Higher systemic inflammation is associated with poorer sleep quality in stable haemodialysis patients.
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.
Chiu
Yen-Ling
YL
Department of Medicine, Far-Eastern Memorial Hospital, Taiwan, Republic of China. yenling.chiu@gmail.com
Chuang
Yi-Fang
YF
Fang
Kai-Chi
KC
Liu
Shih-Kai
SK
Chen
Hung-Yuen
HY
Yang
Ju-Yeh
JY
Pai
Mei-Fen
MF
Peng
Yu-Sen
YS
Wu
Kwan-Dun
KD
Tsai
Tun-Jun
TJ
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
D006454:Hemoglobins; D053583:Interleukin-1beta; D010710:Phosphates; D014280:Triglycerides; D002097:C-Reactive Protein