Depression, insomnia and sleep apnea in patients on maintenance hemodialysis

Abstract

Depression and sleep disorders are more frequent in patients on maintenance hemodialysis (HD) than the general population, and are associated with reduced quality of life and increased mortality risk. The purpose of this study was to assess the prevalence of depression, sleep apnea, insomnia in patients on HD as well as depression in their primary caregiver and to correlate these with the demographic profile. A cross-sectional study was conducted among 69 patients on maintenance HD for more than 3 months. There was high p revalence of depression (47.8%), insomnia (60.9%), increased risk of sleep apnea (24.6%) and depression in caregiver (31.9%). Depression was significantly more in patients with low monthly income (P=0.03), those on dialysis for more than 1 year (P=0.001) and the unemployed (P=0.009). High-risk patients for sleep apnea tended to be males with low monthly income (P=0.02). Insomnia was significantly higher in patients who were on dialysis for more than 1 year (P=0.003).

Sleep Parameters in Short Daily versus Conventional Dialysis: An Actigraphic Study

“…To the best of our knowledge, there are no available comparative studies employing objective parameters to assess sleep in patients with this profile. To date, studies have employed qualitative, nonparametric measures or overnight polysomnography [ 8 , 9 , 12 ].…”

Depression among patients undergoing maintenance hemodialysis at a tertiary care center in Kathmandu, Nepal

“…The rates of depression in dialyzed patients was 47.8%, 46.6%, 50%, and 46% in Delhi, Lucknow, Lebanon, and Brazil respectively. 8,9,10,11 The rates of depression was higher in South India, Pakistan, and Egypt, at 83.5%, 83.1%, and 76% respectively. [12][13][14] In a nation-wide USA study, Choices for Healthy Outcomes in Caring for ESRD (CHOICE) for screening depressive symptoms (CHOICE study), the prevalence of depression at baseline was 24%.…”

“…11 The mean BDI score for the males (19.56±10.50) was not significantly different than those of the females (18.66±9.87) and similarly the depression rates were also not different than in other studies from South Asia and other countries. [7][8][9][10][11][12][13][14][15][16] Even though, the rates of depressions seemed to be higher among the single patients than those who were married, the differences were not statistically significant. Likewise, the differences in BDI scores were not significantly different in the groups.…”

“…6 With the reported rate of depression around 50% among the HD patients from India, the Cochran's formula was used to calculate sample size of 384. 8,9 As the total number of patients undergoing HD for end stage renal failure was 57, using the formula for the finite population correction, the final sample size was 50.…”

“…7 The prevalence of depression ranged from 46.6% to 83.5% from studies done in India and 83.1% from Pakistan. 8,9,12 Data is scarce locally. Aim of this study is to analyse the prevalence of depression among the patients undergoing HD at a tertiary care center in Kathmandu, Nepal.…”