title: Intradialytic subjective sleepiness and oral body temperature.
abstract: OBJECTIVE
  Hemodialysis (HD) patients are often observed to sleep during treatment. Because of the well-described, inverse association between body temperature and sleep propensity, the purpose of this study was to describe the course of intradialytic (during HD) subjective sleepiness and examine its relationship to oral body temperature. In addition, we sought to determine if that relationship varied with dialysis treatment time of day.
  
  
  METHODS
  Subjective sleepiness and oral body temperature were recorded every 15 minutes through the entire course of HD.
  
  
  METHODS
  The study was conducted at two large, inner-city dialysis units.
  
  
  METHODS
  The sample included 60 chronic HD patients, 20 on each of three shifts based on treatment time of day (shift 1-6:00A.M. to 10:00A.M.; shift 2-10:00A.M. to 2:00P.M.; and shift 3-2:00P.M. to 6:00P.M..
  
  
  RESULTS
  Subjects on shift 1 were found to have a mean intradialytic sleepiness level greater than those on shift 2 (p<.04) and shift 3 (p<.003). Irrespective of shift, sleepiness increased during the first half of dialysis and decreased slightly as treatment progressed, a significant quadratic trend (p<.001). During the same period, temperature initially increased, subsequently dropped in temporal proximity to maximal sleepiness and increased again, a significant quadratic trend (p<.02). The relationship between sleepiness and temperature revealed a significant negative correlation (r=-.59, p<.03) and did not vary with treatment time of day.
  
  
  CONCLUSIONS
  The results argue that sleep propensity increases during HD, an effect that may be related to treatment induced alterations in arousal and/or thermoregulatory processes. The effect is unrelated to treatment time of day.
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA. kpark04@nurse.emory.edu
authors.forename: K P
authors.initials: KP
authors.lastname: Parker
authors.forename: D L
authors.initials: DL
authors.lastname: Bliwise
authors.forename: D B
authors.initials: DB
authors.lastname: Rye
authors.forename: A
authors.initials: A
authors.lastname: De
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D001833:Body Temperature Regulation / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000502:physiology*; D006435:Renal Dialysis; D013997:Time Factors