Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Selection Criteria for Participants in the Study
2.3. Evaluated Variables and Methods
2.4. Statistical Methods
3. Results
3.1. Basic Characteristics of the Participants
3.2. Alexithymia (TAS 26 Scale)
3.3. Sleep Quality (PSQI Questionnaire)
3.4. Epworth’s Daytime Sleepiness Scale
3.5. Levels of Depression (Hamilton Depression Rating Scale)
3.6. Correlation of Interdialytic Weight Gain, Blood Pressure, and Biochemical Indicators with Daytime Sleepiness
3.7. Correlation of Pittsburgh Sleep Quality Index (PSQI) with Biochemical Indicators and Depression
3.8. Correlation of Alexithymia with Factors of Inflammation, Sleep Quality, Daytime Sleepiness, and Depression
3.9. Influence of Individual Factors (Predictors) on Serum Phosphorus Levels and Daytime Sleepiness (Regression Analysis)
4. Discussion
5. Limitations and Lack of Studies
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Median (Interquartile Range) | Minimum–Maximum | |
---|---|---|
Difficulty describing feelings | 15 (11–18) | 5–34 |
Difficulty identifying feelings | 28 (22–38) | 7–58 |
Externally oriented thinking | 12 (10–16) | 3–32 |
Reduced daydreaming | 15 (12–18.75) | 8–22 |
Total Toronto Alexithymia Scale 26 | 68 (62–77) | 27–114 |
Median (Interquartile Range) According to TAS 26 | Difference % | 95% Confidence Interval | p * | ||
---|---|---|---|---|---|
Up to 62 points | Above 63 points | ||||
Age of participants | 54.5 (46–61) | 73 (66–80) | −2 | −7 to 2 | 0.318 |
Arithmetic Mean (Standard Deviation) | Difference % | 95% Confidence Interval | p * | ||
---|---|---|---|---|---|
Men | Women | ||||
Levels of alexithymia | 69.38 (14.87) | 68.04 (15.41) | 1.33 | −3.59 to 6.26 | 0.594 |
Median (Interquartile Range) | Minimum–Maximum | |
---|---|---|
Total points on the sleep scale (PSQI) | 6 (4–10) | 0–21 |
Sleep latency | 1 (1–2) | 0–3 |
Duration of a sleep | 1 (0–2) | 0–3 |
Number (%) of Participants | |
---|---|
Up to 10 | 124 (72.9) |
11 or more (high daytime sleepiness) | 35 (20.9) |
Total | 159 (93.5) |
Median (Interquartile Range) According to the Epworth Scale | Difference % | 95% Confidence Interval | p * | ||
---|---|---|---|---|---|
Up to 10 | Up to 10 | ||||
Interdialytic weight gain | 0.0149 (0.0099–0.0196) | 0.0124 (0.0099–0.0158) | −0.003 | −0.005 to 0 | 0.05 |
Systolic blood pressure (mmHg) | 137 (121–146) | 137 (127–146) | 3 | −5 to 10 | 0.49 |
Diastolic blood pressure (mmHg) | 78 (70–81) | 77 (73–81) | 0 | −3.3 to 3.3 | 0.92 |
Median (Interquartile Range) According to PSQI § | Difference % | 95% Confidence Interval | p * | ||
---|---|---|---|---|---|
Good Sleepers | Bad Sleepers | ||||
CRP | 2.8 (1–5.8) | 5.6 (2.2–10.6) | 1.6 | 0.18 to 3.76 | 0.02 |
Leukocytes | 6.3 (4.85–7.3) | 6.5 (5.2–8.33) | 0.6 | −0.1 to 1.3 | 0.11 |
Depression (HDRS) | 4 (3–6.5) | 9 (5–14) | −5 | −7 to −2 | 0.00 |
