Relationship between dialysis adequacy and sleep quality in haemodialysis patients
Nuran Tosun RN, PhD
Associate Professor of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorCorresponding Author
Nurten Kalender RN
PhD Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Correspondence: Nurten Kalender, Gulhane Military Medical Academy, School of Nursing, GATA Hemşirelik Yüksek Okulu, 06010 Etlik, Ankara, Turkey. Telephone: +9 0312 304 39 43.
E-mail:[email protected]
Search for more papers by this authorFatma Ilknur Cinar RN
Lecturer of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorGulcan Bagcivan RN
Lecturer of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorMujdat Yenicesu MD
Professor, Nephrologist
Can Dialysis Center, Ankara, Turkey
Search for more papers by this authorDilek Dikici
Senior Nursing Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorDilek Kaya
Senior Nursing Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorNuran Tosun RN, PhD
Associate Professor of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorCorresponding Author
Nurten Kalender RN
PhD Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Correspondence: Nurten Kalender, Gulhane Military Medical Academy, School of Nursing, GATA Hemşirelik Yüksek Okulu, 06010 Etlik, Ankara, Turkey. Telephone: +9 0312 304 39 43.
E-mail:[email protected]
Search for more papers by this authorFatma Ilknur Cinar RN
Lecturer of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorGulcan Bagcivan RN
Lecturer of Medical Nursing
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorMujdat Yenicesu MD
Professor, Nephrologist
Can Dialysis Center, Ankara, Turkey
Search for more papers by this authorDilek Dikici
Senior Nursing Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorDilek Kaya
Senior Nursing Student
Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
Search for more papers by this authorAbstract
Aim and objectives
The aim of this study is to examine the relationship between dialysis adequacy and sleep quality in haemodialysis patients.
Background
Sleep problems are common in haemodialysis patients. Dialysis adequacy is one of the factors associated with sleep quality. Studies evaluating the association between dialysis adequacy and sleep quality in haemodialysis patients present different results.
Design
Descriptive and cross-sectional study.
Methods
This study was performed with a total of 119 patients who had applied to dialysis centres for haemodialysis treatment between January and March 2014. The data collection form consists of socio-demographic and medical characteristics as well as laboratory parameters. A modified Post-Sleep Inventory was used to examine sleep quality in the research.
Results
There were no statistically significant relationship between sleep quality and dialysis adequacy (p > 0·05). When the Post-Sleep Inventory scores were evaluated according to sleep quality, 63·0% of patients had poor sleep quality, and 37·0% had good sleep quality. Sleep quality was worse in unemployed patients (X2 = 4·852; p = 0·025) and patients who smoked heavily (Z = 2·289; p = 0·022).
Conclusions
In this study, there is no statistically significant relationship between dialysis adequacy and sleep quality. However, it was found that the majority of haemodialysis patients had poor sleep quality.
Relevance to clinical practice
Even if the dialysis adequacy of patients is at the recommended level, their sleep qualities may be poor. Therefore, evaluations of the sleep quality of haemodialysis patients during the clinical practice must be taken into consideration.
References
- Al-Jahdali HH, Khogeer HA, Al-Qadhi WA, Baharoon S, Tamim H, Al-Hejaili FF, Al-Ghamdi SM & Al-Sayyari AA (2010) Insomnia in chronic renal patients on dialysis in Saudi Arabia. Journal of Circadian Rhythms 8, 1–7.
- Argekar P, Griffin V, Litaker D & Rahman M (2007) Sleep apnea in haemodialysis patients: risk factors and effect on survival. Haemodialysis International 11, 435–441.
- Bastos JP, Sousa RB, Nepomuceno LA, Gutierrez-Adrianzen OA, Bruin PF, Araújo ML & Bruin VM (2007) Sleep disturbances in patients on maintenance haemodialysis: role of dialysis shift. Revista da Associação Médica Brasileira 53, 492–496.
- Bliwise DL, Kutner NG, Zhang R & Parker KP (2001) Survival by time of day of dialysis in an elderly cohort. Journal of the American Medical Association 286, 2690–2694.
- Chan KE, Lazarus JM, Wingard RL & Hakim RM (2009) Association between repeat hospitalization and early intervention in dialysis patients following hospital discharge. Kidney International 76, 331–341.
- Chang SY & Yang TC (2011) Sleep quality and associated factors in haemodialysis patients. Acta Nephrologica 25, 97–104.
- Chen WC, Lim PS, Wu WC, Chiu HC, Chen CH, Kuo HY, Tsai TW, Chien PI, Su YJ, Su YL, Hung SH & Woods HF (2006) Sleep behavior disorders in a large cohort of chinese (Taiwanese) patients maintained by long-term haemodialysis. American Journal of Kidney Disease 48, 277–284.
- Çınar S, Sezerli M, Dinçer F & Yeşilbilek A (1998) Kronik Hemodiyaliz Hastalarında Uyku Sorunları. Hemşirelik Forumu 4, 166–171.
