Depression, sleep disturbance, and quality of life in patients undergoing dialysis therapy

Abstract

Aims: To examine the association between depression, excessive daytime sleepiness (EDS), and quality of life (QOL) in patients undergoing dialysis.

Background: Sleep disturbance and depression are highly prevalent symptoms in patients on dialysis and are associated with poor clinical outcomes. Nevertheless, the complex association between EDS and depression in patients on dialysis and the determination of which of the two has a greater impact on QOL are not well documented.

Methods: This study used a correlational cross-sectional design. A convenience sample of 180 patients on dialysis was surveyed using the Beck Depression Inventory-II (BDI-II), Epworth Sleepiness Scale (ESS), and the short version of the Kidney Disease Quality of Life. Multiple regression analyses were performed to assess the predictors of QOL.

Results: The overall mean total QOL score was 52.13 ± 19.22. The mean scores of depression and EDS were 16.36 ± 9.95 and 7.544 ± 531, respectively. Considering cut-off scores of ≥11 for BDI-II and ≥10 for ESS, 5.6 % of the participants had depression and 32.2 % had EDS. Depression was independently associated with a lower QOL score (r = -0.57, p < 0.001). The model showed a 38 % variation in the total QOL score.

Conclusions: Depression and EDS were high among patients on dialysis, and depression was the main predictor of QOL. Screening for these unpleasant symptoms using brief and proven methods should be included in the standard clinical practice.

Keywords: Depression; Excessive daytime sleepiness; Kidney disease quality of life; Predictors; dialysis.