Association of inflammatory biomarkers with sleep disorders in hemodialysis patients

Abstract

The aim of this study was to investigate the relationship between sleep disorders and C-reactive protein (CRP), hallmark of inflammation, and other biomarkers which may alter in hemodialysis patients. Our study included 108 patients who were dialyzed at least for 3 months. Before hemodialysis, blood samples were collected and serum levels of CRP, ferritin, albumin, phosphorus, parathyroid hormone, and hemoglobin were measured. Sleep disorders were confirmed by the presence of at least one of following criteria: insomnia, restless leg syndrome (RLS), obstructive sleep apnea syndrome (OSAS), narcolepsy, nightmare, sleepwalking, and poor sleep. 82.4% of patients demonstrated sleep disorders; insomnia (50%), RLS (32.4%), OSAS (7.4%), narcolepsy (15.7%), nightmare (15.7%), sleepwalking (0.9%), and poor sleep (71.3%). Our results revealed that CRP ≥3.8 μg/ml and advanced age were significantly associated with sleep disorders in these patients (p = 0.004 and p = 0.006, respectively). We concluded that inflammation has a close relation with sleep disorders in hemodialysis patients.

Sleep apnea in patients with chronic kidney disease: a single center experience

“…Previous reports found higher age to be a predictor for sleep apnea in the general population 23 and in the CKD population. [24][25][26][27] Our finding was different from others, and probably due to the differences in the study populations, assessment methods, and by chance alone. We included dialysis and non-dialysis patients, while others included HD patients.…”

A review of the neuro- and systemic inflammatory responses in post concussion symptoms: Introduction of the “post-inflammatory brain syndrome” PIBS

“…Unfortunately much of these data are hard to interpret due to the bidirectional relationship with sleep, and the propensity for the use of cross-sectional studies in this research. For example, the relationship has been extensively studied in dialysis patients, but the study designs make it difficult to tell if sleep disturbances are a consequence or a cause of inflammation (Bilgic et al, 2007;Chiu et al, 2009;Erten et al, 2005;Gul et al, 2006;Lee et al, 2009;Li et al, 2012;Pertosa et al, 2000;Razeghi et al, 2012;Shiohira et al, 2011;Taraz et al, 2013;Yang et al, 2007). In inflammatory bowel disease (IBD), sleep disturbances, including prolonged sleep latency, frequent sleep fragmentation and inefficient sleep are common.…”

Dream Anxiety in Hemodialysis and Peritoneal Dialysis Patients

“…The available literature stresses the cause of sleep disorders in patients with end-stage renal disease is more complicated than just the accumulation of metabolic waste in the body as well as providing various data on its likely association with inflammation and on the role of low melatonin levels, which all needs to be further clarified. It is clear, on the other hand, that sleep disorders are more frequently observed in these patients than in the healthy individuals [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]23] . Studies, in which sleep qualities of patients undergoing peritoneal dialysis and hemodialysis were separately studied, showed that sleep quality was low in both groups [5,8] .…”