduction section: i suggest to report taht NAFLD is the hepatic border of metabolic 
syndrome, and it is related to many metabolic changes (i.e. Abenavoli et al. World J 
Gastroenterol. 201 6). I suggest also to report the exact definition of sleep apnea  
 
- Methods section: the benzodiazepines are sedative hypnotic drugs, i.e., central nervous system 
depressant drugs, that may adversely affect the control of ventilation during sleep. Prescript ion 
of these drugs may worsen sleep -related breathing disorders, especially in patients with chronic 
obstructive pulmonary disease or cardiac failure. The most frequent users of sedative hypnotics 
are the polymorbid elderly with a secondary complaint of in somnia. Although the 
benzodiazepines may reduce sleep fragmentation, their long -term use may also cause health 
problems, such as complete obstructive sleep apnea in heavy snorers or short repetitive central 
sleep apnea in patients with recent myocardial in farction. In this way are benzodiazepines 
considered as a exclusion criteria?  
 
- Discussion section: considered that these two conditions are exceedingly common in the 
general population, on the basis of the founded data, i suggest to report the profile of the patients 
with sleep apnea in which is necessary to provide the screening for NAFLD.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are r equired in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qua lity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, fees, funding, or salar y 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publicati on of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has  applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I decla re that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
NO 
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is  accepted f or publication, my named report 
including any attachments I upload will be posted on the website  along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant