Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

<p>Abstract</p> <p>Background</p> <p>Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high preval...

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Main Authors: Bliwise Donald L, Kutner Nancy G, Parker Kathy P, Bailey James L, Rye David B
Format: Article
Language:English
Published: BMC 2003-11-01
Series:Health and Quality of Life Outcomes
Online Access:http://www.hqlo.com/content/1/1/68
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author Bliwise Donald L
Kutner Nancy G
Parker Kathy P
Bailey James L
Rye David B
author_facet Bliwise Donald L
Kutner Nancy G
Parker Kathy P
Bailey James L
Rye David B
author_sort Bliwise Donald L
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness</p> <p>Methods</p> <p>The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8) years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Subjects also completed: 1) a brief nocturnal sleep questionnaire; 2) the Epworth Sleepiness Scale; and, 3) the Quality of Life Index (QLI, Dialysis Version) which provides an overall QLI score and four subscale scores for Health & Functioning (H&F), Social & Economic (S&E), Psychological & Spiritual (P&S), and Family (F). (The range of scores is 0 to 30 with higher scores indicating better quality of life.)</p> <p>Results</p> <p>The mean (standard deviation; SD) of the overall QLI was 22.8 (4.0). The mean (SD) of the four subscales were as follows: H&F – 21.1 (4.7); S&E – 22.0 (4.8); P&S – 24.5 (4.4); and, F – 26.8 (3.5). H&F (r<sub>s </sub>= -0.326, p = 0.013) and F (r<sub>s </sub>= -0.248, p = 0.048) subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (r<sub>s </sub>= 0.248, p = 0.048) while the H&F (r<sub>s </sub>= 0.278, p = 0.030) and total QLI (r<sub>s </sub>= 0.263, p = 0.038) scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS scores were unrelated to overall QLI scores or the subscale scores. Subjective reports of difficulty falling asleep and waking up too early were significantly correlated with all four subscale scores and overall QLI. Feeling rested in the morning was positively associated with S&E, P&S, and Total QLI scores.</p> <p>Conclusion</p> <p>Selected measures of both poor nocturnal sleep and increased daytime sleepiness are associated with decreased quality of life in HD patients, underscoring the importance of recognizing and treating these patients' sleep problems.</p>
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spelling doaj.art-6c3fdcf7d1ee47ee89ff7466bdcdd7712022-12-22T03:10:18ZengBMCHealth and Quality of Life Outcomes1477-75252003-11-01116810.1186/1477-7525-1-68Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysisBliwise Donald LKutner Nancy GParker Kathy PBailey James LRye David B<p>Abstract</p> <p>Background</p> <p>Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD). However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness</p> <p>Methods</p> <p>The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8) years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Subjects also completed: 1) a brief nocturnal sleep questionnaire; 2) the Epworth Sleepiness Scale; and, 3) the Quality of Life Index (QLI, Dialysis Version) which provides an overall QLI score and four subscale scores for Health & Functioning (H&F), Social & Economic (S&E), Psychological & Spiritual (P&S), and Family (F). (The range of scores is 0 to 30 with higher scores indicating better quality of life.)</p> <p>Results</p> <p>The mean (standard deviation; SD) of the overall QLI was 22.8 (4.0). The mean (SD) of the four subscales were as follows: H&F – 21.1 (4.7); S&E – 22.0 (4.8); P&S – 24.5 (4.4); and, F – 26.8 (3.5). H&F (r<sub>s </sub>= -0.326, p = 0.013) and F (r<sub>s </sub>= -0.248, p = 0.048) subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (r<sub>s </sub>= 0.248, p = 0.048) while the H&F (r<sub>s </sub>= 0.278, p = 0.030) and total QLI (r<sub>s </sub>= 0.263, p = 0.038) scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS scores were unrelated to overall QLI scores or the subscale scores. Subjective reports of difficulty falling asleep and waking up too early were significantly correlated with all four subscale scores and overall QLI. Feeling rested in the morning was positively associated with S&E, P&S, and Total QLI scores.</p> <p>Conclusion</p> <p>Selected measures of both poor nocturnal sleep and increased daytime sleepiness are associated with decreased quality of life in HD patients, underscoring the importance of recognizing and treating these patients' sleep problems.</p>http://www.hqlo.com/content/1/1/68
spellingShingle Bliwise Donald L
Kutner Nancy G
Parker Kathy P
Bailey James L
Rye David B
Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
Health and Quality of Life Outcomes
title Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
title_full Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
title_fullStr Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
title_full_unstemmed Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
title_short Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis
title_sort nocturnal sleep daytime sleepiness and quality of life in stable patients on hemodialysis
url http://www.hqlo.com/content/1/1/68
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AT parkerkathyp nocturnalsleepdaytimesleepinessandqualityoflifeinstablepatientsonhemodialysis
AT baileyjamesl nocturnalsleepdaytimesleepinessandqualityoflifeinstablepatientsonhemodialysis
AT ryedavidb nocturnalsleepdaytimesleepinessandqualityoflifeinstablepatientsonhemodialysis