Self‐reported subjective sleep quality and fatigue in patients with peritoneal dialysis treatment at home

Abstract

The aim of this study was to describe habitual sleep, daytime symptoms, sleep-disturbing factors, current sleep during 1 week and fatigue in patients with peritoneal dialysis treatment at home and also discover predictions for sleep quality outcome. The knowledge should increase possibilities for supportive nursing health care. Fifty-five patients answered two mailed questionnaires and filled in a sleep diary. Of these, 60% had moderate, persistent sleep problems combined with daytime symptoms. Nocturnal awakenings with difficulties falling asleep again and a sleep duration predicted as 57% of sleep quality. Nocturnal pruritus and 'difficulties finding a comfortable sleeping position' were significant sleep-disturbing factors. Sleep quality predictors means progress in knowledge about the complexity of the situation for peritoneal dialysis patients. Poor sleep, daytime symptoms, sleep-disturbing factors and chronic fatigue need to be enlightened, especially for the nephrology nurses who are in a unique position to give supportive nursing health care.

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

“…In this study 46% of the PD-patients reported RLS, another potential sleep disturber and prevalent in ESRD [1] and PD [16] patients. The high prevalence may explain the inability to consolidate sleep [16,27] causing fragmented sleep or insomnia depending on when the symptoms peak: at the sleep onset or during the night.…”

“…About one-third of all participants from all three groups fulfilled the insomnia criteria which can be one explanation to the fragmented sleep. Insomnia has been described as a prevalent problem in dialysis populations [16,27] earlier. Although the proportion of insomniacs was similar in all three groups, only the PD-patients had significantly higher fragmentation and decreased sleep quality.…”

“…The high prevalence may explain the inability to consolidate sleep [16,27] causing fragmented sleep or insomnia depending on when the symptoms peak: at the sleep onset or during the night. In this study no significant association between RLS and fragmented sleep was found, although such an association has been described previously [28].…”

“…Habitual sleep during the last four weeks was assessed by the Uppsala Sleep Inventory (USI) [15] in a modified form [16] measuring sleep variables; bedtime, sleep latency, nocturnal awakenings, morning awakening, sleep duration, assumed sleep duration, numbers and duration of naps. Items about sleep, pruritus, RLS and daytime functioning were answered in a 5-point scale scored from "never" (1) to "very often" (5).…”

The Minimal Insomnia Symptom Scale (MISS)

“…It has also been used in various patient populations, e.g. in Sjögren's syndrome (16), in systemic lupus erythematosus (17), in ankylosing spondylitis (18), in Wilson's disease (19), in chronic heart failure (20), in coronary artery disease (21), and in patients on dialysis treatment (22). Further, it has been used in a 12-year follow-up study of a middle-aged population (3)(4)(5) and some of its items have also been subject to a validation study against polysomnography (23).…”