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Association between muscular strength and sleep quality in older adults undergoing hemodialysis: a cross-sectional study

  • Nephrology – Original Paper
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Abstract

Purpose

Older adults undergoing hemodialysis experience improved survival rates but often suffer from sleep disorders, resulting in adverse health outcomes. This study aims to assess the association between handgrip strength (HGS), a key indicator of muscular strength, and sleep quality in older adults undergoing hemodialysis.

Methods

This cross-sectional and analytical study assessed 150 older adults undergoing hemodialysis selected by simple randomization. Data on demographics, clinical parameters, HGS, and sleep quality (PSQI) were collected and analyzed using descriptive and inferential statistics with SPSS version 20.

Results

The mean age of the participants was 65.61 ± 4.07 years. Mean mid-upper arm circumference (MUAC) and calf circumference (CC) were 29.59 cm and 36.96 cm, respectively. The mean HGS was 28.7 ± 8.55 kg, with males exhibiting higher HGS (37.72 ± 6.17 kg) than females (23.55 ± 5.38 kg). The mean PSQI score was 6.71, with 54.1% reporting poor sleep quality. Sleep quality was significantly associated with income source, underlying diseases, Charlson Comorbidity Index (CCI), BMI, MUAC, CC, HGS, and blood levels of potassium and creatinine. A moderate negative correlation (r = − 0.438, p < 0.001) was observed between HGS and PSQI scores, indicating better sleep quality with greater muscular strength. Elevated potassium levels increase the risk of poor sleep.

Conclusions

Older adults undergoing hemodialysis frequently experience poor sleep quality, which is associated with lower muscular strength. These findings highlight the importance of implementing targeted interventions, such as strength-training programs, to improve muscular strength and, consequently, sleep quality in this vulnerable population.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

HGS:

Handgrip strength

AMT:

Abbreviated mental test

MUAC:

Mid-upper arm circumference

CC:

Calf circumference

BMI:

Body mass index

CCI:

Charlson comorbidity index

PSQI:

Pittsburgh sleep quality index

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Acknowledgements

This paper was extracted from an M.A. thesis on geriatric nursing with the IR.GUMS.REC.1401.169 ethics code. The researcher would like to thank the Research and Technology Deputy of Guilan University of Medical Sciences for approving this study, all the older adult participants, and the hospital hemodialysis personnel.

Funding

No funding was received for this work.

Author information

Authors and Affiliations

  1. Department of Nursing, Zeynab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

    Marzieh Alsadat Abforoushha, Roya Mansour-ghanaei & Azar Darvishpour

  2. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran

    Roya Mansour-ghanaei

  3. Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran

    Saman Maroufizadeh

Authors
  1. Marzieh Alsadat Abforoushha
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  2. Roya Mansour-ghanaei
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  3. Azar Darvishpour
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  4. Saman Maroufizadeh
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Contributions

All the authors contributed to the study conception and design. MA carried out the data collection. Data analysis was performed by RMG, SM and MA. The first draft of the manuscript was written by MA, RMG, and AD. All the authors edited, read, and approved the final manuscript.

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Correspondence to Roya Mansour-ghanaei.

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Abforoushha, M.A., Mansour-ghanaei, R., Darvishpour, A. et al. Association between muscular strength and sleep quality in older adults undergoing hemodialysis: a cross-sectional study. Int Urol Nephrol 57, 3341–3350 (2025). https://doi.org/10.1007/s11255-025-04509-y

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