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Alshammari B, Alkubati SA, Pasay-an E, Alrasheeday A, Alshammari HB, Asiri SM, Alshammari SB, Sayed F, Madkhali N, Laput V, Alshammari F. Sleep Quality and Its Affecting Factors among Hemodialysis Patients: A Multicenter Cross-Sectional Study. Healthcare (Basel) 2023; 11:2536. [PMID: 37761733 PMCID: PMC10531149 DOI: 10.3390/healthcare11182536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/26/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Sleep quality is one of the most important clinical outcomes of hemodialysis (HD) patients, as it can affect their physical and mental health. This study aimed to investigate sleep quality and its affecting factors among patients with HD. (2) Methods: A cross-sectional design was used to investigate the quality of sleep among HD patients in two cities in Saudi Arabia. The data were collected during the period from January to December 2022. A convenience sample of 250 HD patients was selected in this study. Data were collected using the Arabic version of the Pittsburgh Sleep Quality Index (PSQI). (3) Results: About two-thirds of participants (63.6%) had normal sleep, while one-third had poor sleep (36.4%). There was a significant relationship between the participants' age and the quality of sleep, where participants who were aged more than 50 had poorer sleep than those who were younger (p < 0.001). Male and married participants significantly had poor sleep more than female and single participants (p = 0.011 and 0.015, respectively). In addition, participants who were retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups (p = 0.002, 0.016, 0.023, and <0.001, respectively). The level of education, financial status, distance from home to dialysis center, and participants' satisfaction at the time of dialysis had no influence on the quality of sleep among HD patients. The multiple linear regression shows that exercise (p = 0.017), the number of comorbidities (p = 0.008), and the duration of dialysis (p < 0.020) were the independent factors affecting the quality of sleep among HD patients. (4) Conclusions: About one-third of HD patients in this study had poor sleep. There were significant differences between patients' age, gender, marital status, and sleep-quality levels. Moreover, participants who retired, had a higher number of dependents, did not adhere to exercise, and had more comorbidities had significantly poorer sleep than other groups. Future studies should develop appropriate interventions to address the problem of poor sleep quality among HD patients.
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Affiliation(s)
- Bushra Alshammari
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
| | - Sameer A. Alkubati
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida P.O. Box 3114, Yemen
| | - Eddieson Pasay-an
- Maternal and Child Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
| | - Awatif Alrasheeday
- Nursing Administration Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia; (A.A.); (V.L.)
| | - Hasna B. Alshammari
- Performance Improvement Unit, Hail Health Cluster, Hail 55471, Saudi Arabia;
| | | | - Sadaa B. Alshammari
- Mawqq Primary Health Care Center, Hail Health Cluster, Hail 55471, Saudi Arabia;
| | - Fatimah Sayed
- Family Medicine Academy, Qassim Health Cluster, Buraidah 52367, Saudi Arabia;
| | - Norah Madkhali
- Department of Nursing, College of Nursing, Jazan University, Jazan 45142, Saudi Arabia;
| | - Vivian Laput
- Nursing Administration Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia; (A.A.); (V.L.)
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia;
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Prevalence of Sleep Disorders and Related Factors in Individuals Undergoing Hemodialysis. Cogn Behav Neurol 2021; 34:161-169. [PMID: 34473667 DOI: 10.1097/wnn.0000000000000278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The quality of life of individuals undergoing hemodialysis is related to many factors, including sleep disorders. OBJECTIVE To determine the prevalence of sleep disorders in individuals undergoing hemodialysis and to assess the effect of clinical and biochemical parameters on their sleep quality. METHOD We conducted a cross-sectional descriptive survey in multiple hemodialysis centers. Individuals were interviewed using a questionnaire for obtaining general personal information, the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, and the Epworth Sleepiness Scale (ESS) for assessing excessive daytime sleepiness (EDS). RESULTS The study included 338 individuals with a median age of 55 years. Poor sleep quality (PSQ) and EDS were present in 41.4% and 6.5% of the individuals, respectively. The individuals' PSQI scores were significantly proportional to their ESS scores. Concerns about the disease and its treatment (60.7%) and poor physical conditions (35.7%) were major reported reasons for PSQ. In a logistic regression analysis, female gender, household income, ESS score, chronic heart failure, and creatinine and parathormone levels were found to be independent predictors of PSQ; household income, PSQ presence, parathormone and potassium levels, and urea reduction ratio were found to be independent predictors of EDS. CONCLUSION Sleep disorders are common in individuals undergoing hemodialysis and are related to gender, comorbid diseases, poor economic state, altered biochemical values, dialysis timing, and concerns about the disease and its treatment. Improving these individuals' quality of life through adequate psychological and financial support and early diagnosis of sleep disorders should decrease their mortality and morbidity rates.
