Evening is the time when the body begins its recovery process after a long day of activity. It is also when hidden problems in the internal organs become most noticeable—especially in the liver. The liver is responsible for many vital functions, from detoxification and nutrient metabolism to enzyme production. When the liver is in trouble, the body sends out warning signals, some of which appear most clearly at night. Recognizing these signs early can help you protect your health and prevent dangerous complications such as chronic hepatitis, cirrhosis, or liver cancer.

Below are four nighttime symptoms that may signal the liver is having problems. If you experience one or more of these symptoms consistently, you should visit a hepatology specialist as soon as possible.

⚠️ Do Not Ignore These Nighttime Signs

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1. Discomfort in the Right Upper Abdomen When Lying Down

This is the area where the liver is located. A feeling of heaviness, tightness, or dull pain may indicate inflammation or swelling of the liver. When you lie down at night, more blood flows to the liver, making the discomfort more noticeable. Many people describe it as a pressure pressing on the upper abdomen, sometimes radiating to the back or right shoulder. If this sensation occurs every evening, it may be a sign that your liver is not functioning properly.

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2. Increased Itching at Night

This is a common symptom in people with liver and biliary diseases. When the liver weakens, bile acid clearance becomes impaired, leading to a buildup of bile salts in the bloodstream, which causes persistent itching. At night, slight increases in body temperature and heightened nerve sensitivity make the itching worse. Some individuals even wake up due to intense itching—especially in the hands, feet, palms, or soles. If itching lasts for weeks and topical treatments don’t help, you should have your liver function checked.

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3. Insomnia or Poor-Quality Sleep

The liver plays an essential role in the metabolism of hormones related to sleep. When liver function declines, the body may experience melatonin imbalance—the hormone regulating the sleep–wake cycle. According to Mayo Clinic, people with chronic liver disease often struggle with falling asleep, wake up frequently at night, or experience restless sleep. Some may have vivid dreams or wake up feeling unrefreshed. When insomnia is combined with prolonged fatigue, it is a sign that your liver may be under excessive stress.

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4. Bloating and Gas at Night

Digestive specialists at Bach Mai Hospital note that the liver produces bile to help digest fats. When the liver weakens, digestion becomes less efficient, leading to bloating and indigestion—especially after dinner. Many people feel abdominal tightness, discomfort, or excessive gas at night. If this symptom persists and is accompanied by pale stools or abdominal pain, it may indicate significant liver damage.

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Not every symptom directly indicates liver disease, but none of them should be ignored. To protect your liver, start with these simple lifestyle habits:

• Adopt a healthy diet: eat more vegetables and fruits, reduce saturated fats

• Sleep early and ensure 7–8 hours of rest each night

• Minimize alcohol consumption — the leading cause of fatty liver and hepatitis

• Drink enough water and stay physically active

• Avoid self-medicating or using unverified “liver detox” supplements