title: Prevalence and risk factors of sleep disturbance in continuous ambulatory peritoneal dialysis patients in Guangzhou, southern China.
abstract: OBJECTIVE
  Sleep disturbance is significantly associated with overall morbidity, mortality, and quality of life in end-stage renal disease patients. Although it was reported that the prevalence of poor sleep quality was 41-83% in hemodialysis patients, sleep disturbance was not well understood in peritoneal dialysis (PD) patients, especially in Asian PD patients. The present study attempted to assess the prevalence and related risk factors of sleep disturbance among continuous ambulatory peritoneal dialysis (CAPD) patients in Guangzhou, southern China.
  
  
  METHODS
  Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality in eligible 212 CAPD patients (53.3% men), average age 49.9 ± 16.7 years.
  
  
  RESULTS
  The average global PSQI score of the CAPD patients was 9.5 ± 5.2, with 171 (80.4%) poor sleepers (PSQI scores > or = 5). The PSQI score was negatively correlated with serum albumin (r = -0.21, P = 0.003) subjective global assessment (SGA) score (r = -0.27, P = 0.001) and positively correlated with age (r = 0.34, P < 0.001), high-sensitivity C-reactive protein (r = 0.20, P = 0.008), level of calcium × phosphate product (r = 0.19, P = 0.009), cardiovascular disease (r = 0.17, P = 0.019), Charlson comorbidity index score (r = 0.21, P = 0.004), malnutrition-inflammation score (MIS) (r = 0.31, P < 0.001), and duration on CAPD (r = 0.20, P = 0.005). In multiple analysis, old age, high calcium × phosphate product, low SGA score (β = -0.23, P = 0.042), and high MIS (β = 0.30, P = 0.007) were independent predictors of sleep disturbance in CAPD patients.
  
  
  CONCLUSIONS
  We clearly demonstrated the novel relationship of malnutrition and calcium × phosphate product with poor sleep quality in CAPD patients, which may be a part of the explanation for the strong links between sleep quality and overall morbidity and mortality.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th, Zhongshan Road II, Guangzhou 510080, China.
authors.forename: Jianying
authors.initials: J
authors.lastname: Li
authors.forename: Qunying
authors.initials: Q
authors.lastname: Guo
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Ye
authors.forename: Jianxiong
authors.initials: J
authors.lastname: Lin
authors.forename: Chunyan
authors.initials: C
authors.lastname: Yi
authors.forename: Haiping
authors.initials: H
authors.lastname: Mao
authors.forename: Xiao
authors.initials: X
authors.lastname: Yang
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010710:Phosphates / Q000097:blood; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D012893:Sleep Wake Disorders / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014168:Transferrin / Q000378:metabolism
chemical_list: D010710:Phosphates; D012709:Serum Albumin; D014168:Transferrin; D002097:C-Reactive Protein; D002118:Calcium