Quality Of Sleep And Sleep Disorders In Adult Patients With End Stage Renal Disease Undergoing Hemodialysis At Kenyatta National Hospital

Abstract

Introduction The burden of poor sleep quality and sleep disorders is higher amongst patients with End-Stage Renal Disease (ESRD) on hemodialysis compared to the general population and is associated with increased morbidity and mortality. The quality of sleep and burden of sleep disorders amongst Kenyan patients with ESRD on hemodialysis is not known. Objectives The objective of the study was to assess the quality of sleep and the prevalence of insomnia and high risk for Obstructive Sleep Apnea (OSA) in patients with ESRD on hemodialysis and to determine the associated sociodemographic, clinical and biochemical parameters. Study design A hospital based cross-sectional descriptive study carried out over duration of three months. Study participants and study site Patients with ESRD on hemodialysis for more than three months at the renal unit, Kenyatta National Hospital (KNH) Methods Patients on hemodialysis were invited to participate in the study. All patients who met the inclusion criteria were recruited, after giving written consent, based on consecutive sampling. Targeted history was taken and anthropometric measurements done. Blood was drawn for biochemical parameters (hemoglobin and phosphate). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), high risk for OSA using Berlins Questionnaire (BQ) and insomnia using the Athens Insomnia Scale (AIS). Associations between poor sleep quality, high risk for OSA, insomnia and various sociodemographic, clinical and biochemical factors were explored. Associated variables were subjected to logistic regression analysis with odds ratio reported. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0 software. Results The study was conducted between August 2016 to October 2016. Out of the 115 patients analysed, 59.1% were males, mean age was 44.7(±16.1) and mean BMI was 23.1(±5.1) kg/m2. xi Of the 115 patients assessed, 80 (69.6%) had poor sleep quality, 54 (47%) had insomnia and 40(34.8%) had high risk for Obstructive Sleep Apnea. Conclusion We obtained a high prevalence of poor sleep quality and sleep disorders (insomnia and high risk for OSA), similar to that reported in other populations. Assessment for and management of quality of sleep and sleep disorders in ESRD patients on hemodialysis should be an important component of care.