- Çölbay M, Yüksel Ş, Fidan F, Acartürk G, Karaman Ö & Ünlü M (2007) Hemodiyaliz Hastalarının Pittsburgh Uyku Kalite İndeksi İle Değerlendirilmesi. Tüberküloz ve Toraks Dergisi 55, 167–173.
- Daugirdas JT (1993) Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. Journal of the American Society of Nephrology 4, 1205–1213.
- De Santo RM, Lucidi F, Violani C & Di Iorio BR (2005) Sleep disorders in hemodialyzed patients-the role of comorbidities. International Journal of Artificial Organs 28, 557–565.
- De Vecchi A, Finazzi S, Padalino R, Santagostino T, Bottaro E, Roma E & Bossi R (2000) Sleep disorders in peritoneal and haemodialysis patients as assessed by a self-administered questionnaire. International Journal of Artificial Organs 23, 237–242.
- Dombros N, Dratwa M, Feriani M, Gokal R, Heimbürger O, Krediet R, Plum J, Rodrigues A, Selgas R, Struijk D & Verger C (2005) EBPG Expert Group on Peritoneal Dialysis. Nephrology Dialysis Transplantion 20, ix24–ix27.
- Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, Kurokawa K, Rayner HC, Furniss AL, Port FK & Saran R (2008) 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 23, 998–1004.
- Fresenius Medical Care (2011). ESRD Patients in 2011 A Global Perspective. Available at: http://www.visionfmc.com/files/download/ESRD/ESRD_Patients_in_2011.pdf (accessed 12 July 2014).
- Gigli GL, Adorati M, Dolso P, Piani A, Valente M, Brotini S & Budai R (2004) Restless legs syndrome in end-stage renal disease. Sleep Medicine 5, 309–315.
- Guney I, Atalay H, Solak Y, Altintepe L, Toy H, Tonbul HZ & Turk S (2010) Predictors of sleep quality in haemodialysis patients. International Journal of Artificial Organs 33, 154–160.
- Gusbeth-Tatomir P, Boisteanu D, Seica A, Buga C & Covic A (2007) Sleep disorders: a systematic review of an emerging major clinical issue in renal patients. International Urology and Nephrology 39, 1217–1226.
- Hsu CY, Lee CT, Lee YJ, Huang TL, Yu CY, Lee LC, Lam KK, Chien YS, Chuang FR & Hsu KT (2008) Better sleep quality and less daytime symptoms in patients on evening haemodialysis: a questionnaire-based study. Artificial Organs 32, 711–716.
- Hui DS, Wong TY, Li TS, Ko FW, Choy DK, Szeto CC, Lui SF & Li PK (2002). Prevalence of sleep disturbances in Chinese patients with end stage renal failure on maintenance haemodialysis. Medical Science Monitor Basic Research 8, CR331–CR336.
- Iliescu EA, Coo H, McMurray MH, Meers CL, Quinn MM, Singer MA & Hopman WM (2003) Quality of sleep and health-related quality of life in haemodialysis patients. Nephrology Dialysis Transplantation 18, 126–132.
- Iliescu EA, Yeates KE & Holland DC (2004) Quality of sleep in patients with chronic kidney disease. Nephrology Dialysis Transplantation 19, 95–99.
- Jaber BL, Schiller B, Burkart JM, Daoui R, Kraus MA, Lee Y, Miller BW, Teitelbaum I, Williams AW & Finkelstein FO; FREEDOM Study Group (2011) Impact of short daily Hemodialysis on restless legs symptoms and sleep disturbances. Clinical Journal of the American Society of Nephrology 6, 1049–1056.
- Jefferson CD, Drake CL, Scofield HM, Myers E, McClure T, Roehrs T & Roth T (2005) Sleep hygiene practices in a population-based sample of insomniacs. Sleep 28, 611–615.
- Kalender N & Tosun N (2014) Determination of the relationship between adequacy of dialysis and quality of life and self-care agency. Journal of Clinical Nursing 23, 820–828.
- Lumley M, Roehrs T, Asker D, Zorick F & Roth T (1987) Ethanol and coffeine effects on daytime sleepness. Sleep 10, 306–312.
- Masoumi M, Naini AE, Aghaghazvini R, Amra B & Gholamrezaei A (2013) Sleep Quality in Patients on Maintenance Haemodialysis and Peritoneal Dialysis. International Journal of Preventive Medicine 4, 165–172.
- Masuda T, Murata M, Honma S, Iwazu Y, Sasaki N, Ogura M, Onishi A, Ando Y, Muto S, Shimada K, Kario K, Kusano E & Asano Y (2011) Sleep-disordered breathing predicts cardiovascular events and mortality in haemodialysis patients. Nephrology Dialysis Transplantation 26, 2289–2295.
- Merlino G, Piani A, Dolso P, Adorati M, Cancelli I, Valente M & Gigli GL (2006) Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrology Dialysis Transplantation 21, 184–190.
