Relation between insomnia mood disorders and clinical and biochemical parameters in patients undergoing chronic hemodialysis

Background: Sleep disturbances are usually the outcome of a complex interplay between intrinsicfactors and environmental influences. Aim of this study was to investigate the incidence of insomnia and to assess its relation to clinical and laboratory parameters in hemodialysis patients. Methods: Using Athens Insomnia Scale (AIS), sleeping profile of 45 subjects (32 male, 13 female, mean age 59 +/- 16.2 years) was evaluated. According to AIS, patients were divided into two groups. Group A comprised 32 patients with score 0-9 (absence of sleep disorders), whereas group B included 13 patients scoring higher than 9 (clinically assessed disorder). Subjects were compared in terms of socioeconomic, clinical, laboratory parameters and presence of depression (assessed by Hamilton Depression Scale, HAMD). Results: No significant difference was observed with respect to age, sex, family status, education, selfesteem, coffee and alcohol consumption, time in hemodialysis and laboratory parameters. Group B demonstrated significantly lower albumin levels (3.65 +/- 0.38 and 3.9 +/- 0.24g/dL respectively, p<0.01), higher CRP levels (1.88 +/- 1.9 and 0.92 +/- 0.64mg/dL respectively, p<0.01) and exhibited depression (HAMD score 13.4 +/- 6.4 and 7.8 +/- 5.9 respectively, p<0.005). Moreover, significant correlation was observed when AIS scores were related to albumin (r=-0.29, p<0.05), CRP (r=0.38, p<0.01) and HAMD scores (r=0.54, p<0.0001). Conclusions: Sleep disorders are common in hemodialysis patients. They seem to be related to high CRP and low albumin levels and demonstrate strong correlation to mood disorders, which are equally common to such patients.