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Quality of sleep in patients undergoing hemodialysis

  • Nephrology – Original Paper
  • Published:
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Abstract

Background

Sleeping problems are common in hemodialysis (HD) patients. The aim of this study was to determine sleep quality (SQ) in HD patients and to evaluate its relationship with patient’s quality of life (QoL), sociodemographic and laboratory data.

Methods

Two hundred HD patients from the Hemodialysis Clinic, Bosnia and Herzegovina, were enrolled in the study. There were 122 men and 78 women with a mean age of 56.8 ± 14.3 (range 20–85) years and a mean HD duration of 62.6 ± 57.0 months. We used the Pittsburgh Sleep Quality Index (PSQI) and the Health Survey for Dialysis Patients (SF-36).

Results

Seventy-three percent of patients showed a poor SQ response. The average sleep latency of patients was 48.2 min, and the average sleep duration was 4.9 h. Ninety-eight percent of patients experienced some sort of sleep disturbances on weekly basis. The most common sleep disturbances were insomnia (84.5%), day and night sleep reversal (39.0%), excessive daytime sleepiness (EDS) (34.0%), nightmares (25%) and restless legs syndrome (RLS) (20.5%). The most frequent causes of sleep disorders were snoring (47%), pain (35%), daytime napping (34%), breathing problems (30%) and pruritus (28%). Ninety-three percent of patients experienced daytime dysfunction and 46.5% of them were taking sleep medications. Younger patients, employed patients and patients in 3rd HD shift showed significantly better SQ compared to the others. Compared with good sleepers, poor sleepers were more frequently on conventional HD and had higher serum phosphate and PTH and significantly lower Hb.

Conclusion

The poor SQ in our HD population significantly correlated with their QoL.

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Abbreviations

HD:

Hemodialysis

SQ:

Sleep quality

QoL:

Quality of life

PSQI:

Pittsburgh sleep quality index

SF-36:

Health survey for dialysis patients (short form)

EDS:

Excessive daytime sleepiness

RLS:

Restless legs syndrome

PLMS:

Periodic legs movement syndrome

SAS:

Sleep apnea syndrome

REM:

Rapid eye movement

CKD:

Chronic kidney disease

CSWR:

Circadian sleep-wake rhythm

NPS:

Neuropsychiatric

OSA:

Obstructive sleep apnea

BMI:

Body mass index

PO4:

Phosphate level

Hgb:

Hemoglobin level

PTH:

Parathyroid level

Kt/V:

HD adequacy

HDF:

Hemodiafiltration

SSQ:

Subjective sleep quality

SL:

Sleep latency

SD:

Sleep duration

HSE:

Habitual sleep efficiency

SDis:

Sleep disturbances

USM:

Use of sleep medication

DD:

Daytime dysfunction

PH:

Physical health

MH:

Mental health

PF:

Physical functioning

RE:

Role physical

BP:

Bodily pain

GH:

General health

VT:

Vitality

SF:

Social functioning

RE:

Role emotional

ANOVA:

Univariate analysis of variance

MANOVA:

Multivariate analysis of variance

χ²:

Chi squared

R:

Pearson correlation test

y:

Year

X:

Mean value

SD:

Standard deviation

PTSD:

Post-traumatic stress disorder

MMSE:

Mississippi scale for combat—related PTSD

Bnf:

Bonferroni correction method

PD:

Peritoneal dialysis

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Conflict of interest

The results presented in this paper have not been published previously in whole or part, except in abstract format. All authors declare that there are no conflicts of interest associated with this work.

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Authors and Affiliations

  1. Clinic for Hemodialysis, Clinical Centre University of Sarajevo, Bolnička 25, 71000, Sarajevo, Bosnia and Herzegovina

    Badema Čengić, Halima Resić & Emir Avdić

  2. Department of Nephrology, University of Skopje, Skopje, Republic of Macedonia

    Goce Spasovski

  3. Clinic of Neurology, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

    Azra Alajbegović

Authors
  1. Badema Čengić
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  2. Halima Resić
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  3. Goce Spasovski
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  4. Emir Avdić
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  5. Azra Alajbegović
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Correspondence to Badema Čengić.

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Čengić, B., Resić, H., Spasovski, G. et al. Quality of sleep in patients undergoing hemodialysis. Int Urol Nephrol 44, 557–567 (2012). https://doi.org/10.1007/s11255-010-9881-x

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  • DOI: https://doi.org/10.1007/s11255-010-9881-x

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