Quality of sleep in hemodialysis patients and affecting factors

Alisultanova, A. Quality of sleep in hemodialysis patients and affecting factors. Specialization Thesis of Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, 2025. End-stage renal failure is one of the prevalent diseases worldwide and in our country. It occurs in 100-300 people per million annually. Generally, it is considered as the final stage of renal failure, and when eGFR falls below 15 ml/min, one of the renal replacement therapies such as hemodialysis, peritoneal dialysis, or kidney transplantation is applied. Hemodialysis is a treatment method that temporarily replaces the function of the kidneys. Hemodialysis adequacy refers to how effectively a hemodialysis session cleans waste products and excess fluid in the patient's blood. This adequacy is critically important to increase the patient's quality of life and reduce complications associated with renal failure. Sleep is a natural process where the brain and the entire body rest, the level of consciousness decreases, but certain brain activities continue. Especially in end- stage renal failure, sleep problems are common in patients. These problems may arise from both physical and psychological factors and can significantly affect the quality of life of patients. The accumulation of urea and other harmful substances due to the inability of the kidneys to cleanse toxins can affect brain functions and lead to sleep disorders. The aim of this study is to evaluate the quality of sleep in hemodialysis patients using the Pittsburgh Sleep Quality Index and to determine the influencing factors. A total of 206 patients undergoing hemodialysis in public and private hemodialysis centers in Eskişehir were included in the study. According to the scoring, 93 (45.1%) participants had good sleep quality, and 113 (54.9%) participants had poor sleep quality. As a result of the study, it was found that there was no relationship between age and gender and sleep quality disorder. When participants with good and poor sleep quality were compared, a significant relationship was found with the presence of diabetes, sedative drug use, parathyroid hormone, and high sedimentation. The evaluation and improvement of sleep quality in hemodialysis patients is of great importance both for individual well-being and for the success of the treatment. Key Words: Hemodialysis, Pittsburgh, PUKİ