Sleep Quality and Its Affecting Factors among Hemodialysis Patients: A Multicenter Cross-Sectional Study

Abstract

(1) Background: Sleep quality is one of the most important clinical outcomes of hemodialysis (HD) patients, as it can affect their physical and mental health. This study aimed to investigate sleep quality and its affecting factors among patients with HD. (2) Methods: A cross-sectional design was used to investigate the quality of sleep among HD patients in two cities in Saudi Arabia. The data were collected during the period from January to December 2022. A convenience sample of 250 HD patients was selected in this study. Data were collected using the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). (3) Results: About two-thirds of participants (63.6%) had normal sleep, while one-third had poor sleep (36.4%). There was a significant relationship between the participants’ age and the quality of sleep, where participants who were aged more than 50 had poorer sleep than those who were younger (p < 0.001). Male and married participants significantly had poor sleep more than female and single participants (p = 0.011 and 0.015, respectively). In addition, participants who were retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups (p = 0.002, 0.016, 0.023, and <0.001, respectively). The level of education, financial status, distance from home to dialysis center, and participants’ satisfaction at the time of dialysis had no influence on the quality of sleep among HD patients. The multiple linear regression shows that exercise (p = 0.017), the number of comorbidities (p = 0.008), and the duration of dialysis (p < 0.020) were the independent factors affecting the quality of sleep among HD patients. (4) Conclusions: About one-third of HD patients in this study had poor sleep. There were significant differences between patients’ age, gender, marital status, and sleep-quality levels. Moreover, participants who retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups. Future studies should develop appropriate interventions to address the problem of poor sleep quality among HD patients.

Poor sleep quality and associated factors among adult chronic kidney disease patients

“…In our study, the prevalence of poor quality of sleep was found to be 42.9% with 95% CI (38 to 47%), which was similar to the reported prevalence from Turkey (42.2%) (18), but higher than the prevalence observed in two other studies from Saudi Arabia (36.4%) (22), and Japan (37%) (36). Possible reasons for these variations could be attributed to differences in sample sizes, with Saudi Arabia having a smaller sample size, and variations in the assessment tool's cutoff value, such as Japan using a cutoff of ≥6 to evaluate sleep quality.…”

“…Another factor associated with poor sleep quality was older age, which was supported by other studies ( 9 , 18 , 22 , 37 , 52 ). Aging is associated with decreased ability to maintain sleep, reduced nocturnal sleep duration, and decreased deep sleep ( 53 ).…”

“…It also has an impact on CKD patients’ immune systems, cognitive capabilities, and emotional well-being ( 21 ). Furthermore, poor sleep quality might lead to drug noncompliance and decreased engagement in the overall treatment plan ( 22 , 23 ).…”

Kualitas Tidur dan Kesejahteraan Spiritual pada Pasien End Stage Renal Disease dengan Hemodialisis

“…Gangguan tidur yang dirasakan oleh pasien dapat menyebabkan penurunan tingkat kelangsungan hidup pada pasien hemodialisis, yang menekankan pentingnya mengatasi masalah tidur pada pasien hemodialisis (Al Naamani et al, 2021;Alshammari et al, 2023). Dampak hemodialisis selain gangguan tidur juga terkait dengan rendahnya kualitas hidup (Lerma et al, 2021;Weigert et al, 2019).…”

The influence of social support on sleep and fatigue level among patients receiving hemodialysis in Saudi Arabia: a cross-sectional correlational design

“…Sleep disorders and fatigue are notably prevalent in patients undergoing HD ( Al Naamani et al, 2021 ) Studies have shown that a significant proportion of HD patients experience sleep-related problems, which include insomnia, restless leg syndrome, and sleep apnea. The prevalence rates of sleep disturbances among HD patients, as revealed by several studies worldwide, range from 40 to 85% ( Al Naamani et al, 2021 ; Alshammari et al, 2023 ) Several factors contribute to the high prevalence of sleep disorders in HD patients. Factors such as stress, dietary restrictions, limited physical activity, and the dialysis schedule can interfere with normal sleep routines and contribute to a sense of fatigue ( Hsouna et al, 2022 ; Abdul Rahim et al, 2023 ; Taheri et al, 2023 ) Poor sleep and fatigue have been linked to worse clinical outcomes in HD patients, including higher morbidity and mortality rates ( Kumar et al, 2010 ) They are associated with an increased risk of cardiovascular events, which are a leading cause of death in this population ( Zhang et al, 2014 ).…”