Poor sleep quality is responsible for the nondipper pattern in hypertensive but not in normotensive chronic kidney disease patients

Nephrology ◽  
2017 ◽  
Vol 22 (9) ◽  
pp. 690-698 ◽  
Author(s):  
Jun Zhang ◽  
Cheng Wang ◽  
Wenyu Gong ◽  
Zengchun Ye ◽  
Ying Tang ◽  
...  
2019 ◽  
Vol 11 (1) ◽  
pp. 100-6
Author(s):  
Maulana Antiyan Empitu ◽  
Ika Nindya Kadariswantiningsih ◽  
Mochammad Thaha ◽  
Cahyo Wibisono Nugroho ◽  
Eka Arum Cahyaning Putri ◽  
...  

BACKGROUND: Sleep deprivation is strongly associated with cardiovascular disease (CVD) via sympathetic overstimulation and systemic inflammation in general population. However, the significance of poor sleep quality in chronic kidney disease (CKD) is still underexplored.METHODS: This study assessed the sleep quality of 39 with non-dialysis CKD (ND CKD) patients and 25 hemodialysis CKD (HD CKD) patients using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Poor sleeper was defined as individual with PSQI > 5.RESULTS: The prevalence of poor sleeper (30% vs. 60%, p=0.029) and the cummulative PSQI (ND CKD 4.5±4.4, HD CKD 8±6, p=0.038) are different between ND CKD and HD CKD groups. Among the ND CKD, there are association between short sleep duration (< 5 hours per day) with elevated diastolic blood pressure groups (r=0.421, p<0.05); habitual sleep efficiency with platelet-to-lymphocyte ratio (r= 0.532, p<0.0001); daytime dysfunction with increased hs-CRP (r=0.345, p=0.032) and neutrophil-to-lymphocyte ratio (r=0.320, p=0.046). In HD CKD group, a requirement to use sleep medication was associated with elevated highsensitivity C-reactive protein (hs-CRP) level (r=0.434, p=0.030) and decreased monocyte-to-lymphocyte ratio (r=- 0.410, p=0.042); daytime dysfunction was associated with serum hs-CRP (r=0.452, p=0.023).CONCLUSION: This study revealed that some features of poor sleep quality in CKD patients including low sleep efficiency, daytime dysfunction and requirement to use sleep medication were associated with increased diastolic blood pressure, hs-CRP and blood-count-based inflammatory predictors. Thus, this finding prompt to pay closer attention to sleep complaints in the management of CVD risk factors in CKD patients.KEYWORDS: sleep quality, chronic kidney disease, blood pressure, inflammation


2020 ◽  
Vol 51 (3) ◽  
pp. 249-254 ◽  
Author(s):  
Waleed Ali ◽  
Guimin Gao ◽  
George L. Bakris

Background: Despite the abundance of data documenting the consequences of poor sleep quality on blood pressure (BP), no previous study to our knowledge has addressed the impact of sleep improvement on resistant hypertension among patients with chronic kidney disease (CKD). Methods: The aim of this pilot study was to determine whether improved sleep quality and duration will improve BP control in patients with resistant hypertension and CKD. It was a prospective single-center cohort study that involved 30 hypertensive subjects with CKD presenting with primary resistant hypertension and poor sleep quality or duration <6 h/night. Sleep quality and duration were modified using either sleep hygiene education alone or adding sleep medication. The cohort’s BP was followed every 3 months for 6-month duration. The average home and clinic BPs were collected at each follow-up visit. The primary outcome baseline change in systolic BP (SBP) and diastolic BP (DBP; home and clinic) at 3 and 6 months after documented sleep improvement. Secondary outcomes included change from baseline in mean arterial pressure, and delta SBP after sleep improvement. Results: African American patients represented 50% of the cohort. All patients had evidence of CKD with GFR ≤60 mL/min and were obese with 40% having type 2 diabetes mellitus. The primary endpoint of change in clinic SBP and DBP was significantly reduced at 3 months, baseline 156 ± 15/88 ± 8 vs. 3 months 125 ± 14/73 ± 7 (p < 0.0001). This difference persisted at 6 months. However, there was no further reduction in-home or clinic BPs between the 3- and 6-month periods. Home and clinic average delta SBP change at 3 months from baseline was –34.4 ± 15 and –30.8 ± 19 mm Hg respectively. Delta SBP change was associated with sleep improvement of >6 h/night, that is, gaining an extra 3–4 h’ sleep duration, home; R2 = 0.66, p < 0.0001 and clinic; R2 = 0.49, p < 0.0001. Conclusion: Optimizing sleep quality and duration to >6 h/night improved BP control and was associated with a significant delta change in SBP within 3 months of follow-up. Physicians should obtain a sleep history in patients with CKD who present with resistant hypertension.


