Cognitive-Behavioral Therapy for Sleep Disturbance in Patients Undergoing Peritoneal Dialysis: A Pilot Randomized Controlled Trial

Chen, Hung‐Yuan; Chiang, Chih‐Kang; Wang, Hsi-Hao; Hung, Kuan‐Yu; Lee, Yue-Joe; Peng, Yu‐Sen; Wu, Mai‐Szu; Tsai, Tun‐Jun

doi:10.1053/j.ajkd.2008.03.012

Cited by 87 publications

(76 citation statements)

References 29 publications

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“…20 These sleep related behaviors are specifically targeted when using CBTi and the current results, along with previous studies investigating cognitive behavioral therapy for insomnia among dialysis patients, suggest that such treatment may be a viable treatment option for both dialysis and transplant patients. 21,41 However, it is also important to note that within the current study there were group-specific differences in the impact of quality of life, and sex.…”

Section: Implications For Clinical Practicementioning

confidence: 71%

“…7 Precipitating circumstances co-occur with the onset of acute insomnia and might include stressful personal events or rapid shifts in health which are likely related to increased fatigue, changes in mood resulting in emotional arousal, and decreased quality of life. 20,21 Fatigue, common among ESRD patients, often accompanies a reduction of daytime activity and a perceived decline in quality of life. The combination of reduced activity and increased fatigue can lead to increased idle time in bed and is likely related to mood disturbance.…”

Section: Scientific Investigationsmentioning

confidence: 99%

“…Additionally, there are a small number of studies which have investigated CBTi among kidney dialysis patients and found significant improvements. 21,[38][39][40][41] However, one of the primary limitations of CBTi is the relatively limited number of providers who are trained to provide this intervention and the resulting limited accessibility of this treatment for many patients.…”

Section: -6mentioning

confidence: 99%

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A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

Williams

McCrae

Rodrigue

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Sleep and fatigue difficulties appear to be highly prevalent among individuals with end-stage renal disease and individuals who have received a kidney transplant. While there is some evidence of biopsychosocial factors predicting sleep disturbance in these populations, previous studies have relied on single time point retrospective measurements. Methods: The study utilized a 2-week prospective measurement approach, including one night of polysomnographic measurement, nightly sleep diaries, and self-report measures of health, sleep, and mood. Results: The current study demonstrates that a number of psychological and behavioral factors, including negative mood, quality of life, napping, and caffeine consumption, are related to sleep disturbance among pre-and post-kidney transplant patients. This study also found that many of these factors have different relationships with sleep disturbance when comparing pre-and post-kidney transplant patients. Conclusions: These results suggest that such factors may be worthwhile areas for intervention in treating the symptoms of insomnia among pre-and posttransplant recipients. A nuanced approach to understanding sleep problems is likely warranted when conceptualizing insomnia and developing a treatment plan. I NTRO DUCTI O NSleep complaints are common among individuals with endstage renal disease (ESRD) and patients who have received kidney transplantation (KTX).1-6 While on dialysis, patients report that sleep disturbance is one of their most prominent symptom complaints.1 Compared to dialysis, kidney transplantation is considered the treatment of choice for ESRD due to longer patient survival, fewer morbidities, and better quality of life. Unfortunately, little is known about the relationship between ESRD and sleep or the impact of KTX on that relationship. The research that does exist suggests that the rates of common sleep disorders including insomnia (50% to 75% v 9%), restless legs syndrome (30% to 80% v 5% to 15%), and sleep apnea (~24%), are higher in ESRD than in the general population, and ESRD patients are also at risk for more severe sleep apnea.2-7 The rates of these disorders tend to decrease following KTX (expect apnea), but nonetheless remain elevated compared to normative estimates.8 While considerable research has focused on predictors of sleep apnea and restless legs syndrome (RLS), relatively little research has focused on insomnia in these populations. Additionally, due to a reliance on cross-sectional designs and retrospective assessment of insomnia, previous research has been unable to provide greater insights into sleep's relationships with ESRD. Previous research has been largely atheoretical and has examined insomnia in relative isolation without consideration of important biopsychosocial relationships that may be relevant in the context of ESRD and KTX. Biopsychosocial Correlates of Sleep and End-Stage Renal DiseaseThere are several biopsychosocial factors which have been found to be associated with ESRD including age, sex, medical ...

