Dialysis adequacy and sleep quality in hemodialysis patients: A cross-sectional study

This study investigates dialysis adequacy and sleep quality in hemodialysis patients. This cross-sectional study was conducted on 208 hemodialysis patients at the Mazandaran University of Medical Sciences educational and therapeutic centers in Sari, Iran. Data were collected using a demographic questionnaire, dialysis adequacy (Kt/V) values from medical records, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Patients meeting inclusion criteria were included through a census method. Statistical analysis was performed using descriptive statistics, t-tests, Pearson correlation, multiple linear regression, and structural equation modeling (SEM). The study included 208 patients, with a mean age of 57.72 (standard deviation [SD]=12.78) years, and 56.3% were male. Dialysis adequacy was adequate in 59.1% of patients (Kt/V≥1.2). The mean PSQI score was 5.52 (SD=3.46), with 56.2% of patients having acceptable sleep quality (PSQI≤5). A significant inverse relationship was found between dialysis adequacy and sleep quality (P<0.05). Patients with higher dialysis adequacy reported fewer sleep disturbances. SEM revealed direct and indirect associations between dialysis adequacy and various components of sleep quality, except for using sleep medications. There is a significant inverse relationship between dialysis adequacy and sleep quality in hemodialysis patients. Enhancing dialysis adequacy can reduce sleep disturbances and improve these patients' overall quality of life. Future research should include longitudinal studies, objective sleep assessments, and interventions to enhance dialysis adequacy and sleep quality.