Investigation of Depression, Anxiety, Sleep Quality, and Fatigue in Thalassemia Major Patients: A Study of the Correlation Between Sleep Quality and Laboratory Findings.

Introduction: Thalassemia major (TM) experiences a high rate of psychiatric problems, with frequent occurrences of depression and anxiety as well as a high incidence of insomnia. In the present study, we aimed to investigate the severity of depression, anxiety, sleep disorders, sleep quality, and fatigue and explore the relationship between sleep quality and laboratory parameters.

Methods: Twenty-eight patients and 37 healthy volunteers were included. Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Beck Depression Inventory, Beck Anxiety Inventory, and Fatigue Severity Scale were used.

Results: We found 46.43% of TM patients had depression, 78.5% had mild anxiety, and 3.57% had severe anxiety. ISI score (p = 0.027), ISI subthreshold insomnia percentage (p = 0.027), PSQI global score (p = 0.002), PSQI insomnia percentage (p = 0.025), PSQI subjective sleep quality (p = 0.008), PSQI sleep latency (p = 0.003), fatigue score (p = 0.026), and chronic fatigue (p = 0.037) percentage were significantly higher in the patients group than in the controls group. Ferritin was positively correlated with PSQI subjective sleep quality (r = 0.478, p = 0.010) and fatigue score (r = 0.427, p = 0.023). Heart involvement in magnetic resonance imaging was positively correlated with ISI score (r = 0.426, p = 0.024) and ISI classification (r = 0.455, p = 0.015).

Discussion: Depression and anxiety were significantly higher in TM patients compared to healthy controls. Chronic fatigue and insomnia were more common in TM patients, with subjective sleep quality being impaired and sleep latency prolonged. Furthermore, it was observed that individuals with higher ferritin levels had higher scores of subjective sleep quality and fatigue. Additionally, as cardiac involvement increased, severity of insomnia also increased.