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Prevalence of Depression and Sleep Disorders in Patients on Dialysis: A Cross-Sectional Study in Qatar. Int J Nephrol 2021; 2021:5533416. [PMID: 34136284 PMCID: PMC8175178 DOI: 10.1155/2021/5533416] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/15/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with end-stage renal disease treated with dialysis have poor quality of life (QOL). Improving QOL in these patients with multiple comorbidities is a large challenge. We performed a cross-sectional study to evaluate the prevalence and associated factors of depression and sleep disorders in this population. Our primary aim was to evaluate QOL measures in dialysis patients in Qatar through a series of validated questionnaires mainly concerning depression and sleep disorders. Our secondary aim was to study the associations of age, sex, and comorbid conditions with the QOL measures. We hypothesized that end-stage renal disease (ESRD) patients on dialysis would have disturbed QOL due to both ESRD and dialysis and comorbidities. This prospective cross-sectional study included adult ESRD patients receiving either hemodialysis (HD) or peritoneal dialysis (PD) in the main tertiary dialysis unit in Qatar. We administered two surveys to evaluate depression (the Center for Epidemiologic Studies Depression Scale, http://www.bmedreport.com/archives/7139) and sleep disorders (the Pittsburgh Sleep Quality Index, https://www.sleep.pitt.edu/instruments/). We also reviewed patient demographics, comorbidities, and laboratory test results to evaluate any associated factors. We randomly studied 253 patients (62% on HD and 38% on PD). Overall, 48% of patients had depression, while 83.8% had sleep disorders. The PD had more poor sleepers than the HD group (89.1% versus (vs.) 75%, p=0.003). Most of our dialysis patients had poor sleep, but it was more significant in the elderly group 109 (90%) than in the young group 103 (78%) (p=0.009). Patients with diabetes mellitus (DM) had significantly more prevalence of poor sleep (131 (88.5%)) than those without DM (81 (77.1%), p=0.01). More female patients had depression than male patients (52% vs. 25%, p < 0.0001; odds ratio: 3.27 (95% confidence interval: 1.9-5.6), p < 0.0001). This is the first study in Qatar to evaluate depression and sleep disorders in patients on dialysis therapy.
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Rosdiana I, Cahyati Y. The effect of the progressive muscle relaxation combined withs lavender aromatherapy on insomnia of hemodialysis patients. ENFERMERÍA NEFROLÓGICA 2021. [DOI: 10.37551/s2254-28842021004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
disorder in hemodialysis patients, which will cause a decrease in quality of life. Aromatherapy combined with progressive muscle relaxation are expected to increase the effects of relaxation on the patient so that the patient's sleep quality can improve optimally.Objective: The study aimed to investigate the effect of the progressive muscle relaxation combined with lavender aromatherapy on insomnia among patients undergoing hemodialysis. Material and Methods: The design of this study included a quasi-experiment with a pretest-posttest control group approach. The sample selection was performed using a consecutive sampling technique and involved 50 respondents, divided into two equal control and study group. Patients in study group recommended to do progressive muscle relaxation at least four times per week for three weeks and were told to drop two – three drops lavender aromatherapy on a pillow 30 minutes before bedtime at least 4 nights per week for three weeks. The control group recommended to do muscle relaxation and daily routine care at least four times per week for three weeks. Results: The results showed that both study and control groups were equal in terms of demographics, and scores of insomnia at the baseline. There no significant difference between the mean insomnia scores of two group before intervention, while the difference was statistically significant after the intervention. The mean insomnia scores were lower in study group than in the control group.Conclusion: Progressive muscle relaxation and lavender aromatherapy were effective in decreasing insomnia scores among patients undergoing hemodialysis.
