Comparison of Sleep/Wake Behavior in CKD Stages 4 to 5 and Hemodialysis Populations Using Wrist Actigraphy

Barmar, Babak; Dang, Qianyu; Isquith, Daniel; Buysse, Daniel J.; Unruh, Mark

doi:10.1053/j.ajkd.2008.10.045

Cited by 32 publications

(18 citation statements)

References 32 publications

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“…If patient oversleeps as a result of the extra sleep time one day, then he or she may experience a sleepless night the next day leading to fluctuating sleep quality and changes in day time performance (alertness) and possibly mood. On the other hand, a patient receiving in-center HD would have to adjust (shorten) one’s wake-up time in order to show up for his dialysis treatment the same day [28]. We postulate that irrespective of the specific nature of this adjustment, the end result is a disruption of the normal sleep behavioral patterns as well as poor and more variable sleep scores of the dialysis population.…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD

et al. 2010

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Background/Aims: Little is known about the association of chronic kidney disease (CKD) with sleep quality, mood, and alertness. In this report, we assessed these symptoms among patients with advanced CKD (stages 4–5) and those with end-stage renal disease (ESRD) and compared them to healthy controls without known kidney disease. Methods: Patients were recruited from local dialysis units, outpatient nephrology clinics and the Thomas E. Starzl Transplant Institute. Healthy control subjects matched for age, gender and race were drawn from an archival database. Daily symptoms of sleep quality, mood, and alertness were assessed by visual analogue scales of the Pittsburgh Sleep Diary. Health-related quality of life was assessed by the Short Form-36 instrument. Results: Sixty-nine dialysis patients and 23patients with advanced CKD demonstrated worse scores in sleep quality, mood, and alertness (p < 0.001) than controls. In adjusted analyses, European-American race, dialysis dependency, younger age, and physical performance SF-36 components were significantly associated with poor sleep quality, mood and alertness (p < 0.05). The dialysis population demonstrated higher day-to-day variability in scores than either the advanced CKD patients or the controls. Conclusion: Advanced CKD and dialysis dependency are associated with impaired and highly variable sleep quality, mood, and alertness.

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Section: Discussionmentioning

confidence: 99%

Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD

et al. 2010

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“…Barmar et al 14 measured sleep using actigraphy in 36 non-dialysis-dependent patients with stages 4–5 of CKD and 51 hemodialysis patients. These investigators found that both groups had short and fragmented sleep and that both subjective and objective measures were worse in hemodialysis patients than in the CKD patients who were not undergoing hemodialysis.…”

Section: Prevalence Of Sleep Disorders In Ckdmentioning

confidence: 99%

Sleep Disturbances as Nontraditional Risk Factors for Development and Progression of CKD: Review of the Evidence

Turek

Ricardo

Lash

2012

American Journal of Kidney Diseases

137

140

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Despite the high prevalence and enormous public health implications of chronic kidney disease (CKD), the factors responsible for its development and progression remain incompletely understood. To date, only a few studies have attempted to objectively characterize sleep in CKD patients prior to kidney failure, but emerging evidence suggests a high prevalence of sleep disorders, particularly obstructive sleep apnea. Laboratory and epidemiologic studies have shown that insufficient sleep and poor sleep quality promote the development and exacerbate the severity of three important risk factors for CKD, namely hypertension, type 2 diabetes, and obesity. In addition, sleep disturbances might have a direct effect on CKD through chronobiological alterations in the renin-angiotensin-aldosterone system and sympathetic nervous system activation. The negative impact of sleep disorders on vascular compliance and endothelial function may also have also have a deleterious effect on CKD. Sleep disturbances may therefore represent a novel risk factor for the development and progression of CKD. Optimizing sleep duration and quality and treating sleep disorders may reduce the severity and delay the progression of CKD.

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“…Compared with age-matched controls, patients on dialysis are more likely to report symptoms of insomnia and demonstrate shorter and less efficient sleep on polysomnography 2–4 . The prevalence of restless leg syndrome (RLS) in patients on dialysis is 3-to 4-fold higher than that seen in the general population; RLS is also associated with mortality and withdrawal from dialysis 5 .…”

Section: Introductionmentioning

confidence: 99%

Physical activity and self‐reported symptoms of insomnia, restless legs syndrome, and depression: The comprehensive dialysis study

Anand

Johansen

Grimes

et al. 2012

Hemodialysis International

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Background Symptoms of sleep and mood disturbances are common among patients on dialysis and are associated with significant decrements in survival and health-related quality of life. We used data from the Comprehensive Dialysis Study (CDS) to examine the association of self-reported physical activity with self-reported symptoms of insomnia, restless legs syndrome (RLS) and depression in patients new to dialysis. Methods The CDS collected data on physical activity, functional status, and health-related quality of life from 1678 patients on either peritoneal (n=169) or hemodialysis (n=1509). The Human Activity Profile was used to measure self-reported physical activity. Symptoms were elicited in the following manner: insomnia using three questions designed to capture difficulty in initiating or maintaining sleep, RLS using three questions based on the National Institutes of Health workshop, and depression using the 2-item Patient Health Questionnaire. Results We obtained data on symptoms of insomnia and depression for 1636, and on symptoms of RLS for 1622 (>98%) patients. Of these, 863 (53%) reported one of three insomnia symptoms as occurring at a persistent frequency. Symptoms of RLS and depression occurred in 477 (29%) and 451 (28%) of patients, respectively. The Adjusted Activity Score of the Human Activity Profile was inversely correlated with all three conditions in models adjusting for demographics, comorbid conditions, and laboratory variables. Conclusion Sleep and mood disturbances were commonly reported in our large, diverse cohort of patients new to dialysis. Patients who reported lower levels of physical activity were more likely to report symptoms of insomnia, RLS and depression.

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Comparison of Sleep/Wake Behavior in CKD Stages 4 to 5 and Hemodialysis Populations Using Wrist Actigraphy

Cited by 32 publications

References 32 publications

Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD

Sleep Quality, Mood, Alertness and Their Variability in CKD and ESRD

Sleep Disturbances as Nontraditional Risk Factors for Development and Progression of CKD: Review of the Evidence

Physical activity and self‐reported symptoms of insomnia, restless legs syndrome, and depression: The comprehensive dialysis study

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