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NDT Advance Access published online on July 29, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn439
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Higher systemic inflammation is associated with poorer sleep quality in stable haemodialysis patients

Yen-Ling Chiu1,2, Yi-Fang Chuang3, Kai-Chi Fang4, Shih-Kai Liu4, Hung-Yuen Chen1,2, Ju-Yeh Yang1,2, Mei-Feng Pai1, Yu-Sen Peng1, Kwan-Dun Wu2 and Tun-Jun Tsai2

1 Department of Internal Medicine, Far-Eastern Memorial Hospital 2 Department of Medicine, National Taiwan University Hospital 3 Department of Psychiatry, Min-Sheng Hospital 4 Department of Psychiatry, Far-Eastern Memorial Hospital, Taiwan, Republic of China

Correspondence and offprint requests to: Yu-Sen Peng, Department of Medicine, Far-Eastern Memorial Hospital, Taiwan, Republic of China. Tel: +886-2-8966-7000 ext. 1164; Fax: +886-2-8966-7000 ext. 1162; E-mail: yenling.chiu{at}gmail.com



  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 ≥ 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-1β level and negatively correlated with the haemoglobin and phosphate level. In the multi-variable linear regression model, levels of hsCRP (β = 0.209, P = 0.029) and triglyceride (β = 0.212, P = 0.025) were both significant independent predictors for the global PSQI score.

Conclusion. Our study demonstrated severe impairment of sleep quality in HD patients and corroborated the role of inflammation in the pathogenesis of sleep disturbance.

Keywords: haemodialysis; inflammation; sleep quality; triglyceride

Received for publication: 13. 5.08
Accepted in revised form: 8. 7.08


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