title: Higher systemic inflammation is associated with poorer sleep quality in stable haemodialysis patients.
abstract: BACKGROUND
  Increased inflammation has been noted in sleep disorder patients with normal renal function. However, the relationship between sleep quality and circulating inflammatory markers has not been previously studied in haemodialysis (HD) patients.
  
  
  METHODS
  A total of 114 HD end-stage renal disease patients receiving maintenance HD for >3 months were included in this study. Pittsburgh Sleep Quality Index (PSQI) was used to measure individual's sleep quality. Based on the global PSQI score, patients were divided into groups of good sleepers (PSQI < 5) and bad sleepers (PSQI >or= 5).
  
  
  RESULTS
  Twenty-three patients (20.2%) were classified as good sleepers and 91 patients (79.8%) were bad sleepers. Bad sleepers have significantly higher serum hsCRP level and lower serum phosphate level (all P < 0.05). The global PSQI score, or worse sleep quality are positively correlated with serum triglyceride level, high-sensitivity C-reactive protein (hsCRP) level, IL-1beta level and negatively correlated with the haemoglobin and phosphate level. In the multi-variable linear regression model, levels of hsCRP (beta = 0.209, P = 0.029) and triglyceride (beta = 0.212, P = 0.025) were both significant independent predictors for the global PSQI score.
  
  
  CONCLUSIONS
  Our study demonstrated severe impairment of sleep quality in HD patients and corroborated the role of inflammation in the pathogenesis of sleep disturbance.
authors.affiliation: Department of Medicine, Far-Eastern Memorial Hospital, Taiwan, Republic of China. yenling.chiu@gmail.com
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chiu
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Chuang
authors.forename: Kai-Chi
authors.initials: KC
authors.lastname: Fang
authors.forename: Shih-Kai
authors.initials: SK
authors.lastname: Liu
authors.forename: Hung-Yuen
authors.initials: HY
authors.lastname: Chen
authors.forename: Ju-Yeh
authors.initials: JY
authors.lastname: Yang
authors.forename: Mei-Fen
authors.initials: MF
authors.lastname: Pai
authors.forename: Yu-Sen
authors.initials: YS
authors.lastname: Peng
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.forename: Tun-Jun
authors.initials: TJ
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D053583:Interleukin-1beta / Q000097:blood; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood / Q000209:etiology; D012893:Sleep Wake Disorders / Q000097:blood / Q000209:etiology*; D014280:Triglycerides / Q000097:blood
chemical_list: D006454:Hemoglobins; D053583:Interleukin-1beta; D010710:Phosphates; D014280:Triglycerides; D002097:C-Reactive Protein