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Affiliation(s)
- Ida Rosdiana
- Departamento de Enfermería. Poltekkes Kemenkes Tasikmalaya. Java Occidental. Indonesia
| | - Yanti Cahyati
- Departamento de Enfermería. Poltekkes Kemenkes Tasikmalaya. Java Occidental. Indonesia
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Alkhuwaiter RS, Alsudais RA, Ismail AA. A prospective study on prevalence and causes of insomnia among end-stage renal failure patients on hemodialysis in selected dialysis centers in Qassim, Saudi Arabia. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2020; 31:454-459. [PMID: 32394919 DOI: 10.4103/1319-2442.284021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Studies directed toward improving the life quality of hemodialysis (HD) patients revealed different etiologies for insomnia. We aimed to assess the prevalence of insomnia and determine associated etiologies in the AL Qassim region. This interview-based questionnaire study was conducted in HD centers for assessment of insomnia and its related causes using a validated screening questionnaire, developed by the JPS health network. Accordingly, patients were classified as insomnia, insomnia for further evaluation and management and no insomnia. Of 111 patients, there were 55 males and 56 females. The prevalence of primary insomnia was 28.82%, compared to 44% for secondary insomnia. Significant correlations linked insomnia with apnea, night itching, and not using phosphate binder usage. Primary and secondary insomnia is frequent among dialysis patients and require an application of diagnostic tools and severity scales. The assessment of causes and treatment of the complaints of apnea, usage of phosphate binders, and itching should be considered to decrease complications and improve quality of life.
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Affiliation(s)
- Rand Suliman Alkhuwaiter
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Raneem Ahmad Alsudais
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Amal Ahmed Ismail
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia
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Mirghaed MT, Sepehrian R, Rakhshan A, Gorji H. Sleep Quality in Iranian Hemodialysis Patients: A Systematic Review and Meta-analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:403-409. [PMID: 31772913 PMCID: PMC6875887 DOI: 10.4103/ijnmr.ijnmr_184_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 05/01/2019] [Accepted: 05/28/2019] [Indexed: 12/20/2022]
Abstract
Background: Hemodialysis is a major therapeutic method for many chronic kidney disease patients that causes complications. One of these complications tends to be sleep disorders. This study was performed through systematic review and meta-analysis to determine the prevalence of low sleep quality in hemodialysis patients in Iran. Materials and Methods: Journal papers written in English and Persian searched from January 2000 to July 2018 were selected. The search keywords included (Prevalence OR Epidemiology) AND (hemorenodialysis OR hemodialysate OR 'intermittent chronic haemodialysis' OR 'intermittent chronic hemodialysis' OR 'intermittent haemodialysis' OR 'intermittent hemodialysis' OR 'kidney dialysis' OR 'renal dialysis') AND ('sleep problem' OR 'sleep disturbance' OR 'sleep disorder' OR 'sleep quality' OR 'chronobiology disorders' OR dyssomnia). To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95 per cent confidence interval. The main international electronic databases were Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, Psych INFO, and Iranian databases such as MagIran, SID and Irandoc. The data were analysed using the Stata (version 13.0). Results: After searching through the databases and other resources, 21 articles (7 in Persian and 14 in English language) were included. The overall prevalence of low sleep quality in dialysis patients was 75.30 per cent (95 per cent confidence interval, 70.08–82.50). The heterogeneity study showed moderate heterogeneity among studies (I2 = 50.30 per cent, p < 0.05). Conclusions: The results of this study showed that the prevalence of low sleep quality in hemodialysis patients has become a common problem. Thus, patients' sleep quality need to be evaluated periodically.
