Chandra Smita, Gupta Vibha, Chandra Harish, Dhyani Mohan, Kotwal Aarti, Verma Sanjiv Kumar, Gupta Ravi
Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
Department of Psychiatry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
J Neurosci Rural Pract. 2019 Jan-Mar;10(1):94-100. doi: 10.4103/jnrp.jnrp_159_18.
Serum interleukin (IL)-6 has been found to be associated with sleep quality, mood, and survival in patients with solid tumors. Results in these studies were confounded by knowledge of diagnosis to study subjects. Moreover, such data among subjects with hematological malignancies and data regarding restless legs syndrome is limited. The present study was, therefore, conducted to assess the sleep quality, depression, and restless leg syndrome in hematological malignancies and to study if there is any role of IL6 associated with it.
Sixty-six subjects having hematological malignancy were included in this study after excluding the potential confounders. Sleep quality was examined using Pittsburg Sleep Quality Index, depression by the Patient Health Questionnaire-9. Diagnosis of RLS was made through clinical examination. Serum for measurement of IL-6 was collected at baseline and after 1 month of initiation of chemotherapy. Patients were followed up for 6 months.
Average age of study subjects was 50.16 years with male predominance. Nearly 22.7% had clinical depression, 28.8% had poor quality sleep, and restless legs syndrome (RLS) was reported in 6.1% cases. Nearly 22.7% patients died at 6 months. Disturbed sleep at baseline was associated with depression (odds ratio [OR] =7.89) and poor 6 months survival. Serum IL-6 did not show any association with sleep quality, restless-legs-syndrome, and depression. However, baseline high level of serum IL-6 (OR = 26.06) and low level after chemotherapy (OR = 0.03) were associated with poor survival at 6 months.
Poor quality sleep, depression, and RLS are prevalent among adult subjects with hematological malignancies. Sleep disturbance, high pretreatment inflammatory and lowering of inflammatory load after chemotherapy increase likelihood for poor prognosis. Serum IL-6 did not show any association with sleep quality, restless legs syndrome and depression.
血清白细胞介素（IL）-6已被发现与实体瘤患者的睡眠质量、情绪和生存率有关。这些研究的结果因研究对象知晓诊断情况而受到混淆。此外，血液系统恶性肿瘤患者中的此类数据以及与不宁腿综合征相关的数据有限。因此，本研究旨在评估血液系统恶性肿瘤患者的睡眠质量、抑郁情况和不宁腿综合征，并研究IL-6是否与之存在任何关联。
在排除潜在混杂因素后，本研究纳入了66例血液系统恶性肿瘤患者。使用匹兹堡睡眠质量指数检查睡眠质量，通过患者健康问卷-9评估抑郁情况。通过临床检查诊断不宁腿综合征。在基线时以及化疗开始1个月后采集用于测量IL-6的血清。对患者进行6个月的随访。
研究对象的平均年龄为50.16岁，以男性为主。近22.7%的患者有临床抑郁，28.8%的患者睡眠质量差，6.1%的病例报告有不宁腿综合征。近22.7%的患者在6个月时死亡。基线时睡眠障碍与抑郁（优势比[OR]=7.89）和6个月生存率低有关。血清IL-6与睡眠质量、不宁腿综合征和抑郁均无关联。然而，基线时血清IL-6水平高（OR=26.06）和化疗后水平低（OR=0.03）与6个月时生存率低有关。
睡眠质量差、抑郁和不宁腿综合征在成年血液系统恶性肿瘤患者中普遍存在。睡眠障碍、化疗前炎症水平高以及化疗后炎症负荷降低增加了预后不良的可能性。血清IL-6与睡眠质量、不宁腿综合征和抑郁均无关联。
