Abstract
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. Aim: 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 HD maintenance 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 more often had significantly better quality of sleep (p=0.047), whereas patients receiving dialysis treatment in the afternoon shift more frequently had poor quality of sleep (p=0.017). Age, sex, employment status, comorbidities, dialysis vintage and adequacy were not related to the quality of sleep significantly. Conclusion: The type of dialysis treatment and dialysis shift are closely interrelated with the quality of sleep in patients on chronic HD treatment.
Highlights
Sleep disorders are common among patients treated with chronic dialysis
From a total of 90 patients dialyzed at the Department of hemodialysis in a University Hospital Center in Belgrade at the time of the research, 7 did not meet the criteria for inclusion in the study (2 were dialyzed 2 times a week; 2 had cardiac decompensation or complications related to dialysis in the last 30 days prior to this study; 2 had experienced a stressful event and one had a cognitive deficit)
The consequences of poor sleep are more pronounced in patients on dialysis than in the general population, i.e. poor sleep quality is related to worse quality of life and increased morbidity and mortality in these patients [14,15,16]
Summary
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. Aim: 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). Poor quality of sleep (PSQI>5) was present in 47 (57.3%) patients. Patients treated with hemodiafiltration statistically more often had significantly better quality of sleep (p=0.047), whereas patients receiving dialysis treatment in the afternoon shift more frequently had poor quality of sleep (p=0.017). Sex, employment status, comorbidities, dialysis vintage and adequacy were not related to the quality of sleep significantly. According to the latest available data, there were 5858 patients with ESRF in Serbia in 2014, treated mainly with HD (88.3%) and PD (10.7%) [6]
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