Median (Interquartile Range) Based on Alexithymia | Difference % | 95% Confidence Interval | p * | ||
---|---|---|---|---|---|
Without Alexithymia (n = 45) | With Alexithymia (n = 109) | ||||
Age (years) | 66.5 (53–72) | 67 (59–75) | 2 | −2 to 7 | 0.32 |
Interdialytic weight gain | 0.0128 (0.009–0.0185) | 0.0146 (0.01–0.0191) | 0.001 | −0.002 to 0.004 | 0.39 |
CRP | 5.2 (1.5–10.8) | 4.05 (1.8–9.8) | −0.29 | −2.1 to 1.1 | 0.62 |
Leukocytes | 5.9 (4.1–7.4) | 6.5 (5.4–8.2) | 0.9 | 0.2 to 1.6 | 0.02 |
Pre-HD phosphorus | 1.71 (1.38–2.09) | 1.45 (1.13–1.77) | −0.27 | −0.44 to −0.08 | 0.005 |
Subjective sleep quality (PSQI §) | 1 (0.75–1) | 1 (1–2) | 0 | 0 to 0 | 0.10 |
Sleep latency | 1 (1–2) | 1 (1–2) | 0 | 0 to 0 | 0.437 |
Duration of a sleep | 1 (0–2) | 1 (0–2) | 0 | 0 to 1 | 0.316 |
Epworth Sleepiness Scale | 4 (3–6) | 8 (4–11) | 3 | 1 to 4 | 0.001 |
Depression (HDRS $) | 5 (3–10) | 8 (4–15) | −3 | −6 to −1 | 0.01 |
Bivariate Linear Regression | ||||
---|---|---|---|---|
ß * | 95% CI % ß | p | R2 | |
Pre-HD phosphorus | ||||
Alexithymia | −0.01 | −0.01 to −0.004 | 0.001 | 0.079 |
Predictive Factors | ß * | Standard Error | Wald | Odds Ratio (OR) | 95% Confidence Interval | p |
---|---|---|---|---|---|---|
Bivariate Regression | ||||||
Age | 0.001 | 0.015 | 0.01 | 1.01 | 0.97 to 1.03 | 0.94 |
Gender | 0.286 | 0.401 | 0.509 | 1.33 | 0.60 to 2.92 | 0.48 |
Interdialytic weight gain | −65.74 | 29.75 | 4.82 | 0.00 | 0.00 to 0.001 | 0.03 |
Systolic blood pressure | 0.01 | 0.011 | 0.42 | 1.01 | 0.98 to 1.03 | 0.52 |
Diastolic blood pressure | −0.002 | 0.023 | 0.01 | 0.99 | 0.95 to 1.04 | 0.94 |
Hemoglobin | −0.005 | 0.015 | 0.10 | 0.99 | 0.96 to 1.02 | 0.75 |
Alexithymia (scale) | 0.49 | 0.014 | 11.6 | 1.05 | 1.02 to 1.08 | 0.001 |
Depression (HDRS §) | 0.02 | 0.034 | 0.002 | 1.002 | 0.93 to 1.07 | 0.96 |
Sleep quality (poor) (PSQI %) | 0.03 | 0.043 | 0.59 | 1.03 | 0.95 to 1.12 | 0.44 |
Sleep latency | 0.28 | 0.225 | 1.530 | 1.321 | 0.85 to 2.05 | 0.21 |
Duration of a sleep | −0.43 | 0.22 | 3.87 | 0.65 | 0.42 to 0.99 | 0.049 |
Multivariate Regression (Stepwise Method) | ||||||
Alexithymia | 0.049 | 0.018 | 7.336 | 1.051 | 1.014 to 1.089 | 0.007 |
Constant | −4.015 | 1.47 | 7.46 | 0.006 |
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Pojatić, Đ.; Nikić, D.; Tolj, I.; Pezerović, D.; Šantić, A.; Degmečić, D. Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis. J. Clin. Med. 2022, 11, 3218. https://doi.org/10.3390/jcm11113218
Pojatić Đ, Nikić D, Tolj I, Pezerović D, Šantić A, Degmečić D. Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis. Journal of Clinical Medicine. 2022; 11(11):3218. https://doi.org/10.3390/jcm11113218
Chicago/Turabian StylePojatić, Đorđe, Dajana Nikić, Ivana Tolj, Davorin Pezerović, Andrijana Šantić, and Dunja Degmečić. 2022. "Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis" Journal of Clinical Medicine 11, no. 11: 3218. https://doi.org/10.3390/jcm11113218