- Millman RP, Kimmel PL, Shore ET & Wasserstein AG (1985) Sleep apnea in haemodialysis patients: the lack of testosterone effect on its pathogenesis. Nephron 40, 407–410.
- Mucsi I, Molnar MZ, Rethelyi J, Vamos E, Csepanyi G, Topma G, Barotfi S, Marton A & Novak M (2004) Sleep disorders and illness intrusiveness in patients on chronic dialysis. Nephrology Dialysis Transplantation 19, 1815–1822.
- National Kidney Foundation (2001) K/DOQI Clinical Practice Guidelines for Haemodialysis Adequacy, 2000. American Journal of Kidney Disease 37, S7–S64.
- National Kidney Foundation (2006) KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for 2006 Updates: Hemodialysis Adequacy, Peritoneal Dialysis Adequacy and Vascular Access. American Journal of Kidney Disease 48, S1–S322.
- Ng YH, Meyer KB, Kusek JW, Yan G, Rocco MV, Kimmel PL, Benz RL, Beddhu S, Dwyer JT, Toto RD, Eknoyan G & Unruh ML (2006) Haemodialysis Timing, Survival, and Cardiovascular Outcomes in the Haemodialysis (HEMO) Study. American Journal of Kidney Disease 47, 614–624.
- Parker KP, Bliwise DL, Bailey JL & Rye DB (2003) Day time sleepiness in stable haemodialysis patients. American Journal of Kidney Disease 41, 394–402.
- Parvan K, Lakdizaji S, Roshangar F & Mostofil M (2013) Quality of sleep and its relationship to quality of life in haemodialysis patients. Journal of Caring Sciences 2, 295–304.
- Pisoni RL, Wikström B, Elder SJ, Akizawa T, Asano Y, Keen ML, Saran R, Mendelssohn DC, Young EW & Port FK (2006) Pruritus in haemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology Dialysis Transplantation 21, 3495–3505.
- Sabbatini M, Minale B, Crispo A, Pisani A, Ragosta A, Esposito R, Cesaro A, Cianciaruso B & Andreucci VE (2002) Insomnia in maintenance haemodialysis patients. Nephrology Dialysis Transplantation 17, 852–856.
- Sabry AA, Abo-Zenah H, Wafa E, Mahmoud K, El-Dahshan K, Hassan A, Abbas TM, Saleh A-B & Okasha K (2010) Sleep disorders in haemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation 21, 300–305.
- Shcao MF, Chou YC, Yeh MY & Tzeng WC (2010) Sleep quality and quality of life in female shift working nurses. Journal Advanced Nursing 66, 1565–1572.
- Sloand JA, Shelly MA, Feigin A, Bernstein P & Monk RD (2004) A double-blind, placebo-controlled trial of intravenous iron dextran therapy in patients with ESRD and restless legs syndrome. American Journal of Kidney Disease 43, 663–670.
- Szeto CC, Wong TY, Chow KM, Leung CB, Law MC, Wang AY, Lui SF & Li PK (2001) Impact of dialysis adequacy on the mortality and morbidity of anuric Chinese patients receiving continuous ambulatory peritoneal dialysis. Journal of the American Society of Nephrology 12, 355–360.
- The Turkish Society of Nephrology (2011). Dialysis and Transplantation in Turkey, Istanbul, pp. 3.
- Turkmen K, Erdur FM, Guney I, Gaipov A, Turgut F, Altintepe L, Sağlam M, Tonbul HZ & Abdel-Rahman EM (2012) Sleep quality, depression, and quality of life in elderly haemodialysis patients. International Journal of Nephrology and Renovascular Disease 5, 135–142.
- Unruh ML, Buysse DJ, Dew MA, Evans IV, Wu AW, Fink NE, Powe NR & Meyer KB; Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study (2006). Sleep quality and its correlates in the first year of dialysis. Clinical Journal of the American Society of Nephrology 1, 802–810.
- Vural A (2002) Kronik Böbrek Yetmezliği ve Tedavisi. İçHastalıkları Günleri III. GATA Basımevi, Ankara, pp. 339–358.
- Wang MY, Chan SF, Chang LI, Chen TH & Tsai PS (2013) Better sleep quality in chronic haemodialyzed patients is associated with morning-shift dialysis: a cross-sectional observational study. International Journal of Nursing Studies 50, 1468–1473.
- Wasse H, Kutner N, Zhang R & Huang Y (2007) Association of initial haemodialysis vascular access with patient-reported health status and quality of life. Clinical Journal of the American Society of Nephrology 2, 708–714.
- Webb WB, Bonnet MH & White RM (1976) State and trait correlates of sleep stages. Psychological Reports 38, 1181–1182.
- Williams SW, Tell GS, Zheng B, Shumaker S, Rocco MV & Sevick MA (2002) Correlates of sleep behavior among haemodialysis patients. American Journal of Nephrology 22, 18–28.
Citing Literature
