Li Han, Li Xiaobei, Feng Sujuan, Zhang Guizhi, Wang Wei, Wang Shixiang
Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University; Nephrology Faculty, Capital Medical University, Beijing 100020, China.
Institute of Urology, Capital Medical University, Beijing 100020, China.
Chin Med J (Engl). 2014;127(7):1289-93.
The prevalence of sleep disorders has been shown to be high in patients with chronic dialysis patients and may contribute to impaired quality of life and higher mortality in this population. However, there are few data on the relationship of sleep disorders and their risk factors in chronic dialysis patients. The aim of this study was to evaluate the relationship of sleep disorders and their risk factors in chronic dialysis patients.
A total of 42 continuous ambulatory peritoneal dialysis (CAPD) patients were involved in this cross-sectional study. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Restless legs syndrome (RLS) was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group. And depression was assessed by Hamilton depression scale. General information and laboratory data were collected.
The prevalence of sleep disorders was 47.6% in the CAPD patients. According to the PSQI, the 42 CAPD patients were divided into sleep disturbance group and non-sleep disorders group. There were no significant differences in age, gender, dialysis duration, hemoglobin, serum creatinine, urea nitrogen, β2-microglobulin, parathyroid hormone, calcium, and phosphorus between CAPD patients with sleep disorders and those without sleep disorders. But the level of serum albumin (Alb) in CAPD patients with sleep disorders was significantly lower than that in CAPD patients without sleep disorders (31.3 ± 1.4 vs. 34.3 ± 3.7, t = 3.603, P = 0.001) . And the prevalence of RLS and depression was significantly higher than that in CAPD patients without sleep disorders (RLS: 11/22 vs. 1/20, χ(2) = 10.395, P = 0.001; depression: 7/22 vs. 1/20, χ(2) = 4.886, P = 0.027). In CAPD patients with RLS, the prevalence of sleep disorders was significantly higher than that in CAPD patients without RLS (11/22 vs. 11/30, χ(2) = 10.395, P = 0.001). And in CAPD patients with depression, the prevalence of sleep disorders was significantly higher than that in CAPD patients without depression (7/8 vs. 15/34, χ(2) = 4.886, P = 0.027). In CAPD patients, bivariate correlation analysis showed that sleep disorders was negatively correlated with serum Alb (r = -0.606, P = 0.000) and positively correlated with RLS (r = 0.497, P = 0.001) and depression (r = 0.341, P = 0.029). Multivariate regression analysis revealed that the odds ratio of RLS, depression, and low serum Alb was 22.900, 42.209, and 0.597, respectively.
The prevalence of sleep disorders was relatively high in CAPD patients. RLS, depression, and low serum Alb were the risk factors for CAPD patients with sleep disorders.
慢性透析患者睡眠障碍的患病率较高，这可能导致该人群生活质量受损和死亡率升高。然而，关于慢性透析患者睡眠障碍及其危险因素之间关系的数据较少。本研究的目的是评估慢性透析患者睡眠障碍及其危险因素之间的关系。
本横断面研究共纳入42例持续性非卧床腹膜透析（CAPD）患者。采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。根据国际不宁腿综合征研究组的标准诊断不宁腿综合征（RLS）。采用汉密尔顿抑郁量表评估抑郁情况。收集一般信息和实验室数据。
CAPD患者睡眠障碍的患病率为47.6%。根据PSQI，将42例CAPD患者分为睡眠障碍组和非睡眠障碍组。睡眠障碍的CAPD患者与无睡眠障碍的CAPD患者在年龄、性别、透析时间、血红蛋白、血清肌酐、尿素氮、β2-微球蛋白、甲状旁腺激素、钙和磷方面无显著差异。但睡眠障碍的CAPD患者血清白蛋白（Alb）水平显著低于无睡眠障碍的CAPD患者（31.3±1.4 vs. 34.3±3.7，t=3.603，P=0.001）。RLS和抑郁的患病率显著高于无睡眠障碍的CAPD患者（RLS：11/22 vs. 1/二十，χ²=10.395，P=0.001；抑郁：7/22 vs. 1/二十，χ²=4.886，P=0.027）。在患有RLS的CAPD患者中，睡眠障碍的患病率显著高于无RLS的CAPD患者（11/22 vs. 11/30，χ²=10.395，P=0.001）。在患有抑郁的CAPD患者中，睡眠障碍的患病率显著高于无抑郁的CAPD患者（7/8 vs. 15/34，χ²=4.886，P=0.027）。在CAPD患者中，双变量相关分析显示睡眠障碍与血清Alb呈负相关（r=-0.606，P=0.000），与RLS呈正相关（r=0.497，P=0.001），与抑郁呈正相关（r=0.341，P=0.029）。多变量回归分析显示，RLS、抑郁和低血清Alb的比值比分别为22.900、42.209和0.597。
CAPD患者睡眠障碍的患病率相对较高。RLS、抑郁和低血清Alb是CAPD患者睡眠障碍的危险因素。
