Univariate analysis revealed significant associations (P ​< ​0.05) between CRF severity in MDS patients and multiple factors: age, disease subtype, IPSS-R risk stratification, number of chemotherapies, chemotherapy regimens (5-Azacitidine, CHG, and 5-Azacitidine ​+ ​CHG), treatment status, ECOG performance status, serum albumin, prealbumin levels, anxiety/depression, family support, insomnia, and nutritional status. Here, TTR is linked to insomnia.