SLEEP DISTURBANCES IN END-STAGE RENAL-DISEASE PATIENTS ON HEMODIALYSIS

Daily observations of patients with end-stage renal disease have shown us that a significant number of them take a ''nap'' during the hemodi alysis treatment. Our major concern was to investigate whether this be havior was compensation for a modified sleep profile at home, or simpl y a way to cope with the 4-hour treatment sessions. The purpose of thi s study was to evaluate the sleep disturbances associated with regular hemodialysis treatment, especially in relation to treatment schedule and the duration of hemodialysis therapy One hundred thirty-five patie nts (mean age, 59.0 +/- 13.2 years) were studied using a modified post -sleep inventory (PSI). Patients were assigned to three groups accordi ng to their treatment schedule, i.e., morning, afternoon, or late even ing. One-way ANOVA and contingency analysis were used. The majority of the patients (53.3%) reported that they sleep well. Regular dialysis treatment, in and of itself, did not seem to be negatively correlated with sleep quality; however, the schedule of the hemodialysis treatmen t did appear to influence sleep quality: Patients who were dialyzed in the morning reported less nocturnal sleeping hours and less hours of lying in bed, and showed a tendency to have higher PSI scores. A prolo nged number of years on hemodialysis therapy also seemed to contribute to an increase in sleep disturbances. In conclusion, patients who hav e been on hemodialysis therapy for many years, as well as those with s leeping problems in general should be allowed to choose the afternoon or late-evening shift.