doiSerbia

Depression and quality of sleep in maintenance hemodialysis patients

Trbojević-Stanković Jasna (School of Medicine, Belgrade + Clinical Hospital Center “Dr Dragiša Mišović”, Department of Dialysis, Belgrade)
Stojimirović Biljana (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic of Nephrology, Belgrade)
Bukumirić Zoran (School of Medicine, Institute for Medical Statistics and Informatics, Belgrade)
Hadžibulić Edvin (General Hospital “Novi Pazar”, Department of Dialysis, Novi Pazar)
Andrić Branislav (General Hospital “Kruševac”, Department of Nephrology and Dialysis, Kruševac)
Đorđević Verica (General Hospital “Stefan Visoki”, Department of Nephrology, Smederevska Palanka)
Marjanović Zoran (General Hospital “Stefan Visoki”, Department of Nephrology, Smederevska Palanka)
Birđozlić Fatmir (General Hospital “Novi Pazar”, Department of Dialysis, Novi Pazar)
Nešić Dejan (School of Medicine, Institute of Medical Physiology, Belgrade)
Jovanović Dijana (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic of Nephrology, Belgrade)

Introduction. Sleep disorders and psychological disturbances are common in end-stage renal disease (ESRD) patients. However, despite their frequency and importance, such conditions often go unnoticed, since all patients do not clearly manifest fully expressed symptoms. Objective. This study aimed to determine the prevalence of depression and poor sleep quality and to examine the association between these disorders and demographic, clinical and treatment-related characteristics of ESRD patients on hemodialysis (HD). Methods. The study included 222 patients (132 men and 90 women), mean age 57.3±11.9 years, from 3 HD centers in Central Serbia, which provided us with biochemical parameters and demographic data. Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. Results. The average BDI was 16.1±11.3. Depressed patients were significantly older (p=0.041), had a significantly lower dialysis adequacy (p=0.027) and a significantly worse quality of sleep (p<0.001), while they did not show significant difference as regarding sex, employment, marital status, comorbidities, dialysis type, dialysis vintage, shift and laboratory parameters. The average PSQI was 7.8±4.5 and 64.2% of patients were poor sleepers. Poor sleepers were significantly older (p=0.002), they were more often females (p=0.027) and had a significantly higher BDI (p<0.001), while other investigated variables were not correlated with sleep quality. A statistically significant positive correlation was found between BDI and PSQI (r=0.604; p<0.001). Conclusion. Depression and poor sleep quality are frequent and interrelated among HD patients.

Keywords: depression, quality of sleep, dialysis, hemodialysis