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Abstract

The aim of this study was to evaluate the sleep quality and to identify risk factors for poor sleep quality in hemodialysis population. An additional aim of the study was to identify number of patients treated for their sleep problems. Method: 126 patients undergoing hemodialysis treatment were enrolled into the study. Subjective sleep quality was measured using Pittsburgh Sleep Quality Index. All the participants also completed Beck Depression Inventory questionnaire for evaluation of depressive symptoms. The pharmacotherapy and clinical, demographic and socioeconomic variables were also investigated. Results: Among the enrolled patients, poor sleep quality was reported in 67% (n=85). Depressive symptoms were identified in 75% (n=62) of the poor sleepers. Significant association was observed between variables like being single, female gender, older age, low socioeconomic status, increased financial reliability, spending more than INR 10,000 ($ 166) per month for treatment, overweight, morning dialysis shift and dialysis duration more than 3 years. Clinical conditions like depression, diabetes, limb pain, fatigue, hypertension, hypoalbuminemia, hypocalcaemia and hypophosphatemia and use of medications like clonidine, erythropoietin, metoprolol and prazosin were also found to be associated with poor quality of sleep. Out of 67% (n=85) of the patients identified with sleep problems, 13% (n=17) were on sleep medications. Conclusion: The quality of sleep is impaired in hemodialysis population. Therefore, evaluation of sleep quality during regular clinical practice should be taken into consideration. INTRODUCTION: Poor sleep complaints are common in patients with end-stage renal disease (ESRD) on hemodialysis (HD). The prevalence of sleep abnormalities in this population (50-80%) 1, 2 is substantially greater than that reported in the general population 3. Patients with poor sleep may have more difficulty with intellectual, social and vocational functioning. They may have impaired cognitive performance. Defects in sleep decrease the patient's ability to enjoy family and social life. It also decreases job satisfaction and productivity resulting in poorer performance and increased absenteeism.

Study of Lifestyle, Sleep Quality, and Related Factors in Hemodialysis Patients

“…In this study, the sleep quality of hemodialysis patients had a significant relationship with smoking and alcohol consumption, where those who did not have alcohol and smoke had better sleep quality. However, in the study of Menon et al smoking had no significant relationship with sleep quality [19]. This difference can be attributed to the low number of smokers in the current study.…”

“…In the present study, more than 50% of patients had good sleep quality which is consistent with the results of Rezaie and Naji but disagrees with the results of other studies [11,19,23,30]. The difference in the findings can be due to physiological changes in different ages, the difference in hemodialysis duration, the presence of other illnesses, and the use of certain medications that can affect the quality of sleep in these patients.…”

“…In the present study, improvement in the quality of sleep with increasing age can be related to reducing the responsibility of the patients in various occupational and family areas, which can play an important role in reducing stressors. In the study of Menon et al low level of education and consequently, the lack of proper occupation and low income were the factors that reduce the quality of sleep in hemodialysis patients [19].…”

“…tients with hemodialysis are a common complication [23], the results of various studies conducted on sleep disorders of hemodialysis patients have been different [11,19]. Considering the cultural and geographical differences in sleep quality and lifestyle, it is essential to pay attention to this issue in CKD patients under hemodialysis in different countries.…”

“…Inadequate sleep is one of the common complications in CKD patients undergoing hemodialysis [19]. In some studies, the results have shown that insomnia can increase the risk of depression and substance abuse [20], and a direct relationship exists between sleep disorder and increased recovery time after hemodialysis [21,22].…”