Factors contributing to sleep disturbance and hypnotic drug use in hemodialysis patients.
OBJECTIVE
Sleep disturbance and the use of hypnotic medications are common in patients on hemodialysis. Factors that contribute to sleep disturbance and the use of hypnotic medications in hemodialysis patients were investigated.


METHODS
With the use of a questionnaire-based survey, we examined the prevalence of symptoms that reflect sleep disorders such as insomnia, restless legs syndrome (RLS), and snoring and use of hypnotic medications in 252 hemodialysis patients.


RESULTS
The overall prevalence of insomnia was 59.1%, with the prevalence of difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), and early morning awakening (EMA) being 47.6, 24.2, and 28.2%, respectively. Daytime sleepiness and habitual snoring were reported by 42.5 and 33.7%, respectively. The prevalence of routine use of hypnotic drugs was 25.8%. Both RLS and age were significantly associated with insomnia [odds ratio (OR), 3.75; p 0.001, OR, 1.03; p < 0.01]. RLS was a significant factor for DIS, DMS, and EMA (OR, 2.26; p < 0.05, OR, 3.44; p < 0.0005, OR, 4.25; p < 0.0005) and age was a significant factor for DMS and EMA (OR, 1.03; p = 0.053, OR, 1.05; p < 0.005). Both insomnia and snoring were associated with the use of hypnotic drugs (OR, 2.97; p < 0.001, 1.59; p=0.13).


CONCLUSIONS
Both RLS and sleep-disordered breathing may contribute to sleep disturbance in hemodialysis patients. RLS in particular may be an important factor in insomnia, which in turn is likely responsible for the high prevalence of hypnotic drug use in hemodialysis patients.
Noda
Akiko
A
Nagoya University School of Health Sciences, 1-1-20 Daiko, Minami, Higashi-ku, Nagoya, Aichi 461-8673, Japan.
Nakai
Shigeru
S
Soga
Taro
T
Sugiura
Tatsuki
T
Iwayama
Norihisa
N
Maeda
Kenji
K
Atarashi
Misaho
M
Yasuma
Fumihiko
F
Ozaki
Norio
N
Yokota
Mitsuhiro
M
Koike
Yasuo
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012148:Restless Legs Syndrome / Q000453:epidemiology; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy*; D012913:Snoring / Q000139:chemically induced / Q000453:epidemiology; D011795:Surveys and Questionnaires
D006993:Hypnotics and Sedatives