American Journal of Kidney Diseases
Volume 52, Issue 2 , Pages 305-313 , August 2008

Subjective and Objective Sleep Quality in Patients on Conventional Thrice-Weekly Hemodialysis: Comparison With Matched Controls From the Sleep Heart Health Study

  • Mark L. Unruh, MD, MSc

      Affiliations

    • Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, PA
    • Corresponding Author InformationAddress correspondence to Mark Unruh, MD, MSc, University of Pittsburgh Medical Center, Renal-Electrolyte Division, 3550 Terrace St, A909 Scaife Hall, Pittsburgh, PA 15261.
  • ,
  • Mark H. Sanders, MD

      Affiliations

    • Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
  • ,
  • Susan Redline, MD, MPH

      Affiliations

    • Center for Clinical Investigation, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH
  • ,
  • Beth M. Piraino, MD

      Affiliations

    • Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, PA
  • ,
  • Jason G. Umans, MD, PhD

      Affiliations

    • Penn Medical Laboratory, MedStar Research Institute, Washington, DC
    • Department of Medicine, Georgetown University, Washington, DC
    • Department of Obstetrics and Gynecology, Georgetown University, Washington, DC
  • ,
  • Hassan Chami, MD, MSc

      Affiliations

    • Department of Medicine, Boston University, Boston, MA
    • VA Boston Health Care System, Boston, MA
  • ,
  • Rohit Budhiraja, MD

      Affiliations

    • Pulmonary, Sleep, and Critical Care Division, Southern Arizona VA Healthcare System, Tucson, AZ
    • University of Arizona, Tucson, AZ
  • ,
  • Naresh M. Punjabi, MD

      Affiliations

    • Johns Hopkins University School of Medicine, Baltimore, MD
  • ,
  • Daniel Buysse, MD

      Affiliations

    • Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, PA
  • ,
  • Anne B. Newman, MD, MPH

      Affiliations

    • Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA.

Received 29 November 2007 ,Accepted 11 April 2008.

