Quality of sleep in hemodialysis patients: the role of demographic and clinical characteristics

  • Sena M Aljušević University of Belgrade, Medicine school
  • Mirela Vatić University of Belgrade, Medicine school
  • Jasna Trbojević- Stanković Clinic of Internal medicine, University hospital center “Dr Dragiša Mišović- Dedinje”

Abstract


Conclusion: The type of dialysis treatment and dialysis shift are closely interrelated with the quality of sleep in patients on chronic HD treatment.

Introduction: Sleep disorders are common among patients treated with chronic dialysis. Still, these conditions are seldom diagnosed and often undertreated, because they are attributed to the renal disease itself and/or considered a reaction to dialysis treatment.

Objective: The aim of this study was to assess the prevalence of poor sleep quality and its relations with demographic and clinical characteristics of patients undergoing chronic hemodialysis (HD).

Material and Methods: A cross-sectional observational study was performed on 82 patients (49 men, mean age 64.77 ± 10.00 years, range 30-85) on maintenance HD in a University Hospital Center in Belgrade. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Other relevant data were collected by general questionnaire and from patients’ medical histories. Data were analyzed with Chi-square, Fisher and T test, using the SPSS (version 21.0).

Results: The mean PSQI was 6.74 ± 3.99. Poor quality of sleep (PSQI>5) was present in 47 (57.3%) patients. Patients treated with hemodiafiltration statistically significantly more often had better quality of sleep (p=0.047), whereas patients receiving dialysis treatment in the afternoon shift had significantly more frequently poor quality of sleep (p=0.017). Age, sex, employment status, comorbidities, dialysis vintage and adequacy were not significantly related to the quality of sleep.

Key words: quality of sleep, dialysis, hemodialysis

References

Couser WG, Remuzzi G, Mendis S, Tonelli M. The Contribution of Chronic Kidney Disease to the Global Burden of Major Noncommunicable Diseases 2011; 80 (12): 1258-1270.

Vasaloty JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD. Practical Approach to Detection and Menagement of Chronic Kidney Disease for the Primary Care Clinician. The American Journal of Medicine 2016; 129 (2): 153-162.

Sobh MA. Essentials of Clinical Nephrology. Mansoura: 2000.

Fauci AS, Kasper DL, Longo DL, Brauwald E, Hauser SL, Jameson JL, Loscalzo J. Harrison's Nephrology and Acid-Base disorders 2010; S11-S13.

Bello AK, Nwankwo E, El Nahas AM. Prevention of chronic kidney disease: A global challenge. Kidney Int 2005; 68 (98): S11–S17.

Udruženje nefrologa Srbije. Godišnji izveštaj o lečenju dijalizama i transplatacijom bubrega u Srbiji 2014. godine. Beograd 2016.

Leger D, Guilleminault C, Dreyfus JP, Delahaye C, Paillard M. Prevalence of insomnia in a survey of 12.778 adults in France. Journal of Sleep Research 2000; 9(1): 35-42.

Merlino G, Piani A, Dolso P, Adorati M, Cancelli I, Valente M, Gigli GL. Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrology Dialysis Transplatation 2006; 21 (1): 184-90.

Mills PJ, von Kanel R, Norman D, Natarajan L, Ziegier MG, Dimsdale JE. Inflammation and sleep in healthy individuals. Sleep 2007; 30 (6): 729-735.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index (PSQI): a new instrument for psychiatric research and practice. Psychiatry Res. 1989; 28 (2):193-213.

Locatelli F, Covic A, Eckardt K-U, Wiecek A, Vanholder R. Anaemia management in patients with chronic kidney disease: a position statement by the Anaemia Working Group of European Renal Best Practice (ERBP). Nephrology Dialysis Transplantation 2009; 24 (2): 348-354.

Goldsmith DJA, Covic A, Fouque D. et al. Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) Guidelines: a European Renal Best Practice (ERBP) commentary statement. Nephrology Dialysis Transplantation 2010; 25 (12): 3823-31.

Bastos JP, Sousa RB, Nepomuceno LA, Gutierrez-Adrianzen OA, Bruin PF, Araújo ML, Bruin VM. Sleep disturbances in patients on maintenance hemodialysis: role of dialysis shift. Rev Assoc Med Bras. 2007; 53(6): 492-6.

Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, Kurokawa K, Rayner HC, Furniss AL, Port FK, Saran R. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2008; 23(3): 998-1004.

Musci I, Molnar MZ, Rethelyi J, Vamos E, Csephanygi G, Tompa G, Barotfi S, Marton A, Novak M. Sleep disorders and illness intrusiveness in patientson chronic dialysis. Nephol Dial Transplant 2004; 19(7): 1815-22.

Losso RL, Minhoto GR, Riella MC. Sleep disorders in patients with end-stage renal disease undergoing dialysis: comparation between hemodialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. Int Urol Nephrol. 2015; 47(2):369-75.

Trbojević-Stanković J, Stojimirović B, Bukumirić Z et al. Depression and Quality of Sleep in Maintenance Hemodialysis Patients. 2014; 142 (7-8): 437-443.

Sabet R, Naghizadeh MM, Azari S. Quality of sleep in dialysis patients. Iran J Nurs Midwifery Res. 2012; 17(4):270-4.

Unruh ML, Buysse DJ, Dew MA, Evans IV, Wu AW, Fink NE, Powe NR, Meyer KB; Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. Clin J Am Soc Nephrol 2006; 1(14): 802-10.

Guney I, Atalay H, Solak Y, Altintepe L, Toy H, Tonbul HZ, Turk S. Predictors od sleep quality in hemodialysis patients. Int J Artif Organs 2010; 33 (3): 154-60.

Østhus TB, Dammen T, Sandvik L, Bruun CM, Nordhus IH, Os I. Health-related quality of life and depression in dialysis patients: associations with current smoking. Scand J Urol Nephrol. 2010; 44(1): 46-55.

Kimmel PL, Patel SS. Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis. Semin Nephrol. 2006; 26(1):68-79.

Sabbatini M, Minale B, Crispo A, Pisani A, Ragosta A, Esposito R, et al. Insomnia in maintenance haemodialysis patients. Nephrol Dial Transplant. 2002; 17(5):852-6.

Masakane I. How to prescribe hemodialysis or hemodiafiltration in order to ameliorate dialysis-related symptoms and complications. Contrib Nephrol. 2011; 168: 53-63.

Published
2017/12/28
Section
Original Scientific Paper