Diabetic nephropathy: a strong predictor of sleep quality in hemodialysis patients

Sleep complaints are common in hemodialysis (HD) patients. Sleep quality (SQ) is a predictor of quality of life and mortality risk in HD. The aim of this study was to examine factors that may have a role in SQ. In this cross-sectional analytic study,138 end-stage renal disease patients receiving maintenance HD for 3 months were included. The Pittsburgh Sleep Quality Index (PSQI) was used to measure individual s SQ. Patients with a global PSQI score 5 were assumed as poor sleepers. Eighty-eight patients (64%) were classified as poor sleepers. Poor sleepers were older and more likely had diabetes. They had significantly higher serum ferritin and calcium levels and lower serum parathyroid hormone level (all P-values 0.05). The global PSQI score was positively correlated with age,serum calcium level and presence of diabetes as the underlying cause of renal failure. In the multi-variable binary regression model,presence of diabetes (Odds Ratio (OR) = 3.67,P = 0.008) and body pain (OR = 1.182,P = 0.014) were the significant independent predictors for poor SQ. Poor SQ was common among our HD patients,especially among diabetic cases and,therefore,there is a need to pay more attention to the care of this subgroup with regard to the diagnosis and management of sleep complaints.