Kidney disease patients who rely on hemodialysis are also suffering from poor sleep, according to a recent Bahrain-based study.
Researchers are calling for stronger sleep assessment, mental health screening and psychosocial support education to ensure proper care.
“The number of patients on hemodialysis is steadily increasing in Gulf Arab countries, including Bahrain,” researchers noted, in the abstract of their study.
“Such treatment modality has a negative impact on the quality of life, particularly sleep quality. This study aimed to assess the factors affecting the sleep pattern disturbances of hemodialysis patients in Bahrain.”
The cross-sectional study titled ‘Unmasking factors affecting sleep pattern disturbances among patients undergoing hemodialysis’ was conducted by a group of researchers from Bahrain, Saudi Arabia, Oman and Egypt including Hala Sanad, Khaldoon Al Roomi and Zahra Abdlmjeed from the kingdom.
It has been published in the open-access peer-reviewed Public Library of Science One academic journal.
Hemodialysis is a life-sustaining treatment for kidney failure, which uses a machine and a special filter called an artificial kidney or dialyser to pump blood out of the body, filter out accumulated toxins and excess fluids, and return the cleaned blood back into the patient.
A sample of 174 patients was picked from the hemodialysis units of Abdulrahman Kanoo Dialysis Centre (AKDC) located in Muharraq. “AKDC is a government medical centre equipped with 48 beds that provides free services and treatment to all Bahraini citizens who require hemodialysis or peritoneal dialysis,” researchers added.
“A convenience sample of 174 participants was enrolled – the inclusion criteria were adults aged 18 or older, receiving at least three regular hemodialysis sessions, and able to understand the Arabic language.
“Patients with a history of cognitive impairment or a mental illness that may impact their ability to complete the questionnaires and comorbid obese patients were not included.
“The key principle was to exclude patients taking medications known to significantly affect sleep.”
Most of the surveyed sample (95.4 per cent) have three sessions of dialysis each week.
Of the sample, less than half (47.1pc) reported that they have six to seven hours of sleep during the night. Around 36.2pc reported waking up in the middle of the night or early morning once or twice per week.
Most reported disturbances in the quality of sleep in the form of having bad dreams over the past month (65.5pc) or having pain (73.5pc).
Approximately 88.5pc had trouble staying awake while driving, eating meals, or engaging in social activity. Only 9.8pc rated the quality of their sleep as very good.
In addition, 85.6pc stated suffering from episodes of disorientation or confusion during the past month.
“One of the major findings of this research project is the exceptionally high level of sleep disturbances in this population, with 91pc reporting poor sleep quality, indicating a significant clinical and public health concern,” researchers noted. “Further, a detailed analysis of patients’ hemodialysis sleep habits revealed that most participants are suffering from sleep disruptions.
“Over half of the patients used medications or painkillers to aid sleep, which reflects unrecognised psychological distress among these patients.
“This emphasises the need for routine mental health assessments in dialysis settings, a finding supported by previous studies which demonstrated that frailty, age and dialysis duration significantly influenced sleep outcomes.
“This highlights the importance of mental health integration into nephrology care in Bahrain.”
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