Zaleplon Improves Sleep Quality in Maintenance Hemodialysis Patients

Abstract

Background/Aim: A recent survey has shown that insomnia is still a very common problem in maintenance hemodialysis (MHD) patients. The aim of the present study was to test the effects of zaleplon (ZAL), a new nonbenzodiazepine hypnotic drug, on the sleep quality of MHD patients with insomnia. Methods: The sleep quality was assessed by the Pittsburgh questionnaire in 10 patients (6 males/4 females) with insomnia on MHD; these patients underwent a randomized double-blind crossover study versus placebo (PLA). The main exclusion criterion was the presence of any possible cause of insomnia related to other concurrent diseases. Results: Treatment with ZAL significantly improved the total score of sleep quality (p < 0.03 vs. PLA). The analysis of the single components revealed that treatment with ZAL was associated with a higher subjective sleep quality (p < 0.01 vs. PLA) and a reduced sleep latency (p < 0.01 vs. PLA). The duration of sleep was not modified by ZAL, whereas a significant improvement was detected in habitual sleep efficacy (p < 0.05 vs. PLA). No peculiar side effect was recorded on ZAL. Blood parameters did not change, nor were differences recorded in the dialysis parameters (body weight gain, blood pressure) throughout the study. Conclusions: This study suggests that ZAL has a positive effect on the sleep quality in MHD patients. The absence of side effects and its pharmacodynamic properties make ZAL a useful drug in uremic patients.

Association of Nutritional Status with Depression and Sleep Disorders in Elderly End Stage Renal Disease Patients - Does Chronic Inflammation Cause it all?

“…Depending on these findings we think that depression and poor sleep quality are closely associated with inflammatory conditions and malnutrition. In fact, in previous studies it was reported that higher malnutrition-inflammation scores were associated with the presence of moderate-to-severe depression and poor sleep and life quality in hemodialysis patients (26) patients who are good sleepers (21,22). We did not find such a relationship between sleep quality and hemoglobin, PTH, calcium, or phosphorus values.…”

Sleep Disorders, Restless Legs Syndrome, and Uremic Pruritus: Diagnosis and Treatment of Common Symptoms in Dialysis Patients

“…At a dose of 10 mg (5 mg if aged >65 years), there was significant improvement in the total score of sleep quality versus placebo ( P < 0.03) without significant adverse effects. 21 …”

Sleep in Patients with ESRD Undergoing Hemodialysis

“…A multitude of causes including anemia, blood urea levels, plasma creatinine levels, parathyroid hormone (PTH) concentrations, increased blood pressure, quality of life, and illness intrusiveness may contribute to sleep disturbances in patients on maintenance hemodialysis (Hanly et al, 2003;Iliescu et al, 2004;Sabbatini et al,2003). Furthermore, there is a positive correlation between sleep disturbances and increased morbidity and mortality related to cardiovascular disease and infectious complications, the 2 major causes of death in hemodialysis patients (De Santo et al, 2005).…”

“…The Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Berlin Questionnaire are most frequently applied. Results derived from these questionnaires are limited by the subjective perception/sincerity of the patients, and thus are an imperfect substitute for more objective research methods on sleep in patients with chronic uremia (Chen et al, 2006;Iliescu et al, 2003;Mollaoglu & Mollaoglu, 2009;Sabbatini et al, 2003). Researchers have documented that ESRD patients reported significantly poorer subjective quality of sleep in comparison to the general population (Holley et al, 1992;Parker, 2005).…”

“…Periodic clinical assessment of sleep complaints should become routine for dialysis staff. Early identification of sleep problems and interventions to improve sleep quality is essential, because sleep disturbance that persists for a long period of time could decrease general health and functioning (Sabbatini et al, 2003;Tatomir et al, 2007). Increasing evidence supports the effectiveness of both pharmacologic and nonpharmacologic therapies for sleep problems (Edinger et al, 2001;Montgomery & Dennis, 2004;Smith et al, 2002).…”