The Interplay of Anxiety, Depression, Sleep Quality, and Socioeconomic Factors in Somali Hemodialysis Patients

Abstract

Objective: This study aimed to assess anxiety, depression, and sleep quality in kidney failure patients receiving hemodialysis (HD) in Somalia and examine the relationship between anxiety, depression, and sleep quality. Methods: We conducted a study with 200 kidney failure patients on HD treatment for over 3 months. Participants completed sociodemographic questionnaires, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). Results: Among the 200 participants (mean age = 52.3; SD = 14.13), 58.5% were men, 64% had CKD for 1–5 years, and 52.6% received HD for 1–5 years. Depressive symptoms were found in 61.5% (PHQ-9) and 37.5% (HADS depression subscale) of HD patients. Poor sleep quality (PSQI) was observed in 31.5% and significantly correlated with PHQ-9 (rs = 0.633), HADS anxiety (rs = 0.491), and HADS depression (rs = 0.529). The ISI score correlated significantly with PHQ-9 (rs = 0.611), HADS anxiety (rs = 0.494), and HADS depression (rs = 0.586). All PSQI components correlated with depression and anxiety, except sleep medication use. Hierarchical regression analysis revealed that HADS anxiety (β = 0.342) and HADS depression (β = 0.372) predicted ISI scores. HADS anxiety (β = 0.307) and HADS depression (β = 0.419) predicted PSQI scores. Conclusions: Higher anxiety and depression levels negatively correlated with various dimensions of sleep quality in kidney failure patients. Early identification and appropriate management of these psychological disturbances are crucial for enhancing patients’ overall quality of life.