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Affiliation(s)
- Masood Taheri Mirghaed
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Razieh Sepehrian
- School of Health Services Management and Medical Information Science, Department of Health Services Administration, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Rakhshan
- Department of Foreign Language, Tehran University of Medical Sciences, Tehran, Iran
| | - HasanAbolghasem Gorji
- School of Health Services Management and Medical Information Science, Department of Health Services Administration, Iran University of Medical Sciences, Tehran, Iran
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Lufiyani I, Zahra AN, Yona S. Factors related to insomnia among end-stage renal disease patients on hemodialysis in Jakarta, Indonesia. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Enezi A, Al-Jahdali F, Ahmed A, Shirbini N, Harbi A, Salim B, Ali Y, Abdulrahman A, Khan M, Khaleid A, Hamdan AJ. Symptoms of Daytime Sleepiness and Sleep Apnea in Liver Cirrhosis Patients. Ann Hepatol 2018; 16:591-598. [PMID: 28611264 DOI: 10.5604/01.3001.0010.0304] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
UNLABELLED Background/propose. Sleep disturbance and excessive daytime sleepiness (EDS) have been reported in patients with hepatic cirrhosis with no hepatic encephalopathy (HE). The objective of this study was to evaluate daytime sleepiness and risk of obstructive sleep apnea (OSA) among liver cirrhosis patients. MATERIAL AND METHODS A cross-sectional study was conducted at King Abdulaziz Medical City (KAMC)-Riyadh over a period of six months, using a structured questionnaire that investigated: 1) Sleep patterns and daytime sleepiness using the Epworth Sleeping Scale (ESS), and 2) The risk for sleep apnea using the Berlin Questionnaire (BQ). We enrolled patients with a confirmed diagnosis of liver cirrhosis who were being followed at the hepatology and pre-liver transplant clinics. RESULTS We enrolled 200 patients with liver cirrhosis, 57.5% of whom were male. The mean age was 60 (± SD 12.2). The reported prevalence of EDS, OSA, and both EDS and OSA were 29.5%, 42.9%, and 13.6%, respectively. The prevalence of EDS was higher in patients with Hepatitis-C and patients with DM, who experienced short sleep duration. We did not find any association between the severity of liver disease and EDS or OSA as measured by Child-Pugh scores (CPS). CONCLUSIONS The risk of OSA and EDS is high among liver cirrhosis patients. Those patients with cirrhosis secondary to Hepatitis C are at higher risk of EDS and OSA. Both EDS and OSA affect patients designated as CPS Class A more frequently than patients designated as CPS Class B.
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Affiliation(s)
- Abdullah Enezi
- College of Medicine. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fares Al-Jahdali
- College of Medicine. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Anwar Ahmed
- College of Public Health and Health Informatics. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nahid Shirbini
- Department of Medicine, Pulmonary Division, and Sleep Disorders Center. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Harbi
- Department of Medicine, Pulmonary Division, and Sleep Disorders Center. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Baharoon Salim
- Department of Medicine, Pulmonary Division, and Sleep Disorders Center. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yosra Ali
- College of Public Health and Health Informatics. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Aljumah Abdulrahman
- Departments of Hepatobiliary Surgery and Liver Transplantation. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohd Khan
- College of Medicine. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Khaleid
- Departments of Hepatobiliary Surgery and Liver Transplantation. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Al-Jahdali Hamdan
- Department of Medicine, Pulmonary Division, and Sleep Disorders Center. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Ahmed AE, Al-Jahdali H, Fatani A, Al-Rouqi K, Al-Jahdali F, Al-Harbi A, Baharoon S, Ali YZ, Khan M, Rumayyan A. The effects of age and gender on the prevalence of insomnia in a sample of the Saudi population. ETHNICITY & HEALTH 2017; 22:285-294. [PMID: 27846729 DOI: 10.1080/13557858.2016.1244624] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of insomnia among the Saudi adult population. STUDY DESIGN A cross-sectional insomnia survey was conducted at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. The presence of insomnia was defined by difficulty initiating sleep, early morning awakening, or frequent awakening, in addition to the second-day effect in the form of fatigue, tiredness, or changes in the mode because of lack of sleep. RESULTS The crude prevalence of insomnia was 77.7% (95% CI = 75.9-79.5%). The gender-adjusted prevalence of insomnia was higher for females, 88.7% (95% CI = 86.4-90.7%) than for males, 70.4% (95% CI = 67.8-72.9%), p-value = .001. The age-adjusted prevalence of insomnia was higher for the elderly, 93.7% (95% CI = 90.6-96.0%) than for the middle aged, 79.8% (95% CI = 77.4-82.1%), or for the young group, 64.2% (95% CI = 59.9-68.4%), p-value = .001. The Chi-square analyses revealed that (1) being elderly, widowed/divorced, females, or housewives, (2) having a lack of education, and (3) excessive tea consumption were significantly associated with elevated risks for insomnia (p-values < .05). CONCLUSIONS Insomnia is most prevalent among Saudi females and the elderly Saudi population.
