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

Abstract

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.

Physical Activity and Quality of Sleep in Patients with End-Stage Renal Disease on Hemodialysis: A Preliminary Report

“…Their performance in physical activities further aggravates the anxiety of these patients and their physical and mental burden by affecting the quality of sleep as evidenced by the research of Kwabena and Awuah [ 1 ]. According to Roumelioti et al [ 14 ], dialysis dependency was associated with poor sleep quality, and hemodialysis patients with sleep-disordered breathing were found to have poor sleep quality compared with those not on hemodialysis [ 15 ]. Our results showed that patients were classified as bad sleepers at the total PSQI score (8.8 ± 2.8) compared to previous studies which classified patients as poor sleepers when having score > 5.5 in PSQI [ 16 ].…”

Quality of life, clinical outcome, personality and coping in chronic hemodialysis patients

“… 16 Moreover, sleep and mood disturbances are common among patients on dialysis and are significantly associated with worse survival and health-related QoL perceived. 16 , 19 These psychological alterations inexorably lead to a reduced compliance to the treatment and an increase in hospital admissions. 20 …”

Excessive daytime sleepiness in patients with chronic kidney disease undergone hemodialysis

“…Sleep disorders, including delayed sleep onset, frequent awakening, restless leg syndrome, insomnia, and daytime sleepiness, are frequent in patients with end stage renal disease (ESRD) (2,(4)(5)(6)(7)(8). These symptoms affect sleep quality and consequently the quality of life of these patients (9)(10)(11).…”