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Section: Implications For Clinical Practicementioning

confidence: 71%

Section: Scientific Investigationsmentioning

confidence: 99%

Section: -6mentioning

confidence: 99%

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A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

Williams

McCrae

Rodrigue

et al. 2016

Journal of Clinical Sleep Medicine

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“…In a recent study, poor sleep quality was directly associated with higher fatigue severity, and also mediated the association between lower mood and fatigue severity in RA (Rongen‐van Dartel et al ., 2016). In fact, trials of CBT interventions aimed at sleep quality in dialysis patients found significant improvements in fatigue (Chen et al ., 2008, 2011). …”

Section: Discussionmentioning

confidence: 99%

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

Picariello

Moss‐Morris

Macdougall

et al. 2017

British J Health Psychol

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BackgroundFatigue is commonly experienced in end‐stage kidney disease (ESKD) patients. In order to develop patient‐centred psychosocial interventions to help patients manage fatigue symptoms, a more in‐depth understanding regarding the experience of fatigue is needed.ObjectiveThe objective of this study was to explore renal patients’ experiences of fatigue, across renal replacement therapy (RRT) modalities.MethodsTwenty‐five in‐depth semi‐structured interviews were conducted. Interviews were audio‐taped, transcribed, and analysed using inductive thematic analysis.ResultsMain themes included the strong role of the illness and treatment in the aetiology of fatigue. Two contrasting streams of illness–fatigue interpretations emerged: catastrophizing versus normalizing. Participants emphasized the importance of having a sense of purpose in facilitating active management of fatigue. Many participants described the consequences of fatigue on their functioning. Low mood, frustration, and anger were common emotional consequences of fatigue. Three dominant fatigue management strategies emerged: one related to accommodation of activities around fatigue, another on increasing activities to counteract fatigue, and the third one revolved around self‐compassion. Social support emerged as an important aspect of the fatigue experience, serving as a source of motivation, yet participants were wary of becoming a burden to others.ConclusionFindings identify casual attributions, behavioural and emotional reactions, management strategies, and facilitators of active management of fatigue in ESKD. Untying fatigue from the illness and treatment may help patients to develop alternative less catastrophic perceptions of fatigue, increase their perception of control over fatigue, and facilitate active fatigue management. Statement of contribution What is already known on this subject? Fatigue is persistent and debilitating in end‐stage kidney disease (ESKD), with no consistent treatment model.Promising evidence is available for psychological fatigue interventions in other chronic conditions.There is a gap in studies looking at the fatigue experiences of patients with ESKD across renal replacement therapies. What does this study add? Fatigue is not inherently negative, but shaped by patients’ beliefs and behaviours.Findings provide novel insights, for example, on the important role social support seems to play in fatigue.An in‐depth understanding of fatigue may help to inform a future patient‐centred intervention in ESKD.

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“…Deux autres variables sont particuliè rement discuté es : le sommeil et l'alimentation. En effet, le sommeil est ré guliè rement perturbé chez les patients dialysé s [54]. C'est pourquoi, une é valuation de la qualité du sommeil par un relevé pré cis des heures d'endormissement, de ré veils nocturnes, de siestes et d'é veils matinaux est ré alisé e.…”

Section: Les Techniques D'interventionunclassified

Intérêt des interventions psychologiques en dialyse : étude exploratoire

Augusto¹,

Krzesinski

Warling³

et al. 2011

Néphrologie & Thérapeutique

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Cognitive-Behavioral Therapy for Sleep Disturbance in Patients Undergoing Peritoneal Dialysis: A Pilot Randomized Controlled Trial

Cited by 87 publications

References 29 publications

A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

Intérêt des interventions psychologiques en dialyse : étude exploratoire

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