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Affiliation(s)
- Anwar E Ahmed
- a King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - Hamdan Al-Jahdali
- b Department of Medicine, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
- c Pulmonary Division, Sleep Disorders Center , King Abdulaziz Medical City , Riyadh , Saudi Arabia
| | - Abdulhamid Fatani
- d Medical College, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - Khalid Al-Rouqi
- d Medical College, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - Fares Al-Jahdali
- d Medical College, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - Abdullah Al-Harbi
- b Department of Medicine, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
- c Pulmonary Division, Sleep Disorders Center , King Abdulaziz Medical City , Riyadh , Saudi Arabia
| | - Salim Baharoon
- b Department of Medicine, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
- c Pulmonary Division, Sleep Disorders Center , King Abdulaziz Medical City , Riyadh , Saudi Arabia
| | - Yosra Z Ali
- a King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
| | - Mohammad Khan
- b Department of Medicine, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
- c Pulmonary Division, Sleep Disorders Center , King Abdulaziz Medical City , Riyadh , Saudi Arabia
| | - Ahmad Rumayyan
- d Medical College, King Saud bin Abdulaziz University for Health Sciences , Riyadh , Saudi Arabia
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Ghanei Gheshlagh R, Farajzadeh M, Zarei M, Baghi V, Dalvand S, Sayehmiri K. The Prevalence of Restless Legs Syndrome in Patients Undergoing Hemodialysis: A Systematic Review and Meta-analysis Study. Basic Clin Neurosci 2017; 8:105-112. [PMID: 28539994 PMCID: PMC5440919 DOI: 10.18869/nirp.bcn.8.2.105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Restless legs syndrome is a sensory-motor disorder that causes sleep disorder. The syndrome in patients undergoing hemodialysis associates with depression, sleep deprivation, performance disorder, day fatigue, excessive daytime sleepiness, stress, anxiety, and higher risk of cardiovascular diseases. The objective of this systematic meta-analysis study was to estimate prevalence of restless legs syndrome in patients undergoing hemodialysis. METHODS Twenty-six relevant articles published between 2000 and 2015 indexed in Iranian (MagIran and IranMedex) and international databases (SID, Google Scholar, ScienceDirect, PubMed, Pre Quest, and Scopus) were selected. Data analysis was carried out through meta-analysis (random effect model) and heterogeneity of the studies was determined using I2 index. The obtained data were analyzed in STAT (11.2). RESULTS Prevalence of the syndrome according to the found articles was 50% (95% CI: 38-61) in Iranian and 30% (95% CI:23-37) in international databases. There was an ascending trend of prevalence of the syndrome corresponding to the publication year of the articles (P=0.419), while the trend based on age of the patients was descending (P=0.604). However, the variations were not significant. CONCLUSION Given the high prevalence and considerable effects of restless legs syndrome on patients undergoing hemodialysis, it is recommended that these patients be screened for the syndrome.