Medicinus ◽  
2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Nata Pratama Hardjo Lugito ◽  
Theo Audi Yanto ◽  
Andree Kurniawan ◽  
Indra Wijaya ◽  
Margaret Merlyn Tjiang ◽  
...  

<p>Background: In Indonesia, geriatric population in the year 2005 was 15.8 million (7.2 % population), and expected to reach 11.34% in the year 2020. There was growing evidence for poor sleep as an independent risk factor for poor physical and mental health. Geriatric population may be particularly vulnerable to effects of sleep disturbance due to significant age-related changes in both sleep and inflammatory regulation<br />Objective: To study the epidemiological (gender, age group) and health status (co-morbidities), sleep quality according to Pittsburgh Sleep Quality Index (PSQI) and its associations in geriatric population hospitalized in General Hospital in Karawaci, Tangerang, Banten Province, Indonesia.<br />Materials and Methods: A hospital based cross sectional study was conducted from January to June 2014. A total of 92 subjects aged 60 years and above were selected consecutively from hospitalized geriatric patients for this study. The data was analyzed by means and proportions.<br />Results: The male and female subjects were 51.1% and 48.9%. Mean age was 66.79 + 5.448 years. The age group of 60 – 75 years and above 75 years was 92.4% and 7.6% consecutively. Subjects with diabetes, hypertension, allergy, asthma, cardiac failure and chronic kidney disease were 30.4%, 62.0%, 18.5%, 21.7%, 21.7%, 20.7% consecutively and 63.0% with more than 2 co-morbidities. According to PSQI 72.8% subjects have poor sleep quality. Associations between poor sleep quality to epidemiological and health status were not significant except for diabetes (RR= 3.208 [95% CI: 1.045 – 9.848], p = 0.022) and chronic kidney disease (RR= 6.247 [95% CI: 0.902 – 43.279], p = 0.017)<br />Conclusions: Seventy two percents of subjects have poor sleep quality, and associations between poor sleep quality to epidemiological and health status were not significant except for diabetes.</p>


2021 ◽  
Author(s):  
Van Thi Hai Nguyen ◽  
Aurawamon Sriyuktasuth ◽  
Warunee Phligbua

Background: Uncontrolled blood pressure rates are high in patients with non-dialysis chronic kidney disease, worsening the disease progression and leading to end-stage renal disease. However, studies on uncontrolled blood pressure in patients with non-dialysis chronic kidney disease and its associated factors in Vietnam are scarce. Objectives: This study aimed at identifying uncontrolled blood pressure rates and risk factors associated with uncontrolled blood pressure among Vietnamese patients with non-dialysis chronic kidney disease. Results: 63.2% of the participants could not control their BP less than 130/80 mmHg. Poor sleep quality (OR 2.076, 95%CI 1.059-4.073, p=.034) and severe comorbidities (OR 2.926, 95%CI 1.248-6.858, p=.013) were risk factors associated with uncontrolled blood pressure among Vietnamese patients with non-dialysis chronic kidney disease. Interestingly, the study found a high rate of awareness toward the importance of blood pressure control but a low rate of known blood pressure targets. Conclusion: Uncontrolled blood pressure rates among Vietnamese patients with non-dialysis chronic kidney disease were high. Sleep quality and comorbidity severity were significantly associated with uncontrolled blood pressure in this population. To achieve blood pressure targets, nurses and other healthcare providers should pay more attention to the patients with poor sleep quality and severe comorbidities. Funding: The “2018 Mahidol Postgraduate Scholarship”.


2019 ◽  
Vol 2 (2) ◽  
pp. 211-220
Author(s):  
Ahmed Waqas ◽  
Aqsa Iftikhar ◽  
Zahra Malik ◽  
Kapil Kiran Aedma ◽  
Hafsa Meraj ◽  
...  

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.


SLEEP ◽  
2003 ◽  
Vol 26 (4) ◽  
pp. 467-471 ◽  
Author(s):  
Yuriko Doi ◽  
Masumi Minowa ◽  
Toshiro Tango

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