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.
Highlights
The literature provides evidence that chronic diseases may compromise the quality of sleep
Patients using antidepressants had an additional 34 minutes of wake time after sleep onset (WASO) and 8 additional awakenings as compared to patients who were not using antidepressants. In this sample of patients undergoing daily dialysis and patients undergoing conventional dialysis, no differences were observed between the groups in terms of objective sleep parameters
Previous studies have demonstrated that actigraphy is sensitive to detecting sleep patterns associated with specific sleep disorders as well as with other medical or neurobehavioral disorders [13]
Summary
The literature provides evidence that chronic diseases may compromise the quality of sleep. Recent studies have shown significant improvement in survival with the use of high-flux membranes, ultrafiltration control, bicarbonate dialysate, and other more efficient water treatments [4]. These advancements have led to the introduction of daily dialysis that has some advantages over conventional dialytic therapy, including shorter daily treatment times. Improvements in clinical parameters in daily dialysis have been cited, such as treatment tolerance, blood pressure control, nutritional status, and adverse events (anemia and hospital admissions, among others), with increase in survival and quality of life as well as patient well-being [6]
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