Poor Sleep Quality and Associated Factors in Patients with Common Variable Immunodeficiency

Abstract

Objective:This study aimed to examine the sleep quality of common variable immunodeficiency (CVID) patients and to investigate the relationship between sleep quality and depression, anxiety, fatigue, excessive daytime sleepiness and naturel killer (NK) cell counts.Materials and Methods:The study included 53 patients followed with CVID diagnosis. To determine sleep quality and conditions associated with sleep quality in CVID patients, Pittsburgh sleep quality index (PSQI), fatigue severity scale (FSS), Hamilton depression scale (HAM-D), Hamilton anxiety scale (HAM-A) and Epworth sleepiness scale (ESS) were used.Results:Fatigue was found in 37 (70%) patients, poor sleep quality in 34 (64%), depression in 20 (38%), anxiety in 16 (30%), and excessive daytime sleepiness in 11 (21%) patients. All patients CVID patients received immunoglobulin replacement therapy: Intravenous immunoglobulin (IVIG) in 37 (72%) and subcutaneous immunoglobulin (SCIG) in 16 (28%) patients. The PSQI, HAM-A, HAM-D and FSS scores of the patients receiving IVIG treatment were higher than those of the patients receiving SCIG treatment (all, p<0.05). According to the multivariate logistic regression analysis, lower NK cell counts [odds ratio (OR) =13.384, 95% confidence interval (CI)= 2.478-72.284, p=0.003] and depression (OR=7.030, 95% CI=1.320-37.435, p=0.022) were risk factors for poor sleep quality.Conclusion:Our results showed that patients with CVID had a higher frequency of poor sleep quality, depression, anxiety, fatigue, and excessive daytime sleepiness than the general population. Therefore, sleep quality and mental status should be questioned in detail during routine control in patients with CVID.

Keywords

• common variable immunodeficiency
• sleep quality
• depression
• anxiety
• natural killer cells