| Objective:To investigate the status of sleep and cognitive function in maintenance hemodialysis patients(MHD),explore the influencing factors of sleep and cognitive function,analyze the correlation of sleep disorder and cognitive dysfunction in this population.Methods:In this cross-sectional observational study,a total of 200 patients with MHD were selected from a Top-grade Hospital in Changsha between April 2017 and September 2017.Pittsburgh sleep quality index(PSQI)and Montreal Cognitive Assessment(MoCA)were used to assess sleep status and cognitive function.Socio-demographic information,disease history and dialysis related information were collected by a self-designed questionnaire.The main statistical methods were chi-square test,spearman correlation analysis,and logistic regression analysis.All the data were analyzed using SPSS22.0 statistical package.Results:(1)The highest score of PSQI in MHD patients was 19 points,the lowest was 3 points,and the mean score was(9.88±3.68)points.PSQI scores were higher than 7 points in 138 patients.The score ratio in each dimension of PSQI ranged.from high to low was daytime dysfunction(61%),delayed sleep(59%),sleep duration(50%),subjective sleep quality(49%),sleep efficiency(49%),sleep obstacles(49%),hypnotics(11%).The highest score of MoCA in MHD patients was 29 points,the lowest was 9 points,and the mean score was(21.781±4.91)points.The MoCA score was lower than 26 points in 131 cases.The score ratio in each dimension of MoCA ranged from high to low was delayed recall(48%),abstract(49%),visual function and executive function(61%),naming(72%),attention and calculation(79%),language(82.7%),and orientation(99%).(2)Univariate analysis showed that age(X2=7.539,P=0.006),work status(X2=5.138,P=0.023),medical payment methods(X2=6.281,P=0.043),and physical exercise(X2=6.285,P=0.012)were influencing factors for sleep disorders(P<0.05).Multivariate logistic regression model showed that age,medical payment,and physical exercise were independent influencing factors of sleep disorders.(3)Univariate analysis showed that age(X2=15.621,P=0.000),education level(X2=36.817,P=0.000),personal income(X2=6.907,P=0.032),physical exercise(X2=7.903,P=-0.005),dialysis treatment time(X2=9.773,P=0.002),and sleep quality(X2=14.614,P=0.000)were factors influencing cognitive dysfunction(P<0.05).Multivariate Logistic regression analysis showed that age,education level,dialysis treatment time,and sleep quality were independent factors of cognitive function.The value of OR were 2.98,0.13,1.97,3.64.(4)The results showed that PSQI total score,subjective sleep quality,sleep duration and sleep efficiency were negatively correlated with MoCA total score(r=-0.204?-0.213?-0.172?-0.165,P<0.05),visual space and executive ability(r=-0.264?-0.310?-0.193?-0.233,P<0.05),and delayed recall(r=-0.242?-0.243?-0.252?-0.205,P<0.05)respectively.Sleep disturbance was negatively correlated with MoCA scores,visual space and performance,naming,attention and calculation,language,ion,and orientation(t=-0.308?-0.215?-0.257?-0.250?-0.299?-0.295?-0.154,P<0.05).Conclusions:(1)Sleep quality in maintenance hemodialysis patients was poor.Age,medical payment methods and physical exercise were independent influencing factors of sleep quality.(2)Patients with maintenance hemodialysis had poor cognitive function.Age,education level,dialysis treatment time,and sleep quality were independent influencing factors of cognitive function.(3)For patients with maintenance hemodialysis,the poorer the quality of sleep,the worse the cognitive function. |
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