Hemodialysis patients plagued by insomnia

NEW YORK--Patients with kidney disease treated with hemodialysis have problems sleeping that can't be explained by advanced age or chronic health conditions, according to new research.

"Studies of patients on maintenance hemodialysis have found that 50 percent to 80 percent 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.

Because advanced age, poor health and obstructive sleep apnea can also adversely affect sleep, Unruh's group compared sleep quality in a group of 46 patients on hemodialysis 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 hemodialysis 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 suggested, that changing how hemodialysis 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.