Insomnia in Chronic Hemodialysis Patients: Prevalence and Associated Factors

Introduction: Sleep disorders (SD) are common in chronic hemodialysis (HD) patients. This study aims to determine the prevalence of insomnia and other SD in chronic HD patients and the factors associated with it. Material and Methods: This is a cross-sectional, analytical monocentric study including chronic HD patients. Insomnia and other SD were analysed by questioning and by the Insomnia Severity Index (ISI). We performed an analysis of independence using the Chi-square test between clinical and biological factors and insomnia. Results: 36 patients were included, with a sex ratio of 1.4. The mean age was 44 years (17-85). The mean duration of HD was 94 months (4-408). 21 patients (58.33%) had insomnia. It was mild in 2 cases, moderate in 4 cases and severe in 15 cases. Insomnia was of the sleep maintenance disorder type in 15 cases and difficulty falling asleep in 6 cases. Associated SD was restless legs syndrome in 5 cases and daytime sleepiness in 4 cases. Anxiety was reported in 4 cases and chronic pain in 14 cases. The factors studied were sex, age, length of time on HD, high blood pressure, phosphocalcic balance, thyroid balance and inflammatory balance. The threshold of acceptability is 3.84 for a degree of freedom equal to 1 and was consulted on the table of the Chi-square with a risk of 5%. The deviation of the Chi-square for our study is 4.83 for high blood pressure and vitamin D deficiency which exceeds the threshold of acceptability 3.84. Consequently, we identified high blood pressure and hypovitaminosis D as significant factors associated with insomnia. Conclusion: In our study, insomnia affects more than half of HD patients. Maintaining adequate blood pressure and correcting the phosphocalcic balance, particularly vitamin D levels, could reduce insomnia and improve the quality of life for these patients.