Sleep Quality and Its Correlates in the First Year of Dialysis

Abstract

Although sleep problems are thought to be prevalent among patients who undergo dialysis, there is only limited information on the determinants of sleep quality and the change in sleep quality during the first year of dialysis treatment. This report uses data from a national cohort study of incident hemodialysis and peritoneal dialysis patients to identify the correlates of sleep quality and to determine the extent to which sleep quality is related to patients' health-related quality of life and survival. This report includes 909 incident dialysis patients who responded to questions about sleep quality. Three quarters of incident dialysis patients reported impaired sleep, and 14% had a decline in sleep quality in the first year of treatment. Poor sleep quality was significantly related to black race, higher serum phosphate, current smoking, benzodiazepine prescription, and complaints of severe restless legs. Poor baseline sleep quality was associated with lower SF-36 physical and mental component summary scores, vitality scores, and bodily pain scores (all P < 0.001). Younger age, current smoking, and benzodiazepine prescription were associated with decreases in sleep quality at 1 yr. There was no association between baseline sleep quality and survival; however, a decline in sleep quality during the first year on dialysis was associated with shorter survival (hazard ratio 1.44; 95% confidence interval 1.13 to 1.83; P ‫؍‬ 0.003). Future work should examine the link between sleep quality and daytime functioning in the kidney failure population and the extent to which improving sleep quality will improve dialysis patient outcomes.

Correlates and Outcomes of Fatigue among Incident Dialysis Patients

“…On the CHEQ sleep quality scale, a higher score on a scale of 0 to 100 reflects better sleep quality. The sleep quality scale has demonstrated adequate internal consistency and reliability as measured by the Cronbach ␣ of 0.75, and its construct validity was described previously (16).…”

“…These included: demographics (age, gender, race, education, marital status, and employment) (18,19); lifestyle factors (current smoking, alcohol consumption, and physical exercise); dialysis treatmentrelated factors (mode of dialysis, dose of dialysis, cause of ESRD); laboratory factors (hematocrit, serum albumin, creatinine, phosphate) (20 -23); psychologic factors (SF-36 mental health score, used to assess the role of psychologic well-being) (8,24); comorbid disease (ICED score) (9); sleep disorders (16,25,26); and inflammatory markers (CRP, IL-6, fibrinogen) (27)(28)(29).…”

Health domains and race in generic preference-based health-related quality of life instruments in the United States literature

“…Respondents are asked if they have a lot of energy, all of the time, most of the time, some of the time, little of the time, or none of the time. There are some studies that consider the vitality domain independently, mostly from administering the SF-36v2 TM to groups of the population with certain conditions, such as patients with diabetes mellitus type 2 and undergoing dialysis (BENNETT et al, 2008;UNRUH et al, 2006;CHABOYER;WALLIS, 2008). Among such studies, a few include race as a control variable.…”

Messenger RNA expression profile of sleep-related genes in peripheral blood cells in patients with chronic kidney disease

“…Up to 80 % of such patients have been reported to suffer from sleep abnormalities [1][2][3][4][5][6][7][8][9]. Polysomnographic analysis has revealed a higher prevalence of various types of sleep disorders in CKD patients than in healthy subjects [10].…”