Insomnia in Chronic Hemodialysis Patients: Prevalence and Associated Factors

Insomnia is a frequent but underrecognized sleep disorder in patients with chronic kidney disease on hemodialysis. This cross-sectional study, conducted in October 2024 at a private nephrology center in Kénitra (Morocco), evaluated 47 patients using the Insomnia Severity Index (ISI). The sample (mean age 57 years, 58% men, mean dialysis duration 10 years) showed a high prevalence of insomnia (74.5%), with 42.5% presenting moderate to severe forms. Common comorbidities included hypertension (25.5%), diabetes (19.1%), and heart failure (17%). Contributing factors involve metabolic imbalances, circadian rhythm disturbances, somatic symptoms, medication side effects, and psychiatric comorbidities. Insomnia significantly affects quality of life and may increase cardiovascular morbidity and mortality. Despite its impact, insomnia is rarely screened or managed in hemodialysis care. Simple measures—such as sleep hygiene education, cognitive-behavioral therapy, management of somatic symptoms, and cautious pharmacological interventions like melatonin—could improve outcomes. Insomnia is highly prevalent among chronic hemodialysis patients. Systematic screening and multidimensional management are essential to improve quality of life and reduce complications.