Prevalence and Associated Factors of Insomnia in Patients Undergoing Hemodialysis in Sulaymaniyah City/Iraq

ABSTRACT:Background: Insomnia is a common sleep disturbance among patients undergoing hemodialysis, negatively impacting their quality of life and health outcomes. Understanding its prevalence and associated factors is essential for improving care in this vulnerable population.Objectives: This study aimed to assess the prevalence and associated factors of insomnia in patients receiving hemodialysis in Sulaymaniyah City, Iraq.Methods: A cross-sectional study was conducted from December 1, 2024, to February 1, 2025, at two hemodialysis centers in Sulaymaniyah City (Shar Hospital and Qrga Hemodialysis Center). A total of 133 patients aged 20 years with end-stage renal disease undergoing regular hemodialysis were included. Data were collected through face-to-face interviews using the Athens Insomnia Scale (AIS) and a structured questionnaire covering demographic and clinical characteristics.Results: Of the 133 hemodialysis patients enrolled, 66.2% (n = 88) reported insomnia. Multivariate logistic regression identified three factors independently associated with insomnia: poor economic status (AOR = 1.978; 95% CI: 1.0203.838; p = 0.044), pruritus (AOR = 0.300; 95% CI: 0.1130.795; p = 0.015), and dyspnea (AOR = 0.252; 95% CI: 0.0830.765; p = 0.017). Other variables such as occupation, anemia, fatigue, and sleep medication use were significant in bivariate analysis but not in the multivariate model.Conclusion: Insomnia is highly prevalent among hemodialysis patients and is significantly associated with poor economic status, pruritus, and dyspnea. These findings highlight the need for targeted screening and management strategies to address insomnia in this population.