Erdogan Ayla, Dervisoglu Erkan, Kutlu Ayse
Departments of Internal Medicine, Kocaeli University School of Medicine, Kocaeli, Turkey.
Scand J Urol Nephrol. 2012 Dec;46(6):441-7. doi: 10.3109/00365599.2012.693134. Epub 2012 Jun 8.
The aim of this study was to investigate demographic, clinical and psychosocial factors associated with sleep quality in patients on continuous ambulatory peritoneal dialysis (CAPD).
Demographic data, clinical and biochemical parameters of 112 CAPD patients (convenience sample of 52 women and 60 men, mean age 51 ± 15 years) were measured. In the same patients, the Pittsburgh Sleep Quality Index (PSQI) was used for assessing sleep quality, the Beck Depression Inventory (BDI) for severity of depressive symptoms, the International Restless Legs Syndrome Study Group criteria for the diagnosis of restless legs syndrome (RLS), and the Short Form-36 (SF-36) of Medical Outcomes Study questionnaire for quality of life (QoL).
Patients with PSQI scores of > 5 ("bad sleepers") had lower serum albumin (p = 0.008), total cholesterol (p = 0.034), normalized protein equivalent of nitrogen appearance (p = 0.046) and residual renal function (p = 0.012), but higher serum ferritin (p = 0.016) and BDI scores (p < 0.001). No significant correlation could be demonstrated between sleep quality and other demographic and clinical parameters. Although the prevalence of RLS was higher in poor sleepers, the difference did not reach statistical significance (p = 0.067). In multivariate analysis, only elevated BDI was an independent predictor of poor sleep quality (p = 0.031). Compared with good sleepers, poor sleepers had significantly lower QoL scores in all subscales of the SF-36.
Although poor sleepers had lower nutritional indices, an elevated BDI was the only independent predictor of poor sleep quality. Poor sleep quality was also associated with lower QoL in patients on CAPD.
本研究旨在调查持续性非卧床腹膜透析（CAPD）患者睡眠质量相关的人口统计学、临床和心理社会因素。
测量了112例CAPD患者（52例女性和60例男性的便利样本，平均年龄51±15岁）的人口统计学数据、临床和生化参数。对同一批患者，采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量，贝克抑郁量表（BDI）评估抑郁症状严重程度，国际不宁腿综合征研究组标准诊断不宁腿综合征（RLS），以及医学结局研究问卷简表36（SF-36）评估生活质量（QoL）。
PSQI评分>5分（“睡眠不佳者”）的患者血清白蛋白较低（p = 0.008）、总胆固醇较低（p = 0.034）、蛋白质氮呈现标准化当量较低（p = 0.046）以及残余肾功能较低（p = 0.012），但血清铁蛋白较高（p = 0.016）且BDI评分较高（p < 0.001）。睡眠质量与其他人口统计学和临床参数之间未显示出显著相关性。尽管睡眠不佳者中RLS的患病率较高，但差异未达到统计学意义（p = 0.067）。在多变量分析中，只有BDI升高是睡眠质量差的独立预测因素（p = 0.031）。与睡眠良好者相比，睡眠不佳者在SF-36的所有子量表中的QoL评分均显著较低。
尽管睡眠不佳者的营养指标较低，但BDI升高是睡眠质量差的唯一独立预测因素。睡眠质量差也与CAPD患者较低的QoL相关。
