Sleep Parameters in Short Daily versus Conventional Dialysis: An Actigraphic Study

Abstract

Previous studies have observed worse sleep quality in patients undergoing conventional dialysis as compared to daily dialysis. Our aim was to compare the sleep parameters of patients undergoing daily or conventional dialysis using an objective measure (actigraphy). This cross-sectional study was performed in three dialysis centers, including a convenience sample (nonprobability sampling) of 73 patients (36 patients on daily hemodialysis and 37 patients on conventional hemodialysis). The following parameters were evaluated: nocturnal total sleep time (NTST), expressed in minutes; wake time after sleep onset (WASO), expressed in minutes; number of nighttime awakenings; daytime total sleep time (DTST), expressed in minutes; number of daytime naps; and nighttime percentage of sleep (% sleep). The Mini-Mental State Examination and the Beck Depression Inventory were also administered. The mean age was 53.4 ± 17.0 years. After adjustment of confounding factors using multiple linear regression analysis, no difference in actigraphy parameters was detected between the groups: NTST (p = 0.468), WASO (p = 0.88), % sleep (p = 0.754), awakenings (p = 0.648), naps (p = 0.414), and DTST (p = 0.805). Different from previous studies employing qualitative analysis, the present assessment did not observe an influence of hemodialysis modality on objective sleep parameters in chronic renal patients.

Correlates of objective sleep quality in older peritoneal dialysis patients

“…Even though the average sleep efficiency among elderly peritoneal dialysis patients was suboptimal, a positive association between age and sleep efficiency was observed in the present study. Additionally, older peritoneal dialysis patients had higher average total sleep time (391.0 ± 99.3 min) than the general adult dialysis population, as reported previously, wherein the average total sleep time (on actigraphy) was 349.9 ± 63.9 min among conventional hemodialysis patients with a mean age of 47.6 years [ 29 ], and 5.5 ± 1.3 h among peritoneal dialysis patients with a mean age of 60.2 years [ 30 ]. Furthermore, age was found to be a positive predictor of the total sleep time in this study.…”

“…They found a mean actigraphy measured sleep efficiency of 83.4%±7.6% for 392 cognitively normal community-dwelling older adults with a mean age of 73.1 years old. Compared with that of conventional adult hemodialysis patients, the sleep efficiency of older peritoneal dialysis patients is also lower (84.8%±7.1% versus 75.5% ± 14.2%) [ 29 ].…”