Haemodialysis patients plagued by insomnia

Patients with kidney disease treated with haemodialysis have problems sleeping that can’t be explained by advanced age or chronic health conditions, new research shows.

“Haemodialysis is required by patients with severe kidney disease, when the kidneys can no longer remove enough wastes and fluid from blood,” Dr. Kerry Willis, Senior VP for Scientific Activities, National Kidney Foundation explained.  Common causes of kidney disease are diabetes, hypertension, and glomerulonephritis, a disease caused by injury to the part of the kidney that filters blood (called glomeruli).

“Studies of patients on maintenance haemodialysis have found that 50% to 80% report some sleep complaint or excessive daytime somnolence,” Dr. Mark Unruh, a nephrologist at the University of Pittsburgh Medical Center, and his colleagues report in the August issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

Because advanced age, poor health, and obstructive sleep apnoea can also adversely affect sleep, Dr. Unruh’s group compared sleep quality in a group of 46 patients on haemodialysis with a group of 137 individuals without kidney disease, of similar age, weight, race, and percentage of men and women.  All of the subjects underwent overnight sleep studies and completed a Sleep Habits Questionnaire.

The physicians found that haemodialysis patients were three times more likely to sleep less than 5 hours per night, and that more than half reported difficulty getting back to sleep, waking up too early, feeling tired and not getting enough sleep.

It’s possible, the authors suggest, that changing how haemodialysis is delivered and working with patients to improve their sleep habits — such as not napping during the day and avoiding stimulating activity in the evening – may substantially improve their quality of sleep.

The National Kidney Foundation is dedicated to preventing and treating kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases and increasing availability of all organs for transplantation.

(Source:  American Journal of Kidney Diseases: National Kidney Foundation USA: August 2008)