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终末期肾病血液透析患者的失眠:患病率及相关因素——越南的一项横断面研究

Insomnia Among Patients with End-Stage Kidney Disease on Hemodialysis: Prevalence and Associated Factors - A Cross-Sectional Study in Vietnam.

作者信息

Tran Nhu Minh Hang, Dinh Vu Ngoc Ninh, Dang Tran Khang, Hoang Bui Bao

机构信息

Department of Psychiatry - Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.

Department of Psychiatry, 175 Military Hospital, Ho Chi Minh City, Vietnam.

出版信息

Int J Nephrol Renovasc Dis. 2025 Aug 20;18:243-253. doi: 10.2147/IJNRD.S538153. eCollection 2025.

Abstract

BACKGROUND AND AIMS

The prevalence of insomnia among patients with end-stage kidney disease undergoing hemodialysis is high. Insomnia in patients undergoing hemodialysis may reduce their quality of life. The purpose of this study was to estimate the prevalence of insomnia and to examine the risk factors associated with insomnia among patients with end-stage kidney disease undergoing hemodialysis.

SUBJECT AND METHODS

This cross-sectional study included 216 patients with end-stage kidney disease undergoing hemodialysis at 175 Military Hospital, Ho Chi Minh City, Vietnam. Psychiatrists evaluated insomnia using clinical criteria of The Diagnostic and Statistical Mental Disorders, 5th Edition (DSM5). Participants were recruited using convenience sampling at 175 Military Hospital in Vietnam, with all eligible patients invited. Descriptive statistics (counts, percentages, means, standard deviations) were used to describe population characteristics and insomnia prevalence. Data were collected on patients' sociodemographic factors such as sex, age, marital and economic status; clinical factors including duration of end-stage kidney diseases, duration of hemodialysis, number of hemodialysis sessions per week, co-morbidities (diabetes, hypertension…) and environmental factors (eg, excessive noisy or light bedrooms). Logistic regression analysis model was used to analyze the factors associated with insomnia disorders in patients with end-stage kidney disease undergoing hemodialysis.

RESULTS

The prevalence of insomnia among patients with end-stage kidney disease was 48.1%. Multivariate logistic regression showed diabetes (OR=0.331 for no diabetes, 95% CI: 0.148-0.738, p<0.01), daytime napping (OR=2.122, 95% CI: 1.159-3.885, p=0.02, excessive noisy or light bedrooms (OR=0.251 for no exposure, 95% CI: 0.074-0.854, p=0.03) were significantly associated with insomnia.

CONCLUSION

The prevalence of insomnia in patients with end-stage kidney disease was high. These results may help clinicians in the dialysis department pay more attention to insomnia symptoms in patients with end-stage kidney disease on dialysis and consider collaboration with psychiatrists to explore treatment strategies is also recommended.

摘要

背景与目的

接受血液透析的终末期肾病患者中失眠的患病率很高。接受血液透析的患者失眠可能会降低他们的生活质量。本研究的目的是估计失眠的患病率,并检查接受血液透析的终末期肾病患者中与失眠相关的危险因素。

对象与方法

这项横断面研究纳入了越南胡志明市175军区医院的216例接受血液透析的终末期肾病患者。精神科医生使用《精神疾病诊断与统计手册》第5版(DSM5)的临床标准评估失眠情况。在越南175军区医院采用便利抽样法招募参与者,邀请了所有符合条件的患者。描述性统计(计数、百分比、均值、标准差)用于描述人群特征和失眠患病率。收集了患者的社会人口学因素,如性别、年龄、婚姻和经济状况;临床因素,包括终末期肾病的病程、血液透析的病程、每周血液透析次数、合并症(糖尿病、高血压等)和环境因素(如卧室噪音过大或光线过强)。采用逻辑回归分析模型分析接受血液透析的终末期肾病患者中与失眠障碍相关的因素。

结果

终末期肾病患者中失眠的患病率为48.1%。多因素逻辑回归显示糖尿病(无糖尿病者的比值比=0.331,95%置信区间:0.148-0.738,p<0.01)、白天小睡(比值比=2.122,95%置信区间:1.159-3.885,p=0.02)、卧室噪音过大或光线过强(无暴露者的比值比=0.251,95%置信区间:0.074-0.854,p=0.03)与失眠显著相关。

结论

终末期肾病患者中失眠的患病率很高。这些结果可能有助于透析科的临床医生更加关注接受透析的终末期肾病患者的失眠症状,也建议考虑与精神科医生合作探索治疗策略。

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