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Affiliation(s)
- Reza Ghanei Gheshlagh
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Farajzadeh
- Department of Nursing, School of Nursing & Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mozhdeh Zarei
- Deputy of Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Vajiheh Baghi
- Department of Midwifery, School of Nursing & Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sahar Dalvand
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kourosh Sayehmiri
- Department of Biostatistics, Psychosocial Injuries Prevention Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Tosun N, Kalender N, Cinar FI, Bagcivan G, Yenicesu M, Dikici D, Kaya D. Relationship between dialysis adequacy and sleep quality in haemodialysis patients. J Clin Nurs 2015. [PMID: 26215674 DOI: 10.1111/jocn.12908] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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 (X(2) = 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.
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Affiliation(s)
- Nuran Tosun
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
| | - Nurten Kalender
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
| | | | - Gulcan Bagcivan
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
| | | | - Dilek Dikici
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
| | - Dilek Kaya
- Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey
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13
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Knezevic MZ, Djordjevic VV, Jankovic SM, Djordjevic VM. Influence of dialysis modality and membrane flux on insomnia severity in haemodialysis patients. Nephrology (Carlton) 2014; 18:706-11. [PMID: 23848433 DOI: 10.1111/nep.12131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2013] [Indexed: 11/27/2022]
Abstract
AIM Insomnia is an important problem in dialysis patients. A greater prevalence of insomnia in chronic kidney disease compared with non-renal patients suggests a role for uraemic toxins in contributing to insomnia. The aim of this study was to examine if dialysis modality and membrane permeability is associated with the frequency and severity of insomnia in haemodialysis patients. METHODS In our cross-sectional study, we evaluated 122 patients who were divided into three groups: on-line haemodiafiltration, high flux haemodialysis and low flux haemodialysis. The frequency and severity of insomnia was evaluated with the Insomnia Severity Index. RESULTS Insomnia was present in 47.5% of all patients. The majority of patients who reported insomnia were receiving low flux haemodialysis (80%), followed by patients on high flux haemodialysis (43.6%) and haemodiafiltration (20.9%). Patients using low flux membranes, had a significantly higher Insomnia Severity Index (11.9 ± 6.6) compared with patients receiving high flux haemodialysis (6.8 ± 6.3) and haemodiafiltration (5.2 ± 7.0). The insomnia severity index did not differ between patients receiving high flux haemodialysis compared with on-line haemodiafiltration. CONCLUSION This study indicates that different haemodialysis modalities are associated with insomnia and suggests a potential benefit of using high flux membranes.
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Abstract
Background: Few studies are available regarding the prevalence of
sleep disturbance in cirrhotic patients without overt hepatic encephalopathy.
This study aimed to assess the prevalence of insomnia in stable liver cirrhosis
patients who are attending the outpatient clinics at King Abdulaziz Medical
City, Riyadh (KAMC-KFNGH). Methods: A cross-sectional study
enrolled 200 stable patients with confirmed liver cirrhosis. We used the ICSD-2
definition to assess the prevalence of insomnia. We also collected information
about sleep patterns, demographic data, the underlying cause of liver cirrhosis
and the severity of liver cirrhosis using Child-Pugh scores (CTP). Results: The mean age was 58.9 (SD ± 12.2) years.
Hepatitis C was the most common (60.2%) cause of liver cirrhosis among
respondents. The prevalence of insomnia was 42% (84/200). Univarite analysis
shows association between coffee intake and the presence of insomnia (56.9% vs.
35.9%, p-value = 0.006). The prevalence of insomnia was higher in hepatitis C
(51.7%) compared to hepatitis B (36.8%) and other hepatitis (15%), p-value =
0.001. There was a significant relationship between severity of liver cirrhosis
(CTP-A, CTP-C, CTP-B) and prevalence of insomnia: 55%, 36.1% and 32.1%
respectively, p-value = 0.009. Insomniac patients were significantly older than
non-insomniac (61.6 ± 12.0 vs. 57.0 ± 12.0 years, p = 0.008). Results
from the multivariate stepwise analysis showed coffee intake (OR=2.7), hepatitis
C (OR = 7.2), CTP-A (OR = 1.9), excessive daytime sleepiness (OR = 5.3) and
short sleep duration (OR = 5.7) were the most strongly associated with the
presence of insomnia. Conclusion: Our study showed a high
prevalence of insomnia in patients with liver cirrhosis.
