Associations among nocturnal sleep, daytime intradialytic sleep, and mortality risk in patients on daytime conventional hemodialysis: US Renal Data System special study data

作者：Kutner Nancy^*; Zhang Rebecca; Johansen Kirsten; Bliwise Donald

来源：Hemodialysis International, 2013, 17(2): 223-229.

DOI：10.1111/hdi.12005

• Sleep
• sleep quality
• sleepiness
• hemodialysis
• mortality risk

Fragmented nocturnal sleep is commonly reported by patients undergoing daytime conventional hemodialysis (CHD) and may be associated with higher mortality risk. Subjective sleepiness during CHD is also frequently observed. We examined the association of reported sleep fragmentation and nocturnal and daytime (intradialytic) sleep durations with survival in a national cohort of 1440 CHD patients who were interviewed in 20052007 in a phone survey conducted by the US Renal Data System. Patient survival was followed through September 30, 2010 in the US Renal Data System. A total of 76% of patients reported that they typically dozed off or slept during their treatment, and intradialytic dozing was especially common among patients whose treatment shift started before 1000 hours. There was a trend for patients who reported dozing during CHD to report nocturnal sleep fragmentation (60.4% vs. 55.1%; P=0.07). With adjustment for intradialytic sleep and other covariates, nocturnal sleep fragmentation was not associated with survival. Mortality risk was higher for patients who reported sleeping 9 or more hours/night compared with the referent category of nocturnal sleep equal to 67 hours (hazard ratio: 1.50 [95% confidence interval: 1.042.17]; P=0.03). Continued investigation of the association of timing and duration of sleep with hemodialysis patient outcomes is warranted.

• 出版日期2013-4