Having insomnia was significantly associated with greater difficulty in psychosocial adjustment across multiple domains including vocational environment, domestic environment, sexual relationships, extended family relationships, social environment, and psychological distress in dialysis patients.
Key Findings
Results
Insomnia was significantly associated with greater difficulty in adjustment to the vocational environment among dialysis patients.
Sample size of 402 patients on dialysis participated in the study.
Sleep quality was evaluated via the Athens Insomnia Scale (AIS).
Psychosocial adjustment was measured via the Psychosocial Adjustment to Illness Scale (PAIS-SR).
The association with vocational environment adjustment difficulty reached statistical significance at p = 0.008.
Mann-Whitney test was used to compare PAIS scale scores between patients with and without insomnia.
Results
Insomnia was significantly associated with greater difficulty in adjustment to the domestic environment in dialysis patients.
The association with domestic environment adjustment difficulty was statistically significant at p < 0.001.
Multiple linear regression analysis was used with the PAIS scale as the dependent variable.
Adjusted regression coefficients (β) with standard errors (SE) were computed from linear regression analyses.
Log transformations of the dependent variables were utilized in the multiple linear regression analysis.
Results
Insomnia was significantly associated with greater difficulty in sexual relationships among dialysis patients.
The association with sexual relationship adjustment difficulty was statistically significant at p < 0.001.
402 dialysis patients were included in the study.
Both the Athens Insomnia Scale and PAIS-SR were administered to evaluate sleep quality and psychosocial adjustment respectively.
Results
Insomnia was significantly associated with greater difficulty in extended family relationships among dialysis patients.
The association with extended family relationship adjustment difficulty was statistically significant at p < 0.001.
The PAIS-SR instrument was used to assess psychosocial adjustment across multiple domains.
The Mann-Whitney test was utilized to compare PAIS scale scores between insomnia and non-insomnia groups.
Results
Insomnia was significantly associated with greater difficulty in social environment adjustment among dialysis patients.
The association with social environment adjustment difficulty was statistically significant at p < 0.001.
The study notes that a large proportion of dialysis patients have sleep disorders.
Psychosocial adjustment is described as reduced in dialysis patients due to severe changes in daily life imposed by dialysis therapy.
Results
Insomnia was significantly associated with greater psychological distress in dialysis patients.
The association with psychological distress was statistically significant at p < 0.001.
Psychological distress was one of six PAIS-SR domains showing significant association with insomnia.
All five of the most strongly significant associations (domestic environment, sexual relationship, extended family relationships, social environment, and psychological distress) reached p < 0.001.
Conclusions
The authors recommend individualized sleep management programs and routine screening for sleep disorders as part of regular care for dialysis patients.
Recommended interventions include cognitive-behavioral therapy for insomnia, sleep hygiene education, and relaxation techniques.
The authors state these interventions 'could help dialysis patients achieve better sleep quality and improve their psychosocial adjustment.'
Routine screening for sleep disorders is recommended as part of regular care provided to dialysis patients.
The findings are described as highlighting 'the vital role of sleep quality in dialysis patients' psychosocial adjustment.'
What This Means
This research suggests that poor sleep quality—specifically insomnia—is strongly linked to worse psychosocial functioning across multiple areas of life in people undergoing dialysis treatment. In a study of 402 dialysis patients, those who had insomnia (identified using a standardized sleep scale) had significantly more difficulty adjusting to their work environment, home life, sexual relationships, family relationships, social life, and experienced greater psychological distress compared to dialysis patients without insomnia. All but one of these associations were highly statistically significant (p < 0.001).
Dialysis is a demanding treatment that already places major burdens on patients' daily lives, and this study suggests that sleep problems compound these challenges by making it harder for patients to function and adapt socially and psychologically. The findings highlight that sleep quality is not just a physical health issue but is deeply connected to how well patients can manage relationships, work, and emotional wellbeing.
This research suggests that healthcare providers treating dialysis patients should routinely screen for sleep disorders as part of standard care, rather than treating sleep problems as a secondary concern. Interventions such as cognitive-behavioral therapy for insomnia, sleep hygiene education, and relaxation techniques may offer benefits not only for sleep itself but also for the broader psychosocial wellbeing of dialysis patients.
Zorba E, Fasoi G, Grapsa E, Pisimisi E, Zyga S, Zartaloudi A, et al.. (2026). Association of Sleep Quality and Psychosocial Adjustment in Dialysis Patients.. Advances in experimental medicine and biology. https://doi.org/10.1007/978-3-032-03402-1_23