A systematic review and meta-analysis of sleep hygiene implementation and its effect on sleep quality and fatigue in patients undergoing hemodialysis
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Introduction: The prevalence of patients undergoing hemodialysis who experience sleep disturbances and fatigue is high. Pharmacologic management has consequences and adverse effects, therefore, integrative intervention is important to be investigated. Sleep hygiene is one such integrative intervention that improves comfort including enhancing sleep quality and reducing fatigue. However, none have synthesized the effect of sleep hygiene intervention, particularly in the hemodialysis setting. This systematic review aims to synthesize the effectiveness of sleep hygiene in improving sleep quality and fatigue in patients undergoing hemodialysis.
Methods: This is a systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies. Relevant studies were gathered by searching five databases from 2008-2023 using several keywords, such as sleep hygiene, sleep quality and fatigue. Quality assessment was conducted using relevant tools from the Joanna Briggs Institutes (JBI). Following that, synthesis of research findings was conducted using Review Manager version 5.4.
Results: Seven studies of 3,633 screened were included, with one high-quality study (88%) and six studies of moderate quality (61-76%). The review indicated a significant difference in sleep quality (MD = -2.36; 95% CI = -4.28, -0.44; p=0.016). However, there was no significant difference in fatigue (SMD = -0.08; 95% CI = -0.40, 0.24; p=0.61).
Conclusions: The evidence supports that sleep hygiene is effective in enhancing sleep quality. This systematic review contributes evidence to support the inclusion of sleep hygiene into holistic nursing to assist patients in improving sleep quality and reducing fatigue.
Al Naamani, Z., Gormley, K., Noble, H., Santin, O., & Al Maqbali, M. (2021). Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis. BMC Nephrology, 22(1), 157. doi:10.1186/s12882-021-02349-3
Asghar, M. S., Ahsan, M. N., Jawed, R., Rasheed, U., Ali Naqvi, S. A., Hassan, M., . . . Saleem, M. (2020). A Comparative Study on the Use of Alprazolam and Melatonin for Sleep Disturbances in Hemodialysis Patients. Cureus, 12(11), e11754. doi:10.7759/cureus.11754
Bean, H. R., Stafford, L., Little, R., Diggens, J., Ftanou, M., Alexander, M., . . . Wiley, J. F. (2020). Light-enhanced cognitive behavioural therapy for sleep and fatigue: study protocol for a randomised controlled trial during chemotherapy for breast cancer. Trials, 21(1), 295. doi:10.1186/s13063-020-4196-4
Chen, H. Y., Cheng, I. C., Pan, Y. J., Chiu, Y. L., Hsu, S. P., Pai, M. F., . . . Wu, K. D. (2011). Cognitive-behavioral therapy for sleep disturbance decreases inflammatory cytokines and oxidative stress in hemodialysis patients. Kidney International, 80(4), 415-422. doi:10.1038/ki.2011.151
Chen, H. Y., Chiang, C. K., Wang, H. H., Hung, K. Y., Lee, Y. J., Peng, Y. S., . . . Tsai, T. J. (2008). Cognitive-behavioral therapy for sleep disturbance in patients undergoing peritoneal dialysis: a pilot randomized controlled trial. American Journal of Kidney Disease, 52(2), 314-323. doi:10.1053/j.ajkd.2008.03.012
Chung, K. F., Lee, C. T., Yeung, W. F., Chan, M. S., Chung, E. W., & Lin, W. L. (2018). Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Family Practice, 35(4), 365-375. doi:10.1093/fampra/cmx122
Crombie, I. K., & Davies, H. T. (2009). What is meta-analysis? : Hayward Medical Communications.
