[Sleep disorders in hemodialysis patients]. / Poruchy spánku u hemodialyzovaných pacientu.

BACKGROUND: Many hemodialyzed patients complain about bad sleep. The aim of this study was to learn the subjective view of patients on their sleep and its influence by hemodialysis treatment. METHODS AND RESULTS: A simple questionnary containing 20 questions concerning sleep was prepared and given to regularly hemodialyzed patients in two hemodialysis centres. Uncorperating as well as severely ill patients were excluded. The questionnary was responded by 103 patients (mean age 60.4 years)--61 men (mean age 56.7 years) and 42 women (mean age 65.7 years). 34% of patient regard their sleep as bad. 45.6% of dialyzed patients feel restlessness of legs during the night and 32% snore or have some breath problems. 38% of patients considered their sleep as better before starting the hemodialysis treatment, in 14.6% the sleep became better after starting the dialysis treatment. CONCLUSIONS: Sleep disorders in hemodialysed patients worsen the quality of life of these patients. Moreover, sleep disorders represent a serious problem as they can increase the mortality.

[Evaluation of stress in dialyzed patients]. / Hodnocení stresu u dialyzovaných pacientu.

BACKGROUND: Patients with chronic renal failure treated with hemodialysis are subjected to a high degree of stress. The aim of the study was to determine which components of stress become the most critical for the dialysed persons and how the degree of subjective stress depends on sex, age, and continuance of dialysis. METHODS AND RESULTS: 66 patients (40 females and 26 males) with chronic renal failure regularly treated with hemodialysis were included into the studied group. Average age was 57 years (26 to 75 years). Serial hemodialysis program lasted in average 51 months (4 to 144 months). Patients filled in the Scale of Hemodialysing Stressors, which contained 31 items, 6 of them physiological and 25 psychosocial. Each stressor was ranked in four-point Likert's scale. Results were given in average values with standard deviation. To compare differences in subgroups, non-paired t-test was employed. Results showed that among the most serious stressors belongs the limitation of physical activity (average 1.91), limited possibilities for recreation (average 1.76), loss of body functions (average 1.68), fatigue (average 1.67), restriction of drinking (average 1.61). Average stress score for the whole scale was 32 +/- 11 with theoretically highest value of 93. Global stress score did not differ in males and females, in elderly patients (over 50 years) it was statistically higher than in younger ones (p < 0.05) and in patients treated over one year it was higher than in those cured less long (p < 0.05). CONCLUSIONS: Dialysed patients are stressed namely by psychosocial factors. Most influenced are the older and for longer time dialysed patients. The short and long-lasting dialysis brings about similar level of stress. Stress can reach the highest level during the last year of the patient's life.

[Sleep disorders in patients treated with continuous ambulatory peritoneal dialysis]. / Poruchy spánku u pacientu lécených kontinuální ambulantní peritoneální dialýzou (CAPD).

BACKGROUND: A lot of patients with end stage renal disease with the necessity of renal replacement therapy have some sleep problems. The aim of this study was to get basic information about the sleep of patients treated with continuous ambulatory peritoneal dialysis (CAPD), mainly their subjective view on their sleep, including comparison with hemodialyzed patients (HD). METHODS: All patients treated with continuous ambulatory peritoneal dialysis in two dialysis centres were given a simple questionnary containing 20 questions concerning sleep. It was filled in by all these patients--25 patients (mean age 58.1 years)--12 men and 13 women. Data obtained from 103 hemodialyzed patients from the same two-dialysis centres were used for comparison (mean age 60.4 years)--61 men and 42 women (the same questionnary). RESULTS: 40% of CAPD patients regard their sleep as bad. Thirty six percent of patients have problems with falling asleep, 32% awake three times or more during the night and 28% snore or have some breath problems. CAPD patients feel more frequently tired after the night (32% vs. 18.4% HD), more patients sleep during the day (64% vs. 5.15% HD) and fewer patients feel restlessness of legs (36% vs. 45.6% HD). These differences are not statistically significant. CONCLUSION: Occurrence of sleep disorders and their characteristics in patients on CAPD is similar to that in hemodialyzed patients.