A Comparison of Reported Sleep Disorders in Patients on Chronic Hemodialysis and Continuous Peritoneal Dialysis

There are few data about the prevalence and characteristics of reported sleep disorders in chronic dialysis patients and, although insomnia is often used as a marker of uremia, there are few data relating complaints of sleep to adequacy of dialysis. We therefore surveyed 48 hemodialysis (HD) patients, 22 continuous peritoneal dialysis (PD) patients, and 41 healthy control subjects about disordered sleep. The questionnaire included demographic data, questions characterizing the reported sleep problems, and linear analogue scales quantitating the severity of the sleep disturbance and feelings of anxiety, worry, and sadness. Kt/V determinations were also made for each dialysis patient. Fifty-two percent of the HD, 50% of the PD, and 12% of the control subjects reported problems sleeping (P < 0.001, all dialysis patients v controls). No differences between HD and PD in characteristics of sleep problems were seen. Sleep severity scale results confirmed sleep disorders (7.2 in those with v 0.95 in those without sleep disorders, where 0 = sleep a little problem and 10 = a big problem, P < 0.001). Caffeine intake (P < 0.05) and worry (P < 0.004) were the only factors associated with reported sleep disturbances. Kt/V values (1.4 ± 0.3) did not predict reported sleep problems. Mean reported hours of sleep per night (5.5 ± 2 v 5.8 ± 1.4) and desired hours of sleep per night (8.3 ± 2 v 7.6 ± 1.3) were similar among dialysis patients and controls reporting sleep problems. Dialysis patients and controls without self-reported sleep disorders slept a mean of 7.1 ± 2.4 and 7 ± 1.1 h/night, respectively. These reported hours of sleep per night were not statistically different between those with and without self-perceived sleep disorders. More dialysis patients reported restless legs (30/36 v 1/7 controls, P < 0.009). Nighttime waking (80% of dialysis patients and 71% of controls), early morning waking (72% of dialysis patients and 57% of controls), and trouble falling asleep (67% of dialysis patients and 86% of controls) were similar in the control subjects and the dialysis patients. Further study of sleep disorders in dialysis patients is needed.