References 

  1. Iliescu EA, Coo H, McMurray MH, et al. Quality of sleep and health-related quality of life in haemodialysis patients. Nephrol Dial Transplant. 2003;18:126–132
  2. Unruh M, Hartunian M, Chapman M, Jaber B. Sleep quality and clinical correlates in patients on maintenance hemodialysis. Clin Nephrol. 2003;59:280–288
  3. Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the Kidney Disease Quality of Life (KDQOL) instrument. Qual Life Res. 1994;3:329–338
  4. Ramkumar N, Beddhu S, Eggers P, Pappas LM, Cheung AK. Patient preferences for in-center intense hemodialysis. Hemodial Int. 2005;9:281–295
  5. Walsleben JA, Kapur VK, Newman AB, et al. Sleep and reported daytime sleepiness in normal subjects: The Sleep Heart Health Study. Sleep. 2004;27:293–298
  6. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep. 2004;27:1255–1273
  7. Foley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG. Sleep complaints among elderly persons: An epidemiologic study of three communities. Sleep. 1995;18:425–432
  8. National Sleep Foundation. 2005 Sleep in America Poll. http://www.sleepfoundation.org/_content/hottopics/2005_summary_of_findings.pdfAccessed January 30, 2007
  9. Unruh ML, Sanders MH, Redline S, et al. Sleep apnea in patients on conventional thrice-weekly hemodialysis: Comparison with matched controls from the Sleep Heart Health Study. J Am Soc Nephrol. 2006;17:3503–3509
  10. Quan SF, Howard BV, Iber C, et al. The Sleep Heart Health Study: Design, rationale, and methods. Sleep. 1997;20:1077–1085
  11. Lind BK, Goodwin JL, Hill JG, Ali T, Redline S, Quan SF. Recruitment of healthy adults into a study of overnight sleep monitoring in the home: Experience of the Sleep Heart Health Study. Sleep Breathing. 2003;7:13–24
  12. Psaty BM, Lee M, Savage PJ, Rutan GH, German PS, Lyles M. Assessing the use of medications in the elderly: Methods and initial experience in the Cardiovascular Health Study (The Cardiovascular Health Study Collaborative Research Group). J Clin Epidemiol. 1992;45:683–692
  13. Redline S, Sanders MH, Lind BK, et al. Methods for obtaining and analyzing unattended polysomnography data for a multicenter study (Sleep Heart Health Research Group). Sleep. 1998;21:759–767
  14. Iber C, Redline S, Kaplan Gilpin AM, et al. Polysomnography performed in the unattended home versus the attended laboratory setting—Sleep Heart Health Study methodology. Sleep. 2004;27:536–540
  15. Rechtschaffen A, Kales A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Washington DC: NIMH; 1968;
  16. Report ASD. EEG arousals: Scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. Sleep. 1992;15:173–184
  17. Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep. 1991;14:540–545
  18. Johns MW. Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep. 1992;15:376–381
  19. Fleiss J, Levin B, Paik M. Statistical Methods for Rates and Proportions. Hoboken, NJ: Wiley; 2003;
  20. Breslow N, Day N. Statistical Methods in Cancer Research. Lyon, France: International Agency for Research on Cancer; 1980;
  21. Kapur VK, Redline S, Nieto FJ, et al. The relationship between chronically disrupted sleep and healthcare use. Sleep. 2002;25:289–296
  22. Klink ME, Quan SF, Kaltenborn WT, Lebowitz MD. Risk factors associated with complaints of insomnia in a general adult population (Influence of previous complaints of insomnia). Arch Intern Med. 1992;152:1634–1637(comment)
  23. Foley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG. Incidence and remission of insomnia among elderly adults: An epidemiologic study of 6,800 persons over three years. Sleep. 1999;22:S373–S378(suppl 2)
  24. Unruh ML, Levey AS, D'Ambrosio C, Fink NE, Powe NR, Meyer KB. Restless legs symptoms among incident dialysis patients: Association with lower quality of life and shorter survival. Am J Kidney Dis. 2004;43:900–909
  25. Elder SJ, Pisoni RL, Akizawa T, et al. Sleep quality predicts quality of life and mortality risk in haemodialysis patients: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2008;23:998–1004
  26. Unruh ML, Buysse DJ, Dew MA, et al. Sleep quality and its correlates in the first year of dialysis. Clin J Am Soc Nephrol. 2006;1:802–810
  27. Kutner NG, Zhang R, Huang Y, Bliwise DL. Association of sleep difficulty with Kidney Disease Quality of Life cognitive function score reported by patients who recently started dialysis. Clin J Am Soc Nephrol. 2007;2:284–289
  28. Kutner NG, Zhang R, Huang Y, Bliwise DL. Patient-reported sleep difficulty and cognitive function during the first year of dialysis. Int Urol Nephrol. 2008;40:203–210
  29. Ayas NT, White DP, Manson JE, et al. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003;163:205–209
  30. Patel SR, Ayas NT, Malhotra MR, et al. A prospective study of sleep duration and mortality risk in women. Sleep. 2004;27:440–444
  31. Dew M, Hoch C, Buysse D, et al. Healthy older adults' sleep predicts all-cause mortality at 4 to 19 years of followup. Psychosom Med. 2003;65:63–73
  32. Parker KP, Kutner NG, Bliwise DL, Bailey JL, Rye DB. Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis. Health Qual Life Outcomes. 2003;1:68
  33. Hanly PJ, Gabor JY, Chan C, Pierratos A. Daytime sleepiness in patients with CRF: Impact of nocturnal hemodialysis. Am J Kidney Dis. 2003;41:403–410
  34. Benz RL, Pressman MR, Hovick ET, Peterson DD. A preliminary study of the effects of correction of anemia with recombinant human erythropoietin therapy on sleep, sleep disorders, and daytime sleepiness in hemodialysis patients (the SLEEPO Study). Am J Kidney Dis. 1999;34:1089–1095
  35. Nofzinger EA. Neuroimaging and sleep medicine. Sleep Med Rev. 2005;9:157–172
  36. Edinger JD, Fins AI, Glenn DM, et al. Insomnia and the eye of the beholder: Are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints?. J Consult Clin Psychol. 2000;68:586–593
  37. Salin-Pascual RJ, Roehrs TA, Merlotti LA, Zorick F, Roth T. Long-term study of the sleep of insomnia patients with sleep state misperception and other insomnia patients. Am J Psychiatry. 1992;149:904–908
  38. Kalantar-Zadeh K, Unruh M. Health related quality of life in patients with chronic kidney disease. Int Urol Nephrol. 2005;37:367–378
  39. Unruh ML, Weisbord SD, Kimmel PL. Health-related quality of life in nephrology research and clinical practice. Semin Dial. 2005;18:82–90
  40. Claman DM, Redline S, Blackwell T, et al. Prevalence and correlates of periodic limb movements in older women. J Clin Sleep Med. 2006;2:438–445
  41. Parker KP, Bailey JL, Rye DB, Bliwise DL, Van Someren EJ. Lowering dialysate temperature improves sleep and alters nocturnal skin temperature in patients on chronic hemodialysis. J Sleep Res. 2007;16:42–50
  42. Parker KP, Bliwise DL, Bailey JL, Rye DB. Polysomnographic measures of nocturnal sleep in patients on chronic, intermittent daytime haemodialysis vs those with chronic kidney disease. Nephrol Dial Transplant. 2005;20:1422–1428
  43. Iliescu EA, Yeates KE, Holland DC. Quality of sleep in patients with chronic kidney disease. Nephrol Dial Transplant. 2004;19:95–99
  44. Cohen SD, Patel SS, Khetpal P, Peterson RA, Kimmel PL. Pain, sleep disturbance, and quality of life in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2007;2:919–925

 Originally published online as doi:10.1053/j.ajkd.2008.04.019 on July 10, 2008.

PII: S0272-6386(08)00867-6

doi: 10.1053/j.ajkd.2008.04.019

American Journal of Kidney Diseases
Volume 52, Issue 2 , Pages 305-313 , August 2008