Correlation analysis of anxiety, depression, and sleep quality in end-stage renal disease patients undergoing maintenance hemodialysis

End-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (MHD) often experience significant psychological distress and sleep disturbances, with anxiety and depression being particularly prevalent. These conditions may negatively affect sleep quality. However, comprehensive studies examining the interplay between anxiety, depression, and sleep quality in ESRD patients are limited. Understanding these relationships is crucial for improving patient care. This study aimed to evaluate the prevalence and severity of anxiety, depression, and sleep disorders in ESRD patients on MHD and identify the independent effects of anxiety, depression, and other factors on sleep quality. Data from 65 ESRD patients on MHD between January 2020 and December 2023 were retrospectively analyzed. Inclusion criteria were age ≥ 18 years, MHD for ≥ 3 months, and complete clinical and psychological data. Exclusion criteria included a history of diagnosed psychiatric disorders or significant recent life events. Anxiety, depression, and sleep quality were assessed using the GAD-7, PHQ-9, and PSQI scales. Statistical analyses included t-tests, ANOVA, chi-square tests, Pearson correlation, and multiple linear regression to identify independent predictors of sleep quality, adjusting for potential confounders. Anxiety symptoms were present in 55.38% of patients, depressive symptoms in 50.77%, and sleep disturbances in 72.30%. Significant positive correlations were found between anxiety and depression with poor sleep quality, with depression showing a stronger association. Multivariate regression identified anxiety and depression as independent predictors of sleep quality. Disease-related factors such as longer chronic kidney disease duration, increased dialysis frequency, and elevated serum creatinine levels were associated with poorer sleep quality, while higher household income correlated with better sleep quality. Anxiety, depression, and sleep disorders are highly prevalent among ESRD patients on MHD. Anxiety and depression independently impair sleep quality, with additional contributing factors including disease duration, dialysis frequency, serum creatinine levels, and socioeconomic status. Comprehensive care should address psychological well-being alongside disease management, emphasizing psychological interventions, social support, and targeted strategies for at-risk groups to improve sleep and quality of life.