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15
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Al-Eisa E, Buragadda S, Melam GR, Al-Osaimi AO, Al-Mubarak HA, Al-Huwaimel NA. Association between Physical Activity and Insomnia among Saudi Female College Students. J Phys Ther Sci 2013; 25:1479-82. [PMID: 24396215 PMCID: PMC3881482 DOI: 10.1589/jpts.25.1479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/20/2013] [Indexed: 01/05/2023] Open
Abstract
[Purpose] Insomnia is quite common and it can affect the quality of life of an
individual. Students undergo stress due to various academic demands leading to
sleeplessness and daytime sleepiness. This study was conducted to investigate the
association between physical activity and insomnia among female Saudi students. [Subjects]
62 female students with a mean age of 21 ± 1.5 years took part in a motivational program
to increase the number of steps taken per day for three weeks. [Methods] After obtaining
subject’s informed consent all the subjects were assessed for insomnia using the insomnia
severity index (ISI), They were then given pedometers to calculate the number of steps
they took per day. A physical activity log was kept for three weeks. Pre- and post
-intervention ISI scores were calculated and correlated with the 3-week physical activity
log. [Results] 50% of the subjects had no clinically significant insomnia (NCSI), 42% had
sub threshold (STI), and 8% had moderate clinical (MCI) insomnia. There was a moderate
negative correlation between physical activity and ISI scores after the 3-week motivation
program. [Conclusion] Prevalence of insomnia was common among female Saudi students and
increase in physical activity appears to improve the sleep pattern.
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Affiliation(s)
- Einas Al-Eisa
- Female Centre for Science and Medical Studies, King Saud University, KSA
| | - Syamala Buragadda
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, KSA
| | - Ganeswara Rao Melam
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, KSA
| | - Atheer O Al-Osaimi
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, KSA
| | - Huda A Al-Mubarak
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, KSA
| | - Noura A Al-Huwaimel
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, KSA
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16
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Yngman-Uhlin P, Fernström A, Börjeson S, Edéll-Gustafsson U. Evaluation of an individual sleep intervention programme in people undergoing peritoneal dialysis treatment. J Clin Nurs 2013; 21:3402-17. [PMID: 23145513 DOI: 10.1111/j.1365-2702.2012.04282.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to evaluate effects of a non-pharmacological intervention on sleep, activity and fatigue in patients receiving peritoneal dialysis by the use of both actigraphy registration and self-assessed questionnaires. BACKGROUND Insomnia is estimated to affect up to 60% of haemo- and peritoneal dialysis patients. It is associated with two common uremic symptoms, pruritus and restless legs syndrome. To our knowledge, no interventions have been evaluated by actigraphy. DESIGN A prospective multiple baseline single-case experimental design. METHODS Two women and seven men with sleep problems, 48-77 years, treated with PD participated in a 17-week study from January 2009 to February 2011. Two interventions were separately implemented. First, a pressure-relieving mattress and second, a four week individual sleep hygiene and sleep scheduling intervention. The two interventions were evaluated both objectively by actigraphy and subjectively by questionnaires. RESULTS A total of 315 sleep-wake cycles from nine individuals were evaluated. Three patients improved clinically significantly in five or more of the nine outcomes, i.e. sleep onset latency, nocturnal sleep duration, numbers and duration of napping, movement and fragmentation index, number of steps, metabolic equivalent unit, sleep efficiency and fatigue. The other six patients also showed improvements but to a lesser degree. Physical activity advice was the intervention that yielded most sleep improvements. CONCLUSIONS This study illuminates the need for regular assessment of sleep and tiredness. It also demonstrates how a non-pharmacological treatment and self-management can be applied with renal supportive care to improve sleep quality. RELEVANCE TO CLINICAL PRACTICE This study is a clinical example of a non-pharmacological intervention with supportive care and self-management. This model can improve health and reduce the pharmacological burden because hypnotics can be replaced by sleep hygiene self-care activities.
