title: Subjective and objective sleep quality in patients on conventional thrice-weekly hemodialysis: comparison with matched controls from the sleep heart health study.
abstract: BACKGROUND
  Studies examining sleep in the hemodialysis (HD) population have largely lacked an adequate comparison group. It therefore is uncertain whether poor sleep quality in the HD population reflects age, chronic health conditions, or effects of conventional HD therapy.
  
  
  METHODS
  Cross-sectional matched-group study.
  
  
  METHODS
  Forty-six in-center HD patients were compared with 137 community participants participating in the Sleep Heart Health Study matched for age, sex, body mass index, and race.
  
  
  METHODS
  HD patients compared with community-dwelling non-HD participants.
  
  
  METHODS
  Home unattended polysomnography was performed and scored by using similar protocols. Sleep habits and sleepiness were assessed by using the Sleep Habits Questionnaire and Epworth Sleepiness Scale.
  
  
  RESULTS
  Average age of study samples was 63 years, 72% were white, and average body mass index was 28 +/- 5 kg/m(2). HD patients were significantly more likely than community participants to have short sleep (odds ratio, 3.27; 95% confidence interval, 1.16 to 9.25) and decreased sleep efficiency (odds ratio, 5.5; 95% confidence interval, 1.5 to 19.6). HD patients reported more difficulty getting back to sleep (odds ratio, 2.25; 95% confidence interval, 1.11 to 4.60) and waking up too early (odds ratio, 2.39; 95% confidence interval, 1.01 to 5.66). There was no association between polysomnography sleep time and self-reported sleep time (r = 0.09; P = 0.6) or between the Epworth Sleepiness Scale and severity of sleep apnea (r = 0.10; P = 0.5) in the HD population.
  
  
  CONCLUSIONS
  The study was limited to participants older than 45 years.
  
  
  CONCLUSIONS
  Kidney failure treated with thrice-weekly HD is significantly associated with poor subjective and objective sleep quality.
authors.affiliation: Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA. unruh@pitt.edu
authors.forename: Mark L
authors.initials: ML
authors.lastname: Unruh
authors.forename: Mark H
authors.initials: MH
authors.lastname: Sanders
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Beth M
authors.initials: BM
authors.lastname: Piraino
authors.forename: Jason G
authors.initials: JG
authors.lastname: Umans
authors.forename: Hassan
authors.initials: H
authors.lastname: Chami
authors.forename: Rohit
authors.initials: R
authors.lastname: Budhiraja
authors.forename: Naresh M
authors.initials: NM
authors.lastname: Punjabi
authors.forename: Daniel
authors.initials: D
authors.lastname: Buysse
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D017286:Polysomnography; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires