Mehmet ÇÖLBAY, Şeref YÜKSEL, Gürsel ACARTÜRK, İhsan USLAN, Özcan KARAMAN

Huzursuz bacak sendromlu hemodiyaliz hastalarında uyku kalitesi

Amaç: Günümüzde hemodiyaliz (HD) hastalarının hayat kalitesini düşüren uyku bozuklukları üzerinde durulmaya başlanmıştır. Uyuyamama, bacakların huzursuz oluşu (HBS) ve sık uyanma gibi uyku bozuklukları uyku kalitesini azaltarak hastanın performansını etkilemektedir. Uyku kalitesini belirlemede Pittsburgh uyku kalite indeksi (PUKİ) birçok hasta grubunda kullanılmaktadır. Çalışmamızda HD hastalarında görülen HBS’nin uyku kalitesi üzerine etkilerini PUKİ ile değerlendirmeyi amaçladık. Yöntem: Hemodiyaliz tedavisi gören 95 hastanın sosyodemografik özellikleri, son ay bakılan hemogram ve biyokimya, metabolik ve hormonal durumları, diyaliz yeterlilik ve vücut kitle indeksleri kaydedildi. Huzursuz bacak sendromunu tespit etmek için Uluslar arası HBS Çalışma Grubu’nun minimal tanı kriterleri, son bir aylık uyku kalitesini belirlemek için PUKİ kullanıldı. Bulgular: Hastaların (45 kadın, 50 erkek) yaş ortalaması 49.5±16.7 yıl, ortalama beden kitle indeksleri 22.4±3.1 kg/m2 ve HD süresi 3.7±3.5 yıldı. Huzursuz bacak sendromu olan hastalarda olmayanlara göre uyku latensi yüksek ve uyku daha bozuk, global skor yüksek bulundu. Hastalarda öznel uyku kalitesi, uyku süresi, alışılmış uyku etkinliği, gündüz işlev bozukluğu, uyku ilacı kullanma açısından HBS olup olmamasına göre anlamlı farklılık saptanmadı. Huzursuz bacak sendromu olanların uyku kalitesi olmayanlara göre anlamlı düzeyde kötü saptandı. Sonuç: Hemodiyaliz hastalarında uyku kalitesinin yüksek oranda bozulduğu bulunmuştur. Eşlik eden HBS uyku kalitesini daha da kötüleştirmektedir. Bu nedenle hemodiyaliz hastalarında HBS sorgulaması ve tedavi gayretleri alışılagelen bir uygulama haline gelmelidir.

Sleep quality in hemodialysis patients with restless leg syndrome

Objective: Nowadays sleep disorders that decrease quality of life are investigated in hemodialysis (HD) patients. Sleep disorders such as insomnia, restless leg (RLS), and frequent awakening decrease sleep quality and affect performance status. To determine sleep quality Pittsburgh sleep quality index (PSQI) is used in many disorders. So we aimed to determine RLS effects on sleep quality in HD patients. Methods: Characteristics of patients, recent data about laboratory findings, metabolic and hormonal status, adequacy of dialysis, and body mass index of all 95 HD patients were recorded. Diagnosis of RLS was made based on criteria of the International RLS Study Group. Sleep quality at last month was determined with PSQI. Results: The mean ages were 49.5±16.7 years (45 female, 50 male), the mean body mass index was 22.4±3.1 kg/m2, and average time on dialysis was 3.7±3.5 years. In RLS patients sleep latency was significantly high, sleep disturbance was increased, global score was increased. There was no significant difference in subjective sleep quality, duration, efficiency, use of sleep medication, and daytime dysfunction between two groups. Sleep quality significantly reduced in patients with RLS. Conclusion: It was found out that sleep quality was deteriorated with high rate in hemodialysis patients. Accompanied RLS worsens the sleep quality. So that investigation of RLS and its treatment should be routine application in hemodialysis patients.

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