Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients
Open accessAbstract
Sleep disturbance is common in dialysis patients and is associated with the development of enhanced inflammatory responses. Cognitive-behavioral therapy is effective for sleep disturbance and reduces inflammation experienced by peritoneal dialysis patients; however, this has not been studied in hemodialysis patients. To determine whether alleviation of sleep disturbance in hemodialysis patients also leads to less inflammation, we conducted a randomized controlled interventional study of 72 sleep-disturbed hemodialysis patients. Within this patient cohort, 37 received tri-weekly cognitive-behavioral therapy lasting 6 weeks and the remaining 35, who received sleep hygiene education, served as controls. The adjusted post-trial primary outcome scores of the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory were all significantly improved from baseline by therapy compared with the control group. The post-trial secondary outcomes of high-sensitive C-reactive protein, IL-18, and oxidized low-density lipoprotein levels significantly declined with cognitive-behavioral therapy in comparison with the control group. Thus, our results suggest that cognitive-behavioral therapy is effective for correcting disorganized sleep patterns, and for reducing inflammation and oxidative stress in hemodialysis patients.
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Improved sleep has anti-inflammatory effects.
“antiinflammatory effects from exercise 113 , Mediterranean diet 114 , improved sleep 115 and smoking cessation 116”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [115]
In peritoneal dialysis and hemodialysis patients, CBT-I improved sleep quality compared with a sleep hygiene education intervention, which was paralleled by a decrease of serum levels of inflammatory markers, including IL-1, CRP, and IL-18.
“In peritoneal dialysis and hemodialysis patients, CBT-I improved sleep quality compared with a sleep hygiene education intervention, which was paralleled by a decrease of serum levels of inflammatory markers, including IL-1 (102), CRP, and IL-18 (101).”
From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [102]
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- Authors
- Chen, H.-Y., Cheng, I.-C., Pan, Y.-J., Chiu, Y.-L., Hsu, S.-P., Pai, M.-F., Yang, J.-Y., Peng, Y.-S., Tsai, T.-J., & Wu, K.-D.
- Affiliations
- National Taiwan University (TW)
- Far Eastern Memorial Hospital (TW)
- Corresponding author
- Tsai, Tun-Jun
- ORCID
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 80
- Issue
- 4
- Pages
- 415-422
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W1992463789
- Cited by
- 140
- References
- 45
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 9 · 2021: 9 · 2020: 16 · 2019: 12 · 2018: 11 · 2017: 10 · 2016: 10 · 2015: 9 · 2014: 9 · 2013: 5 · 2012: 9
- FWCI
- 9.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- cognitive behavioral therapy, sleep disorders, hemodialysis, inflammatory cytokines, oxidative stress, C-reactive protein, IL-18, oxidized LDL, sleep hygiene education, fatigue, depression, anxiety, sleep quality
- MeSH terms
- Aged, Analysis of Variance, Female, Renal Dialysis, Humans, Inflammation, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Sleep, Sleep Wake Disorders, Taiwan, Time Factors, Biomarkers, Down-Regulation, Cognitive Behavioral Therapy, Cytokines, Treatment Outcome, Oxidative Stress, Inflammation Mediators
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