Insomnia Among Patients with End-Stage Kidney Disease on Hemodialysis: Prevalence and Associated Factors - A Cross-Sectional Study in Vietnam.

Background and aims: The prevalence of insomnia among patients with end-stage kidney disease undergoing hemodialysis is high. Insomnia in patients undergoing hemodialysis may reduce their quality of life. The purpose of this study was to estimate the prevalence of insomnia and to examine the risk factors associated with insomnia among patients with end-stage kidney disease undergoing hemodialysis.

Subject and methods: This cross-sectional study included 216 patients with end-stage kidney disease undergoing hemodialysis at 175 Military Hospital, Ho Chi Minh City, Vietnam. Psychiatrists evaluated insomnia using clinical criteria of The Diagnostic and Statistical Mental Disorders, 5th Edition (DSM5). Participants were recruited using convenience sampling at 175 Military Hospital in Vietnam, with all eligible patients invited. Descriptive statistics (counts, percentages, means, standard deviations) were used to describe population characteristics and insomnia prevalence. Data were collected on patients' sociodemographic factors such as sex, age, marital and economic status; clinical factors including duration of end-stage kidney diseases, duration of hemodialysis, number of hemodialysis sessions per week, co-morbidities (diabetes, hypertension…) and environmental factors (eg, excessive noisy or light bedrooms). Logistic regression analysis model was used to analyze the factors associated with insomnia disorders in patients with end-stage kidney disease undergoing hemodialysis.

Results: The prevalence of insomnia among patients with end-stage kidney disease was 48.1%. Multivariate logistic regression showed diabetes (OR=0.331 for no diabetes, 95% CI: 0.148-0.738, p<0.01), daytime napping (OR=2.122, 95% CI: 1.159-3.885, p=0.02, excessive noisy or light bedrooms (OR=0.251 for no exposure, 95% CI: 0.074-0.854, p=0.03) were significantly associated with insomnia.

Conclusion: The prevalence of insomnia in patients with end-stage kidney disease was high. These results may help clinicians in the dialysis department pay more attention to insomnia symptoms in patients with end-stage kidney disease on dialysis and consider collaboration with psychiatrists to explore treatment strategies is also recommended.