Quality of Sleep and its associated risk factors among maintenance Hemodialysis patients in Pakistan.

  • Mahjabeen Yaseen Fazaia Ruth Pfau Medical college
  • Shagufta Naqvi
  • Amna Saleem
  • Rida Nasreen
  • Rida Imran
  • Aysha Mahmood
Keywords: Dialysis, Sleep-quality, HADS, PSQI

Abstract

ABSTRACT

Background: Chronic Kidney disease patients on maintenance hemodialysis have a poor and compromised life. Sleep quality and pattern is frequently impaired and leads to psychological   and physical issues among them. The aim of this study is to determine the quality of sleep and its associated risk factors among maintenance hemodialysis patients.

Materials and Methods:

This Observational cross sectional study was carried out at the Hemodialysis units of Al Mustafa Medical Institute and Alamgir International Welfare Trust from March to August 2019.A total of 156 patients above 18 years of age were recruited in the study. Data was collected regarding demographic characteristics (age, gender, education, marital status,    and employment), dialysis characteristics (duration, shift) renal disease characteristics (duration, etiology), smoking status, comorbidities like Cardiovascular Diseases, Hypertension, Diabetes Mellitus, Hepatitis B positive  and  Hepatitis C positive status. Sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI) and sleep quality score was calculated according to that. Those with a scores of < 5 or 5 indicate good sleep quality, and scores of >5 indicate poor sleep quality. Data was analyzed using the Statistical Package for the Social Sciences version 25.0

Results: Total 156 patients undergoing hemodialysis completed the questionnaire. Majority of the participants (52.9%) were male while 47.1% were female. Out of 140 participants 89(57.1) had a poor quality of sleep while 67(42.9) had a good quality of sleep. A significant association was found between poor quality of sleep and increasing age, smoking and hepatitis B positive status (P<0.05).

Conclusion: Sleep quality is impaired in patients on maintenance hemodialysis. Associated risk factors were age, hepatitis B, smoking.

Key words: Sleep Quality, maintenance hemodialysis, Pittsburg Sleep Quality Index.

 

 

 

 

 

