#1785 Sleep disorders in hemodialysis patients enrolled in a tertiary hospital in davao city
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and Aims End stage kidney disease is a chronic condition known to have myriad effects in the different organ systems which directly impact quality of life. One aspect that is commonly affected but, unfortunately, may not be adequately addressed in this population is sleep problems. Various studies have shown that sleep disorders are highly prevalent in the dialysis population. As sleep is one of the inherent reparative mechanisms of the body, screening and identifying sleep problems may greatly translate to an improved quality of life and even over-all health. The aims of this study were to describe the sleep quality of hemodialysis patients in our local setting and ascertain the prevalence of sleep disorders, beginning with assessment of their sleep quality then dwelling more specifically with insomnia and obstructive sleep apnea syndrome (OSAS). These two sleep disorders are one of the most prevalent in the dialysis population with OSAS specifically related with adverse cardiovascular effects. Ultimately, this study envisioned to educate nurses, primary care physicians, and nephrologists about the importance of screening for sleep disorders in order to make proper referrals or initiate interventions that will improve sleep and well-being of dialysis patients. Method This study was a descriptive cross-sectional study conducted at a tertiary government hospital in Davao City, Philippines from July to September 2024. There were 189 adult hemodialysis patients included in the study. Excluded from the study were those below 19 years of age, patients on peritoneal dialysis, patients diagnosed with insomnia or any neurologic disorder that may hinder from understanding the questionnaires used. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) Questionnaire. Screening forms used to identify risk for insomnia and OSAS were PSQI and STOP-BANG Questionnaire, respectively. Results A total of 189 hemodialysis patients were evaluated for their sleep quality and screened for insomnia and obstructive sleep apnea. Majority of the patients were between the age of 41-60 years, males, and married. The top 3 causes of end stage renal disease were chronic glomerulonephritis, hypertensive kidney disease, and diabetic kidney disease. Common co-morbid illnesses were hypertension, diabetes, and cardiovascular disease. Majority were on 3x a week dialysis schedule, in the morning, with a 4-hour dialysis session. Hemodialysis access was mostly via arteriovenous fistula and dialyzers utilized were mostly hi-flux with dialyzer re-use at most for 5 dialysis sessions or below. Mean age was 49.1 years and mean dialysis vintage of 70.2 months. Majority of the patients were anemic with a mean hemoglobin of 106.6 g/L, mean phosphorus level of 5.2 mmol/L, URR reflected adequate hemodialysis with a mean of 69.1%, and mean BMI was 23.2 kg.m2 (overweight based on Asia-Pacific Body Mass Index Classification). The study showed a high prevalence of poor sleep quality and insomnia risk (68.3%) in all age groups of hemodialysis patients using the PSQI Questionnaire. The prevalence rate for OSAS was recorded at 45.0% using the STOP-BANG Questionnaire. None of the demographic and clinical parameters considered were associated with poor sleep quality and risk for insomnia. In contrast, older age, male sex, diabetic kidney disease, presence of co-morbid illness, higher BMI, and larger neck circumference were found to be significantly associated (p-value <.005) with OSAS. Moreover, there was no significant association noted between poor sleep quality and OSAS. Conclusion Poor sleep quality, insomnia, and obstructive sleep apnea are common problems in hemodialysis patients. The use of screening questionnaires like PSQI for sleep quality and insomnia and STOP-BANG for OSAS can be very helpful in hemodialysis patients for further evaluation and management.
Institution: San Pedro Hospital of Davao City, Inc.
Language: English
Topic: Sleep and related disorders
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W4415423904