Objective To investigate the relationship between sleep-wake disturbance and malnutrition in patients with liver cancer. Method A total of 122 patients with hepatocellular carcinoma into our hospital from October 2019 to October 2021 were chosed as the research objects. Before treatment the nutritional status was assessed by the Royal Free Hospital - Nutritional Prioritizing Tool RFH-NPT which was divided into 74 cases in the malnutrition group 2-7 points and 48 cases in the normal nutrition group 0- 1 point . The sleep status was assessed by the Pittsburgh Sleep Quality Index PSQI PSQI > 7 indicated sleep-wake disturbance. Result Univariate comparison showed that the malnutrition group had older age longer course of disease higher tumor TNM stage lower body mass index BMI less serum albumin level higher total score of PSQI and more incidence of sleep-wake disturbance P < 0. 05 . Multivariate Logistic regression analysis showed that age TNM stage and sleep-wake disturbance were the risk factors of malnutrition in patients with liver cancer P<0. 05 . Spearman test showed that RFH-NPT score was positively correlated with PSQI score r = 0. 390 P< 0. 001 . Conclusion The incidence of malnutrition in patients with liver cancer is high which is related to patients􀆳 age TNM stage and sleep-wake disturbance Evaluating the nutritional status and sleep-wake disturbance of patients with liver cancer is of great significance to guide clinical treatment.