title: Sleep complaints, depression and quality of life in Norwegian dialysis patients.
abstract: BACKGROUND
  This study explores sleep problems in dialysis patients and the associations to health-related quality of life (HRQoL) and depression. A comparison between different validated sleep questionnaires was done in order to find an appropriate diagnostic tool in clinical practice.
  
  
  METHODS
  In a cross-sectional study of 301 prevalent dialysis patients, sleep problems were elaborated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Poor sleep was defined as PSQI score > 5 and daytime sleepiness as ESS > 10. HRQoL, including quality of sleep, was evaluated with the Kidney Disease and Quality of Life - Short Form (KDQoL-SF), and physical (PCS) and mental component summary scores (MCS) were computed. Depression was assessed with Beck Depression Inventory (BDI).
  
  
  RESULTS
  Poor sleep and excessive daytime sleepiness was found in 74.3% and 22.2%, respectively. Depression was common (29.5%) and associated with reduced sleep quality (ρ = 0.49, p < 0.001). Poor sleepers had significantly lower MCS (51.8 ± 9.6 vs. 46.6 ± 10.6, p = 0.001) and PCS (41.8 ± 9.6 vs. 35.2 ± 10.0, p < 0.001) compared to good sleepers. PSQI scores were independently associated with PCS (p = 0.001), but not MCS (p = 0.468) in multivariate analyses. The sleep subscale from KDQoL-SF was strongly correlated to PSQI (r = -0.75, p < 0.001).
  
  
  CONCLUSIONS
  As sleep complaints, daytime sleepiness and depression were prevalent, all dialysis patients should routinely be screened for self-perceived sleep problems with a simple Questionnaire.
authors.affiliation: Faculty of Medicine, University of Oslo, Oslo, Norway. f.b.brekke@medisin.uio.no
authors.forename: Fredrik Barth
authors.initials: FB
authors.lastname: Brekke
authors.forename: Amin
authors.initials: A
authors.lastname: Amro
authors.forename: Tone Brit
authors.initials: TB
authors.lastname: Hortemo Østhus
authors.forename: Toril
authors.initials: T
authors.lastname: Dammen
authors.forename: Bård
authors.initials: B
authors.lastname: Waldum
authors.forename: Ingrid
authors.initials: I
authors.lastname: Os
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D012893:Sleep Wake Disorders / Q000209:etiology*