Benetou Sofia, Alikari Victoria, Vasilopoulos Georgios, Polikandrioti Maria, Kalogianni Antonia, Panoutsopoulos Georgios I, Toulia Georgia, Leftheriotis Dionyssios, Gerogianni Georgia
Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC.
Department of Nutritional Studies and Dietetics, University of Peloponnese, Kalamata, GRC.
Cureus. 2022 Feb 14;14(2):e22197. doi: 10.7759/cureus.22197. eCollection 2022 Feb.
Insomnia is the most common sleep disorder among patients on hemodialysis and has a strong relation with fatigue, depression, low immune system, increased risk of cardiovascular problems, and low quality of life. The aim of this study was to explore the factors associated with insomnia in patients undergoing hemodialysis. Methods: In this cross-sectional study, 100 patients on hemodialysis (75 males and 25 females) from a hemodialysis center in Greece were included. Insomnia was assessed via the "Athens Insomnia Scale (AIS)" and a questionnaire about demographic and clinical characteristics. The Kruskal-Wallis, Mann-Whitney tests, and Spearman's rho criterion were used to evaluate the association between insomnia score and patients' characteristics. Multiple linear regression was performed to assess the effect of characteristics on patients' insomnia.
Statistically significantly high levels of insomnia were found in patients over the age of 60 years (p = 0.002), in divorced/widowed patients (p = 0.007), in patients who had comorbid diseases (p = 0.001), in patients who felt tired after hemodialysis (p = 0.001), in those who had continuous fatigue (p = 0.001) and change in body image (p = 0.003), in those who often had itching (p = 0.007) and stiffness in joints (p = 0.001) and in patients who had limitations in the clothes they could wear (p = 0.001).
The findings of this study showed that insomnia had a strong association with increased age of patients, comorbidities, fatigue, change in body appearance, pruritus, and limitation in clothes they could wear. Therefore, there is a necessity for early assessment of sleep quality and effective treatment of sleep disorders in hemodialysis patients in order to reduce morbidity and mortality and improve the quality of their life.
失眠是血液透析患者中最常见的睡眠障碍，与疲劳、抑郁、免疫系统低下、心血管问题风险增加以及生活质量低下密切相关。本研究旨在探讨血液透析患者失眠的相关因素。
在这项横断面研究中，纳入了希腊一家血液透析中心的100名血液透析患者（75名男性和25名女性）。通过“雅典失眠量表（AIS）”以及一份关于人口统计学和临床特征的问卷对失眠进行评估。使用Kruskal-Wallis检验、Mann-Whitney检验和Spearman秩相关系数标准来评估失眠评分与患者特征之间的关联。进行多元线性回归以评估各特征对患者失眠的影响。
60岁以上患者（p = 0.002）、离异/丧偶患者（p = 0.007）、患有合并症的患者（p = 0.001）、血液透析后感到疲倦的患者（p = 0.001）、持续疲劳的患者（p = 0.001）、身体形象有变化的患者（p = 0.003）、经常瘙痒的患者（p = 0.007）和关节僵硬的患者（p = 0.001）以及穿着衣物受限的患者（p = 0.001）的失眠水平在统计学上显著较高。
本研究结果表明，失眠与患者年龄增长、合并症、疲劳、身体外观变化、瘙痒以及穿着衣物受限密切相关。因此，有必要对血液透析患者的睡眠质量进行早期评估并有效治疗睡眠障碍，以降低发病率和死亡率，提高他们的生活质量。
