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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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