Association between antiinflammatory cytokine, IL‐10, and sleep quality in patients on maintenance hemodialysis

Abstract

Elevated proinflammatory cytokines have been attributed to poor sleep quality in patients receiving hemodialysis. This is the first investigation about the relationship between sleep quality and circulating levels of antiinflammatory markers in these patients. A total of 72 patients who were receiving maintenance hemodialysis were enrolled in this cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Patients were divided into two groups: good sleepers (PSQI score < 5) and poor sleepers (PSQI score ≥ 5). Assessments were made for serum biochemical parameters (albumin, parathyroid hormone), inflammatory (interleukin [IL]-6, tumor necrosis factor-alpha [TNF-α], and high-sensitivity c-reactive protein [hs-CRP] ) and antiinflammatory (IL-10) markers. Fifty-four patients (75%) were classified as poor sleepers. Poor sleepers showed significantly lower levels of serum IL-10 and higher serum triglyceride and parathyroid hormone concentrations. These patients were more likely to have more comorbidities. The global PSQI score was significantly correlated with serum IL-10 (p = 0.03) and triglyceride levels (p = 0.01). Multivariate logistic regression analysis showed a direct correlation between PSQI and having comorbidities (p = 0.011, odds ratio [OR] = 3.918; confidence interval 95% [CI] = 2.742-19.031), between PSQI and serum triglyceride (p = 0.027, OR = 1.027 [95% CI = 1.007-1.048] ), and an inverse correlation between PSQI and serum IL-10 level (p = 0.021, OR = 0.424 [95% CI = 0.195-0.922]). Reduced circulating levels of the antiinflammatory cytokine IL-10 were significantly associated with poor sleep quality in hemodialysis patients. Factors including serum IL-10 and triglyceride concentrations and having comorbidities may predict patients prone to poor sleep quality.