Cukor, D., Unruh, M., McCurry, S. M., & Mehrotra, R. (2021). The challenge of insomnia for patients on haemodialysis. Nature Reviews Nephrology, 17(3), 147-148. doi:10.1038/s41581-021-00396-5
Ebrahimi, F., Saraei, S. S., & Navidian, A. (2023). The Effect of Sleep Hygiene Education on Sleep Quality, Depression, and Fatigue of Hemodialysis Patients. Medical Surgical Nursing Journal, 12(1). doi:https://doi.org/10.5812/msnj-138254
Elmetwaly, A. A., Badran, H., & Mahmoud, S. (2019). Sleep Hygiene: Improving Sleep Quality and Fatigue for Patients Receiving Chemotherapy. doi:10.12691/ajnr-7-x-x
Fatemeh, G., Sajjad, M., Niloufar, R., Neda, S., Leila, S., & Khadijeh, M. (2022). Effect of melatonin supplementation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Journal of Neurology, 269(1), 205-216. doi:10.1007/s00415-020-10381-w
Gregg, L. P., Bossola, M., Ostrosky-Frid, M., & Hedayati, S. S. (2021). Fatigue in CKD: Epidemiology, Pathophysiology, and Treatment. Clinical Journal of American Society of Nephrology, 16(9), 1445-1455. doi:10.2215/cjn.19891220
Haynes, J., Talbert, M., Fox, S., & Close, E. (2018). Cognitive Behavioral Therapy in the Treatment of Insomnia. Southern Medical Journal, 111(2), 75-80. doi:10.14423/smj.0000000000000769
Herscher, M., Mikhaylov, D., Barazani, S., Sastow, D., Yeo, I., Dunn, A. S., & Cho, H. J. (2021). A Sleep Hygiene Intervention to Improve Sleep Quality for Hospitalized Patients. Joint Commission Journal on Quality and Patient Safety, 47(6), 343-346. doi:10.1016/j.jcjq.2021.02.003
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (2023). Cochrane Handbook for Systematic Reviews of Interventions version 6.4: Cochrane
Hill, K., Neylon, K., Gunn, K., Sharplin, G., & Eckert, M. (2023). The Australian and New Zealand nephrology nursing workforce: clinical pressure and organisational culture. Contemporary Nurse, 59(1), 16-24. doi:10.1080/10376178.2023.2172442
Himmelfarb, J., Vanholder, R., Mehrotra, R., & Tonelli, M. (2020). The current and future landscape of dialysis. Nature Reviews Nephrology, 16(10), 573-585. doi:10.1038/s41581-020-0315-4
Hou, Y., Hu, P., Liang, Y., & Mo, Z. (2014). Effects of cognitive behavioral therapy on insomnia of maintenance hemodialysis patients. Cell Biochemistry and Biophysics, 69(3), 531-537. doi:10.1007/s12013-014-9828-4
Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23-36. doi:10.1016/j.smrv.2014.10.001
Jang, C. H., Kim, S. H., & Oh, D. H. (2013). Cognitive Behavioral Therapy of Insomnia. Hanyang Medical Reviews, 33(4), 210-215.
Kalantar-Zadeh, K., Jafar, T. H., Nitsch, D., Neuen, B. L., & Perkovic, V. (2021). Chronic kidney disease. Lancet, 398(10302), 786-802. doi:10.1016/s0140-6736(21)00519-5
Kovesdy, C. P. (2022). Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplement, 12(1), 7-11. doi:10.1016/j.kisu.2021.11.003
Li, H., Zuo, L., Long, S., & Li, B. (2021). Effects of nonpharmacological intervention on sleep quality in hemodialysis patients: A protocol for systematic review and meta-analysis. Medicine, 100(27), e26401. doi:10.1097/md.0000000000026401
Lv, J. C., & Zhang, L. X. (2019). Prevalence and Disease Burden of Chronic Kidney Disease. Advances in Experimental Medicine and Biology, 1165, 3-15. doi:10.1007/978-981-13-8871-2_1
Majlessi, A., Burton, J. O., & March, D. S. (2022). The effect of extended hemodialysis on nutritional parameters: a systematic review. J Nephrol, 35(8), 1985-1999. doi:10.1007/s40620-022-01395-w
Mariano, C. (2019). Holistic Nursing: Scope of Practice. In Holistic nursing: scope and standards of practice (3rd ed.). Maryland.
