Wu Yongyao, Zhang Haojie, Jiang Lei, Liu Zhiping, Li Xinfei, Guo Bei, Li Junyuan, Xu Pengjie, Liu Jiang, Yu Rizhen
Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Front Psychiatry. 2025 Jun 13;16:1542028. doi: 10.3389/fpsyt.2025.1542028. eCollection 2025.
Long-term physiological, psychological, economic, and lifestyle pressures make maintenance hemodialysis (MHD) patients prone to anxiety and depression. This study aims to evaluate the effects of mindfulness meditation combined with progressive muscle relaxation on sleep and emotional disorders in hemodialysis patients with sarcopenia.
Patients with uremic sarcopenia and sleep issues were randomly divided into a control group (n=24) and an intervention group (n=25), with an average age of 45.4 ± 4.77 years and an average dialysis duration of 56.86 ± 17.48 months. The control group received standard treatment (hemodialysis three times per week, medication, health education, dietary guidance, and exercise recommendations), while the intervention group additionally underwent home-based mindfulness and relaxation training for at least 0.5 hours daily over 12 weeks. Sleep quality, emotional states, and quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and 36-Item Short Form Health Survey (SF-36). Data analysis included descriptive statistics, t-tests, analysis of covariance, Mann-Whitney U tests, and chi-square tests.
Before the intervention, there were no significant differences between the two groups in sleep, anxiety, depression, or quality of life (P>0.05). After the intervention, the intervention group showed significant improvements in all PSQI dimensions (e.g., sleep medication use, sleep quality, and sleep duration) (P<0.01), significant reductions in SAS and SDS scores (P<0.05), and significantly higher SF-36 scores compared to the control group (P<0.05).
Mindfulness and muscle relaxation training can alleviate psychological stress, reduce skeletal muscle tension, promote muscle anabolism, and significantly improve sleep quality, anxiety, and depression in hemodialysis patients with sarcopenia. This approach is simple, unrestricted, and widely applicable, making it worthy of clinical promotion.
The study had a small sample size and a short follow-up period.
https://register.clinicaltrials.gov/, identifier NCT06261372.
长期的生理、心理、经济和生活方式压力使维持性血液透析（MHD）患者容易出现焦虑和抑郁。本研究旨在评估正念冥想结合渐进性肌肉松弛对伴有肌肉减少症的血液透析患者睡眠和情绪障碍的影响。
将患有尿毒症性肌肉减少症和睡眠问题的患者随机分为对照组（n = 24）和干预组（n = 25），平均年龄为45.4 ± 4.77岁，平均透析时间为56.86 ± 17.48个月。对照组接受标准治疗（每周进行三次血液透析、药物治疗、健康教育、饮食指导和运动建议），而干预组在12周内每天额外进行至少0.5小时的居家正念和放松训练。使用匹兹堡睡眠质量指数（PSQI）、自评抑郁量表（SDS）、自评焦虑量表（SAS）和36项简短健康调查（SF - 36）评估睡眠质量、情绪状态和生活质量。数据分析包括描述性统计、t检验、协方差分析、曼 - 惠特尼U检验和卡方检验。
干预前，两组在睡眠、焦虑、抑郁或生活质量方面无显著差异（P>0.05）。干预后，干预组在所有PSQI维度（如助眠药物使用、睡眠质量和睡眠时间）上均有显著改善（P<0.01），SAS和SDS评分显著降低（P<0.05），与对照组相比，SF - 36评分显著更高（P<0.05）。
正念和肌肉松弛训练可以减轻心理压力，降低骨骼肌紧张度，促进肌肉合成代谢，并显著改善伴有肌肉减少症的血液透析患者的睡眠质量、焦虑和抑郁状况。这种方法简单、不受限制且广泛适用，值得临床推广。
本研究样本量小且随访期短。
