Razi Journal of Medical Sciences

    Background & Aim: One the most common problems of patients on maintenance hemodialysis is sleep disorders that depends on comorbidities, age, morning dialysis shift, blood pressure and female gender. In addition, nocturnal and daytime sleep abnormalities are accompanied with cardiovascular and infectious diseases. On the other hand, inflammatory processes play an important role in individuals with end-stage renal diseae(ESRD) undergoing hemodialysis, and may affect the levels of additional inflammatory molecules, such as serum C-reactive protein(CRP) which is accompanied with the aggravation of atherosclerosis, protein-dependent malnutrition and cardiovascular diseases. Therefore, the aim of this study was to evaluate the relationship between serum CRP level and the severity of sleep disorders in patients undergoing maintenance hemodialysis no such study has been conducted in Iran or elsewhere. Patients and Methods: This analytical cross-sectional study was performed on 158 chronic hemodialysis patients(with hemodialysis duration of ≥6 months) in Autumn 2005. The patients underwent hemodialysis trice a week(each time 3.5-4 hours). They completed Modified Post Sleep Inventory(PSI) questionnaire to assess sleep related disturbances in 3 forms of sleep: bedtime(PSI1), nocturnal sleep(PSI2) and awakening(PSI3). Simultaneously, a peripheral blood sample was taken for quantitive CRP level before initiating hemodialysis course. The data were collected, described and analyzed using SPSS V.13 software. Results: Statistically significant correlation was found between serum CRP level and PSImean(rs=0.191 and P=0.016). This correlation was more notable in females(rs=0.345 and P=0.002), patients with hemodialysis duration of ≥48 months(rs=0.364 and P=0.001) and during nocturnal sleep(PSI2)(rs=0.249 and P=0.002). Whereas, no significant relationship was found between serum CRP level either with age categories or other forms of sleep disorder. Conclusion: The results of our study show that recommending anti-inflammatory treatment in patients on chronic hemodialysis for sleep disturbances is reasonable and rationale.