Associations of dietary and lifestyle inflammation scores with sleep quality and mental health in hemodialysis patients: a multicenter cross-sectional study

BACKGROUND: Poor sleep quality and mental disorders are common issues among patients undergoing dialysis. Diet and lifestyle may be associated with sleep quality and mental health. The current study aimed to evaluate the associations between the Dietary and Lifestyle Inflammation Scale (DLIS) score and mental health and sleep quality among Iranian hemodialysis patients. METHODS: This multicenter cross-sectional study was conducted on 423 patients undergoing hemodialysis at eight centers in three cities. The DLIS was calculated using information from a validated 168-item semiquantitative food frequency questionnaire. Mental health was evaluated via the 21-item Depression, Anxiety, and Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Other assessments included physical activity levels, biochemical parameters, and patient dialysis data. Statistical analyses via SPSS software were conducted to identify associations. A total of 58.9% of the participants were men. After controlling for potential confounders, participants in the top quartile of DLIS had greater odds of having poor sleep quality (OR: 3.18; 95% CI: 1.71-5.90), depression (OR: 1.94; 95% CI: 1.06-3.54), anxiety (OR: 2.82; 95% CI: 1.51-5.27), and stress (OR: 2.15; 95% CI: 1.14-4.03) than did those in the bottom quartile. CONCLUSION: Our findings revealed that increased dietary and lifestyle inflammatory potential, characterized by increased DLIS, was positively associated with increased risks of depression, anxiety, stress and poor sleep quality.