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J Educ Health Promot. 2019 Mar 14;8:56. doi: 10.4103/jehp.jehp_205_18. eCollection 2019.

The effects of cool dialysate on quality of sleep among patients undergoing hemodialysis: A randomized clinical trial.

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Department of Nursing, Nursing Student of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Nephrology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Statistics, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Nursing, School of Nursing and Midwifery, Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.



Low quality of sleep is a common problem among hemodialysis patients. This study was conducted to evaluate the effect of a cold dialysis solution on the quality of sleep in patients undergoing hemodialysis.


This double-blind clinical trial was performed on 26 hemodialysis patients with chronic renal failure and sleep disorders in the dialysis center of Sabzevar, Iran, in 2016-2017. Of the 26 patients, 13 each were allocated to the intervention and control groups. The patients in both groups received 4 weeks of hemodialysis (3 sessions per week) using a standard solution with a temperature of 37°C. In the next stage, the control group continued to receive the standard-temperature dialysis, while the intervention group received dialysis using a solution with a temperature of 35.5°C for 4 weeks (3 sessions per week). The Pittsburgh Sleep Quality Index was used to assess and compare the quality of sleep before and after the intervention in the two groups. Data were analyzed using R 1.2.3 software, at 95% confidence level.


Although the mean scores of sleep quality were not significantly different between the intervention (9.53 ± 3.12) and control (11.23 ± 3.37) groups at baseline, postintervention, significant differences were observed (intervention group: 4.7 ± 4.55; control group: 10.61 ± 2.69; P < 0.001).


This study showed that dialysis with cold solution is a simple, cost-effective, and nonpharmacological method that can be used to improve sleep quality in patients undergoing hemodialysis.


Chronic renal failure; dialysis solution; hemodialysis; sleep quality

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