References

1. Wang R, Tang C, Chen X, Zhu C, Feng W, Li P, et al. Poor sleep and reduced quality of life were associated with symptom distress in patients receiving maintenance hemodialysis. Health and quality of life outcomes. 2016 Dec;14(1):1-8.
2. Abbasi MR, Safavi A, Haghverdi M, Saedi B. Sleep Disorders in ESRD Patients Undergoing Hemodialysis. Acta Medica Iranica. 2016;54(3):176-184.
3. Edalat-Nejad M, Jafarian N, Yousefichaijan P. Diabetic nephropathy: A strong predictor of sleep quality in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation.2014;25(4):774-80.doi10.4103/1319-2442.134994.
4. Edalat-Nejad M, Qlich-Khani M. Quality of life and sleep in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2013 May 1;24(3):514.
5. Malekmakan L, Tadayon T, Azadian F, Sayadi M. Who is sleeping more efficient? Patients on peritoneal dialysis or hemodialysis. Saudi Journal of Kidney Diseases and Transplantation. 2018 May-Jun;29(3):630-636.doi: 10.4103/1319-2442.235182.
6. Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, et al. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2008 Mar;23(3):998-1004. doi: 10.1093/ndt/gfm630.
7. Zubair UB, Butt B. Assessment of quality of sleep and its relationship with psychiatric morbidity and socio-demographic factors in the patients of chronic renal disease undergoing hemodialysis. J Coll Physicians Surg Pak. 2017 Jul;27(7):427-431.
8. Kovacs AZ, Molnar MZ, Szeifert L, Ambrus C, Molnar-Varga M, Szentkiralyi A,et al. Sleep disorders, depressive symptoms and health-related quality of life—a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis. Nephrology Dialysis Transplantation. 2011 Mar ;26(3):1058-65. doi: 10.1093/ndt/gfq476.
9. Zhang J, Wang C, Gong W, Peng H, Tang Y, Li CC, et al. Association between sleep quality and cardiovascular damage in pre-dialysis patients with chronic kidney disease. BMC nephrology. 2014 Dec;15(1):131. doi.org/10.1186/1471-2369-15-131
10. Maniam R, Subramanian P, Singh SK, Lim SK, Chinna K, Rosli R. Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients. Singapore medical journal. 2014 Sep;55(9):476-482. doi: 10.11622/smedj.2014119.
11. Unruh ML, Larive B, Eggers PW, Garg AX, Gassman JJ, Finkelstein FO, et al. The effect of frequent hemodialysis on self-reported sleep quality: Frequent Hemodialysis Network Trials. Nephrology Dialysis Transplantation. 2016 Jun 1;31(6):984-91. doi: 10.1093/ndt/gfw062.
12. dos Reis Santos I, Danaga AR, de Carvalho Aguiar I, Oliveira EF, Dias IS, Urbano JJ, et al. Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial. BMC nephrology. 2013 Oct 8;14:215. doi: 10.1186/1471-2369-14-215.
13. Iliescu EA, Coo H, McMurray MH, Meers CL, Quinn MM, Singer MA, et al. Quality of sleep and health‐related quality of life in haemodialysis patients. Nephrology Dialysis Transplantation. 2003 Jan;18(1):126-32. doi: 10.1093/ndt/18.1.126.
14. Tel, H, Tel H, and Esmek M. Quality of Sleep in Hemodialysis Patients. Dialysis & Transplantation. 2007; 36(9):479-484. https://doi.org/10.1002/dat.20138.
15. De Santo RM, Bilancio G, Santoro D, Vecchi ML, Perna A, De Santo NG et al. A longitudinal study of sleep disorders in early-stage chronic kidney disease. Journal of Renal Nutrition. 2010;20(5):S59-63. doi: 10.1053/j.jrn.2010.06.003.
16. Güney İ, Biyik M, Yeksan M, Biyik Z, Atalay H, Solak Y et al. Sleep quality and depression in peritoneal dialysis patients. Renal failure. 2008; 30(10):1017-22. doi: 10.1080/08860220802406419.
17. Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S et al. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation. 2007;23(3):998-1004.doi: 10.1093/ndt/gfm630.
18. Araujo SM, Bruin VM, Daher EF, Medeiros CA, Almeida GH, Bruin PF. Quality of sleep and day-time sleepiness in chronic hemodialysis: a study of 400 patients. Scandinavian journal of urology and nephrology. 2011;45(5):359-64. doi.org/10.3109/00365599.2011.584694.
19. Yoshioka M, Ishii T, Fukunishi I. Sleep disturbance of end‐stage renal disease. Psychiatry and Clinical Neurosciences.1993;47(4):847-51. doi.org/10.1111/j.1440-1819.1993.tb01832.x
20. Sabet, R, Naghizadeh MM, and Azari S. (2012). Quality of sleep in dialysis patients. Iran J Nurs Midwifery Res.2012; 17(4):270-74.
21. Huang X, Zhang H, Qu C, Liu Y, Bian C, Xu Y. Depression and Insomnia Are Closely Associated with Thyroid Hormone Levels in Chronic Hepatitis B. Medical Science Monitor. 2019;25:2672-2678. doi: 10.12659/MSM.914444.
22. Donovan LM, Rise PJ, Carson SS, Feemster LC, Griffith MF, Kapur VK et al. Sleep Disturbance in Smokers with Preserved Pulmonary Function and with Chronic Obstructive Pulmonary Disease. Annals of the American Thoracic Society. 2017;14(12):1836-1843.doi.org/10.1513/AnnalsATS.201706-453OC.
Published
2021-06-30
How to Cite
1.
Yaseen M, Naqvi S, Saleem A, Nasreen R, Imran R, Mahmood A. Quality of Sleep and its associated risk factors among maintenance Hemodialysis patients in Pakistan. JRMC [Internet]. 30Jun.2021 [cited 4Dec.2021];25(2):165-70. Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1382
Section
Articles