Study of sleep quality and daytime sleepiness in maintenance hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To assess sleep quality and daytime sleepiness in patients on maintenance high flux hemodialysis, and discussed the associated factors. Methods A total of 112 high flux hemodialysis patients and 53 normal subjects were estimated by Pittsburgh sleep quality index (PSQI) and Epworth Sleep Scale (ESS) to assess the sleep quality and day time sleepiness. Global score of these questionnaires were analyzed. Seven components' scores and 9 reasons for sleep disturbances were compared between "good" (global PSQI ≤5) and "bad" (global PSQI＞5) sleepers. Sleep quality was compared among different shifts of hemodialysis. The impact of clinical factors on sleep quality were analyzed by multivariate linear regression and logistic regression. Results Compared with control group, hemodialysis group had a higher PSQI (7.02±4.94 vs 3.28±2.79, P＜0.05) and a lower ESS score [3(0-6) vs 8(4.25-11.75), P＜0.05] . 58% patients were "bad" sleepers and sleep latency was longer (30 min vs 15 min, P＜0.05). Insomnia was the main problem. Patients on morning shift, afternoon shift and night shift had similar subjective sleep quality. Age (OR=1.75, P=0.003), dialysis vintage (OR=1.26, P=0.008),hemoglobin (OR=0.64, P=0.008), calcium phosphate product (OR=1.60, P=0.02) were significantly related to sleep quality score. Conclusions Sleep disturbance is common in hemodialysis patients. Older age, longer dialysis vintage, anemia and higher calcium phosphate product are risk factors for poor sleep quality.