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Effects of mindfulness meditation combined with progressive muscle relaxation on sleep disorders, anxiety, and depression in patients with sarcopenia undergoing hemodialysis.

Yongyao Wu, Haojie Zhang, Lei Jiang, Zhiping Liu, Xinfei Li, Bei Guo, Junyuan Li, Pengjie Xu, Jiang Liu, Rizhen Yu

Frontiers in psychiatry January 1, 2025 DOI: 10.3389/fpsyt.2025.1542028

Summary

Patients undergoing hemodialysis often struggle with sleep and mood. A promising approach explored whether combining mindfulness meditation with progressive muscle relaxation could aid those with uremic sarcopenia and sleep disorders. Individuals on hemodialysis were split: one group received standard care, the other added daily home-based mindfulness and relaxation for 12 weeks. This beneficial intervention significantly improved sleep quality, reduced anxiety and depression, and boosted overall well-being, offering a simple, effective solution.

Abstract

Long-term physiological, psychological, economic, and lifestyle pressures make maintenance hemodialysis (MHD) patients prone to anxiety and depression. This study aims to evaluate the effects of mindfulness meditation combined with progressive muscle relaxation on sleep and emotional disorders in hemodialysis patients with sarcopenia. Patients with uremic sarcopenia and sleep issues were randomly divided into a control group (n=24) and an intervention group (n=25), with an average age of 45.4 ± 4.77 years and an average dialysis duration of 56.86 ± 17.48 months. The control group received standard treatment (hemodialysis three times per week, medication, health education, dietary guidance, and exercise recommendations), while the intervention group additionally underwent home-based mindfulness and relaxation training for at least 0.5 hours daily over 12 weeks. Sleep quality, emotional states, and quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and 36-Item Short Form Health Survey (SF-36). Data analysis included descriptive statistics, t-tests, analysis of covariance, Mann-Whitney U tests, and chi-square tests. Before the intervention, there were no significant differences between the two groups in sleep, anxiety, depression, or quality of life (P>0.05). After the intervention, the intervention group showed significant improvements in all PSQI dimensions (e.g., sleep medication use, sleep quality, and sleep duration) (P<0.01), significant reductions in SAS and SDS scores (P<0.05), and significantly higher SF-36 scores compared to the control group (P<0.05). Mindfulness and muscle relaxation training can alleviate psychological stress, reduce skeletal muscle tension, promote muscle anabolism, and significantly improve sleep quality, anxiety, and depression in hemodialysis patients with sarcopenia. This approach is simple, unrestricted, and widely applicable, making it worthy of clinical promotion. The study had a small sample size and a short follow-up period. https://register.clinicaltrials.gov/, identifier NCT06261372.

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