Kidney360
March 7, 2025
Dialysis-Imposed Patterns of Nocturnal Sleep Duration: A Multi-Center Prospective Study in Patients Using a Wearable Activity Tracker
Maggie Han, Frank M van der Sande, Jeroen P Kooman, Xia Tao, Priscila Preciado, Lela Tisdale, Ohnmar Thwin, Peter Kotanko
RESULTS109 patients contributed data (age 54±12 years, 73% males, 23% diabetic). Sleep duration was 276±91 minutes; 102 (94%) patients slept on average less than the recommended 420 minutes per night. On dialysis days, participants slept 55 (95% CI [51,59]) and 48 (95% CI [43,54]) minutes less compared to post-dialysis and 2nd interdialytic days, respectively. Early starters slept on average 40 (95% CI [6,74]) minutes less compared to late starters. On dialysis days, early starters slept 86 (95% CI [55,118]) minutes less compared to late starters. We observed greater sleep-wake disturbance in early starters. Irrespective of dialysis schedule, patients slept on average 26 (95% CI [19,33]) to 32 (95% CI [24,40]) minutes longer on Sunday. In winter, sleep was 7 (95% CI [1,13]) to 10 (95% CI [5,16]) minutes shorter. In multivariate analysis, higher blood pressure and higher serum creatinine were significantly associated with shorter sleep duration.CONCLUSIONSOn average, patients on hemodialysis slept less than the recommended amount of time. The timing of hemodialysis treatment has pronounced effects on sleep duration and could be considered in patient care.BACKGROUNDIn patients on hemodialysis, the effects of determinants of sleep duration are not widely studied. Using wearable activity trackers, we aimed to characterize natural and hemodialysis-imposed temporal patterns of nocturnal sleep.METHODSIn this yearlong prospective observational study, patients on in-center hemodialysis were equipped with activity trackers (Fitbit® Charge 2™). Nocturnal sleep duration was assessed according to dialysis start time (early starters: before 8 a.m., late starters: others), dialysis versus interdialytic days (post-dialysis day and 2nd interdialytic day), weekdays, and seasons. Clinical, laboratory, and hemodialysis treatment data were extracted from electronic medical records. Linear mixed-effects models were constructed to determine the effect of various time patterns and predictors of nocturnal sleep duration.