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Affiliation(s)
- Pia Yngman-Uhlin
- Division of Nursing Science, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
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Abstract
AbstractThe prevalence of insomnia is greater in end-stage renal disease. The aim of our study was to determine the frequency of insomnia and subclinical insomnia in patients with various dialysis therapy and kidney transplant recipients, in order to assess the severity of insomnia and examine whether there is a difference in severity among groups. In cross-sectional study, we evaluated 120 patients with terminal renal failure. Based on therapy, patients were divided into four groups: hemodiafiltration, standard bicarbonate dialysis, peritoneal dialysis and kidney transplant recipients. The severity of insomnia was evaluated through the use of the Insomnia Severity Index (ISI). Most patients who reported any kind of insomnia problems with ISI were on conventional dialysis (80%), followed by hemodiafiltration (76.7%) and peritoneal dialysis (63.3%). Transplant recipients had least difficulties with insomnia (46.7%). Insomnia Severity Index showed that insomnia in end-stage renal patients is not very severe. Most of the patients had “no clinically significant insomnia”. Our findings indicate that patients on hemodiafiltration and transplant recipients have a significantly lower score on Insomnia Severity Index. Patients with end-stage renal disease have high frequency insomnia problems. However, our study shows that insomnia in these patients is not severe. Insomnia is the most frequent and severest in patients on standard bicarbonate dialysis.
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Abstract
PURPOSE OF REVIEW Recently published literature indicates that sleep disorders present with medical comorbidities quite frequently. The coexistence of a sleep disorder with a medical disorder has a substantial impact for both the patient and the health system. RECENT FINDINGS Insomnia and hypersomnia are highly comorbid with medical conditions, such as chronic pain and diabetes, as well as with various cardiovascular, respiratory, gastrointestinal, urinary and neurological disorders. Restless legs syndrome and periodic leg movement syndrome have been associated with iron deficiency, kidney disease, diabetes, and neurological, autoimmune, cardiovascular and respiratory disorders. Rapid eye movement behaviour disorder has been described as an early manifestation of serious central nervous system diseases; thus, close neurological monitoring of patients referring with this complaint is indicated. SUMMARY Identification and management of any sleep disorder in medical patients is important for optimizing the course and prognosis. Of equal importance is the search for undetected medical disorder in patients presenting with sleep disorders.
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19
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Ibrahim JM, Wegdan OM. Epidemiology of sleep disorders in patients with chronic renal disease in Cairo, Egypt. J Egypt Public Health Assoc 2011; 86:68-72. [PMID: 21844762 DOI: 10.1097/01.epx.0000399136.00486.4e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Many patients with end-stage renal disease undergoing dialysis therapy suffer from sleep disturbances. The aims of this study were to determine the prevalence of sleep disorders in patients with end-stage renal disease on maintenance dialysis and to determine the risk factors underlying these disorders. PATIENTS AND METHODS A total of 264 patients on maintenance dialysis were enrolled in the study. Demographic, renal, and dialysis data were recorded. Using Personal Professional Interviews, we assessed the presence of the following sleep disorders: insomnia, restless leg syndrome (RLS), and obstructive sleep apnea syndrome (OSAS). Moreover, to determine the prevalence of sleep disturbances and the possible effect of demographic or clinical data on sleep, we divided our population into two groups: with and without sleep disorders. RESULTS The prevalence of sleep disorders was 61.4%. The survey revealed the presence of insomnia (57.6%), RLS (56.4%), and OSAS (21.2%). Insomnia, RLS, and OSAS were significantly associated with inadequate dialysis, hyperphosphatemia, and hypoalbuminemia. Insomnia and RLS were also significantly associated with anemia. Significant independent association was observed between insomnia and both RLS and OSAS as well as between RLS and OSAS. CONCLUSION The survey showed a high prevalence of sleep disruption in dialytic populations. Our data might help nephrologists to deal with patients with uremia with possible sleep disorders.
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Affiliation(s)
- Jehan M Ibrahim
- aDepartment of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University bMinistry of Health and Population, Cairo, Egypt
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