Morin, C. M. (2004). Cognitive-behavioral approaches to the treatment of insomnia. Journal of Clinical Psychiatry, 65 Suppl 16, 33-40.
Munn, Z., Barker, T. H., Moola, S., Tufanaru, C., Stern, C., McArthur, A., . . . Aromataris, E. (2020). Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evidence and Synthesize, 18(10), 2127-2133. doi:10.11124/jbisrir-d-19-00099
Muz, G., Erdoğan Yüce, G., Yıldırım, C., & Dağdelen, M. (2021). The effect of sleep hygiene training applied to hemodialysis patients on sleep quality and quality of life: randomized controlled trial. Sleep and Biological Rhythms, 19(3), 227-236. doi:10.1007/s41105-020-00293-7
Natale, J. J. (2018). Overview of the prevention and management of CINV. American Journal of Management and Care, 24(18 Suppl), S391-s397.
Nestoriuc, Y., Martin, A., & Rief, W. (2008). Combining effect sizes from controlled and uncontrolled study designs: benefit, bias, and control strategies. Retrieved from https://abstracts.cochrane.org/2008-freiburg/combining-effect-sizes-controlled-and-uncontrolled-study-designs-benefit-bias-and
Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 5(1), 210. doi:10.1186/s13643-016-0384-4
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., . . . Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. doi:10.1136/bmj.n71
Parker, L. A., Saez, N. G., Porta, M., Hernández-Aguado, I., & Lumbreras, B. (2013). The impact of including different study designs in meta-analyses of diagnostic accuracy studies. European Journal of Epidemiology, 28(9), 713-720. doi:10.1007/s10654-012-9756-9
Redeker, N. S., Yaggi, H. K., Jacoby, D., Hollenbeak, C. S., Breazeale, S., Conley, S., . . . Jeon, S. (2022). Cognitive behavioral therapy for insomnia has sustained effects on insomnia, fatigue, and function among people with chronic heart failure and insomnia: the HeartSleep Study. Sleep, 45(1). doi:10.1093/sleep/zsab252
Richardson, W. S., Wilson, M. C., Nishikawa, J., & Hayward, R. S. (1995). The well-built clinical question: a key to evidence-based decisions. American College of Physician Journal Club, 123(3), A12-13.
Saeedi, M., Shamsikhani, S., Varvani Farahani, P., & Haghverdi, F. (2014). Sleep hygiene training program for patients on hemodialysis. Iran Journal of Kidney Disease, 8(1), 65-69.
Shareh, H., Hasheminik, M., & Jamalinik, M. (2022). Cognitive behavioural group therapy for insomnia (CBGT-I) in patients undergoing haemodialysis: a randomized clinical trial. Behavioural and Cognitive Psychotherapy, 50(6), 559-574. doi:10.1017/s1352465822000364
Soleimani, F., Motaarefi, H., & Hasanpour-Dehkordi, A. (2016). Effect of Sleep Hygiene Education on Sleep Quality in Hemodialysis Patients. Journal of Clinical Diagnosis Research, 10(12), Lc01-lc04. doi:10.7860/jcdr/2016/19668.8941
Tan, L. H., Chen, P. S., Chiang, H. Y., King, E., Yeh, H. C., Hsiao, Y. L., . . . Kuo, C. C. (2022). Insomnia and Poor Sleep in CKD: A Systematic Review and Meta-analysis. Kidney Medicine, 4(5), 100458. doi:10.1016/j.xkme.2022.100458
Webber, S., & Prouse, C. (2018). The New Gold Standard: The Rise of Randomized Control Trials and Experimental Development. Economic Geography, 94(2), 166-187. doi:10.1080/00130095.2017.1392235
Zengin, L., & Aylaz, R. (2019). The effects of sleep hygiene education and reflexology on sleep quality and fatigue in patients receiving chemotherapy. European Journal of Cancer Care 28(3), e13020. doi:10.1111/ecc.13020
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