Sleep Quality and Associated Factors in Hemodialysis Patients

BACKGROUND: Many patients on regular hemodialysis have sleep disorders, which affect not only their quality of life but also their immune function, thus causing inflammatory disorders and cardiovascular disease. The aim of this study was to assess the sleep quality and related risk factors of sleep disorder in hemodialysis patients from a rural area in central Taiwan. METHODS: The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were adopted to assess sleep quality in hemodialysis patients and the associated factors. These two questionnaires were translated into Chinese and were completed by the participants under the assistance of the nursing staff during dialysis session. RESULTS: Most of the patients with PSQI > 6 (poor sleep quality) were female (60.5%) with longer dialysis history. Age was positively correlated with PSQI and ESS scores. The serum triglyceride level and Kt/V had a positive relation with PSQI scores, and the serum albumin level had an inverse relation with PSQI scores. In multivariate logistic regression analysis, female gender was a significant predictor of poor sleep quality. CONCLUSION: Most dialysis patients in Taiwan are elders, who were generally more susceptible to sleep disorder. We should pay more attention to sleep disorders and the ensuing clinical burden. Patient management protocols should include improving sleep quality, in addition to managing common medical problems. (Acta Nephrologica 2011; 25: 97-104)