SLEEP QUALITY IN END-STAGE RENAL DISEASE PATIENTS ON MAINTENANCE HEMODIALYSIS: A SIX MONTH PROSPECTIVE SURVEY

Objective: The aim of this study was to evaluate the sleep quality and to identify risk factors for poor sleep quality in hemodialysis population. An additional aim of the study was to identify number of patients treated for their sleep problems. Method: 126 patients undergoing hemodialysis treatment were enrolled into the study. Subjective sleep quality was measured using Pittsburgh Sleep Quality Index. All the participants also completed Beck Depression Inventory questionnaire for evaluation of depressive symptoms. The pharmacotherapy and clinical, demographic and socioeconomic variables were also investigated. Results: Among the enrolled patients, poor sleep quality was reported in 67% (n=85). Depressive symptoms were identified in 75% (n=62) of the poor sleepers. Significant association was observed between variables like being single, female gender, older age, low socioeconomic status, increased financial reliability, spending more than INR 10,000 ($ 166) per month for treatment, overweight, morning dialysis shift and dialysis duration more than 3 years. Clinical conditions like depression, diabetes, limb pain, fatigue, hypertension, hypoalbuminemia, hypocalcaemia and hypophosphatemia and use of medications like clonidine, erythropoietin, metoprolol and prazosin were also found to be associated with poor quality of sleep. Out of 67% (n=85) of the patients identified with sleep problems, 13% (n=17) were on sleep medications. Conclusion: The quality of sleep is impaired in hemodialysis population. Therefore, evaluation of sleep quality during regular clinical practice should be taken into consideration