Poor quality of sleep in patients on chronic hemodialysis

Abstract

Patients with chronic renal disease, and in particular chronic hemodialysis patients, are prone to various sleep disorders (SDs) that may affect their daily quality of life and contribute to increased their cardiovascular morbidity and mortality. [1] In comparison to the general population, the prevalence of SDs in patients with renal impairment is significantly increased due to the presence of usual risk factors such as age, gender, obesity and other factors specific to uremia and dialysis (anemia, uremic toxins, inflammation, side effects of drugs). [2] Sleep disorders appear very early during stages 1 and 2 of chronic renal failure and may worsen with decreasing renal function. [2] It's reported in other studies that up to 80% of dialysis patients complain of poor quality of sleep. [3] Insomnia, sleep apnea, restless legs syndrome and excessive daytime sleepiness are the most commonly reported SDs. [4] Besides, studies have shown that SDs may increase the risk of cardiovascular death in patients with chronic renal failure. [3] patiEnts and mEthodsThe study was designed as prospective observational single-center study conducted in the renal nephrology and renal transplant department of the Mohammed V Military Training Hospital in Rabat. All the 52 chronic hemodialysis patients were recruited for this study. The inclusion criteria were: adult dialysis patients (over 18 years of age), chronic hemodialysis patients for more than 1 year, three sessions per week, 4 h each. In the included patients, the SDs studied were: Insomnia, sleep apnea syndrome (SAS), restless legs syndrome and excessive daytime sleepiness.We conducted this study using a questionnaire in French and/or translated into dialectal Arabic, and based on the Insomnia Severity Index questionnaire which contains seven questions (difficulty falling asleep, difficulty staying asleep or Introduction: Sleep disorders (SD) are common in patients with renal failure, particularly in those on dialysis. This can impair their daily quality of life and worsen their cardiovascular prognosis. Objective: Our work aimed to describe the prevalence and risk factors of SDs among chronic hemodialysis patients in the Nephrology and Dialysis Department of the Rabat Military Hospital, Morocco. Patients and Methods: The trial was designed as a prospective single-center study and included all hemodialysis patients in the nephrology department of the Rabat Military Hospital. For each patient, we assessed four SDs: insomnia, sleep apnea, restless legs syndrome, and excessive daytime sleepiness. Results: We included 52 patients; the mean age of the patients was 50 ± 17 year (range 24-76); male:female ratio was 1.1. SDs were found in 40 patients with a predominance of insomnia and sleep apnea syndrome (SAS), and multivariate logistic regression was used to identify factors associated with different SD Insomnia was correlated with anemia, excessive daytime sleepiness, and inflammation; SAS was correlated with age ≥50 years, obesity and excessive daytime sleepiness. Restless legs s...

Factors affecting quality of daytime and nighttime sleep among dialysis patients: A single center experience

“…In the present study, patients with diabetes mellitus had significantly ( P < 0.05) poor nighttime sleep. Similar results were reported with a lower quality of sleep in patients with diabetes mellitus undergoing MHD 26,33,34 . Night sleep quality was reported significantly poor among patients who did not complain of numbness ( P < 0.05) This was in contrast to findings in which nighttime sleep quality was significantly poor due to symptoms such as itching, tingling and numbness in the patients 35 …”

“…The current study showed no significant association of interdialytic weight gain, hemoglobin, and albumin with sleep quality (daytime sleepiness and nighttime sleep). In another study, they have also reported similar results where sleep quality did not have any significant association with serum Hb, albumin, and intradialytic weight gain 34 . This study reported that consumption of diuretic drugs had no association with daytime sleepiness and nighttime sleep.…”

“…Similar results were reported with a lower quality of sleep in patients with diabetes mellitus undergoing MHD. 26,33,34 Night sleep quality was reported significantly poor among patients who did not complain of numbness (P < 0.05) This was in contrast to findings in which nighttime sleep quality was significantly poor due to symptoms such as itching, tingling and numbness in the patients. 35 In relation to bioclinical markers there was statistically significant difference found between potassium and nighttime sleep.…”

“…In another study, they have also reported similar results where sleep quality did not have any significant association with serum Hb, albumin, and intradialytic weight gain. 34 This study reported that consumption of diuretic drugs had no association with daytime sleepiness and nighttime sleep. Similar findings were reported and indicated that diuretic drugs did not affect sleep quality.…”

Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial

“…Poor sleep is linked to an increased risk of hypertension, progressive CKD, impaired glucose tolerance, diabetes mellitus, depression, and greater use of medical services ( 16 ). If left untreated, these conditions are also more likely to result in heart disease and a higher mortality rate ( 17 , 18 ). Sedative medicines are the first line of treatment for sleep disruption in these individuals ( 19 ).…”