Sleep Problems in Patients on Peritoneal Dialysis: Prevalence, Effects on Daily Life and Evaluation of Non-Pharmacological Interventions

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Sleep Problems in Patients on Peritoneal Dialysis : Prevalence, Effects on Daily Life and Evaluation of Non-Pharmacological Interventions

Yngman-Uhlin, Pia, 1964- (author): Östergötlands Läns Landsting,Linköpings universitet,Omvårdnad,Hälsouniversitetet,Njurmedicinska kliniken US

Edéll-Gustafsson, Ulla, Dr. (thesis advisor): Linköpings universitet,Omvårdnad,Hälsouniversitetet

Fernström, Anders, Professor (thesis advisor): Östergötlands Läns Landsting,Linköpings universitet,Institutionen för medicin och hälsa,Hälsouniversitetet,Neurofysiologiska kliniken US

Börjeson, Sussanne, Dr. (thesis advisor): Östergötlands Läns Landsting,Linköpings universitet,Omvårdnad,Hälsouniversitetet,Onkologiska kliniken US

Heimbürger, Olof, Professor (opponent): Karolinska Universitetssjukhuset, Stockholm

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(creator_code:org_t)

ISBN 9789173932073
Linköping : Linköping University Electronic Press, 2011
English 103 s.
Series: Linköping University Medical Dissertations, 0345-0082 ; 1233

Related links:: https://liu.diva-por... (primary) (Raw object); show more...; https://liu.diva-por...; https://urn.kb.se/re...; show less...

Doctoral thesis (other academic/artistic)

Abstract Subject headings

Sleep problems affect a considerable number (49-86%) of patients undergoing peritoneal dialysis (PD) treatment. Insomnia i.e. difficulties to initiate and/or maintain sleep or too early wakening, combined with daytime symptoms, seems to be the dominating problem. Despite these facts there is a lack of research in PD-patients, especially studies with objective data on the sleep-wake cycle and evaluation of sleep promoting non-pharmacological interventions.The overall aim of this thesis was to describe sleep problems from different perspectives, and how these problems affect daily life and health in patients treated with PD at home. The aim was also to evaluate an individualised non-pharmacological intervention for improvement of sleep quality outcomes.Four studies were conducted during eight years, starting in 2002. Patients from six hospitals in the south-east of Sweden were invited to participate. In addition, data from a reference group with Coronary Artery Disease and a population group were used for comparisons with PD-patients in one of the studies. Data was collected by self-reported questionnaires, actigraphy registrations and interviews. Sleep was evaluated in a 17-week single-case study with an intervention focusing on sleep hygiene advice.Data from a total of 700 sleep-wake cycles was collected in the patients’ homes. The main findings clearly demonstrated that PD-patients have seriously fragmented sleep compared to the CAD- and population group, and that the PD-patients have a high prevalence of insomnia. The sleep was mainly disturbed by pruritus and Restless Legs Syndrome (RLS). Daytime impairments and a frequent napping behaviour were detected. The prevalence of fatigue was also reported to be extremely high. The patients described that an ever-present tiredness and poor sleep had consequences in their everyday life both physically, mentally, socially and existentially. The nurse-led intervention demonstrated that individual, non-pharmacological sleep interventions can improve sleep and daytime activities in PD-patients.This thesis elucidates that deteriorated sleep with serious fragmentation leads to a variety of daytime impairments and fatigue. By adopting “renal supportive care” in clinical work a more elaborate assessment and individualised non-pharmacological treatment of sleep problems may improve sleep quality and activity in frail patients undergoing peritoneal dialysis at home.

Keyword

Fatigue
insomnia
peritoneal dialysis
renal supportive care
sleep
self-care management
sleep hygiene
MEDICINE
MEDICIN

Publication and Content Type

vet (subject category)
dok (subject category)

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