腹膜透析患者的自主神经调节与睡眠质量相关。

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-05-09 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S501926

Baodi Huang, Yujun Qian, Ying Gao, Zhenye Chen, Li Zhang, Huijuan Mao, Changying Xing, Haibin Ren, Jing Wang

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引用次数: 0

摘要

背景：终末期肾病（ESKD）患者睡眠质量受损的问题，特别是那些接受腹膜透析（PD）的患者，是非常明显的。透析患者表现出心脏自主神经活动的显著改变。然而，自主神经系统活动和睡眠之间的关系仍然没有充分阐明。方法：本横断面研究纳入了我们中心的成人维持性PD患者。采用匹兹堡睡眠质量指数（PSQI）评价睡眠质量。记录心率变异性（HRV）和皮肤交感神经活动（SKNA）参数，以反映自身活动反应或调节能力。结果：共73例PD患者参与本研究，睡眠质量差的患病率为38.4%。睡眠质量差组血清肌酐（1157.0±294.3 vs 969.6±353.4 mmHg, p = 0.022）和磷水平（2.1±0.5 vs 1.7±0.5 mmHg, p = 0.002）高于睡眠质量好的组。线性回归分析显示PSQI评分与SKNA相关(β, -2.54；95% CI, -4.90 ~ -0.19；P=0.035)，窦性RR区间标准差（SDNN） (β, -0.05；95% CI, -0.09 ~ -0.01；P=0.015), SD2 (β, -0.04；95% CI, -0.07 ~ -0.01；P = 0.018)。结论：PD患者睡眠质量差可能与透析时间较长、BMI较高、舒张压较高、血清尿毒症毒素水平升高有关，并受心脏自主神经功能障碍影响。

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Autonomic Nervous Regulation was Associated with Sleep Quality Among Peritoneal Dialysis Patients.

Background: The issue of compromised sleep quality among patients with end-stage kidney disease (ESKD), particularly those undergoing peritoneal dialysis (PD), is notably pronounced. Dialysis patients exhibit significant alterations in cardiac autonomic nerve activity. However, the relationship between autonomic nervous system activity and sleep remains inadequately elucidated.

Methods: This cross-sectional study enrolled adult maintenance PD patients in our center. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Heart rate variability (HRV) and Skin sympathetic nerve activity (SKNA) parameters were recorded to reflect autonerve activity responses or regulation capacity.

Results: A total of 73 PD patients participated in this study, with a prevalence of poor sleep quality at 38.4%. Serum creatinine (1157.0±294.3 vs 969.6±353.4 mmHg, p = 0.022) and phosphorus levels (2.1±0.5 vs 1.7±0.5 mmHg, p = 0.002) were higher in the poor sleep quality group compared to the good group. Linear regression analyses indicated that PSQI scores were associated with SKNA (β, -2.54; 95% CI, -4.90 to -0.19; P=0.035), standard deviation of all sinus RR intervals (SDNN) (β, -0.05; 95% CI, -0.09 to -0.01; P=0.015), and SD2 (β, -0.04; 95% CI, -0.07 to -0.01; P=0.018).

Conclusion: Poor sleep quality in PD patients may be associated with longer dialysis vintage, higher BMI, higher diastolic blood pressure, and higher level of serum uremic toxin, and affected by cardiac autonomic nerve function disorder.

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.