Kidney Disease

Patients with chronic kidney disease suffer from poor sleep quality and a number of sleep disorders.

Individuals who are on Hemodialysis (HD) often get tired and sleepy during these HD days. They may sleep during HD or take long naps later during the day, therefore causing insomnia at night. Those who miss their HD sessions, will have a build-up of waste products and fluids can be uncomfortable and lead to restless sleep. Since naps might be needed in such a population, it is a good idea to keep the nap short (less than 45 minutes) and no later than 2 pm. Some dialysis clinics around the country offer HD treatment during night sleep.

Restless legs syndrome (RLS) is common in people with kidney disease and especially those on hemodialysis. RLS is an uncomfortable sensation  described as an urge to move the legs typically in the evenings or during prolonged rest. Movements and getting up to walk relieve the symptoms. They are also associated with leg jerks during sleep, known as periodic limb movements of sleep (PLMS). RLS is also associated with iron deficiency anemia, pregnancy and diabetes. Certain substances and medications can worsen RLS. They include alcohol, tobacco and medications such as ant-idopaminergic drugs (risperidal, seroquel, haldol) and certain antihistamines (benadryl) and anti nausea drugs.

Sleep apnea is also very common in individuals with kidney disease. It is important to discuss your symptoms with your doctor. Symptoms of sleep apnea include one or more of the following: snoring, restless sleep, episodes of gasps at night and daytime sleepiness. Diagnosing and treating sleep apnea in someone with kidney disease can have major effect on one’s health because sleep apnea is linked to hypertension and treatment improve blood pressure. Treatment of hypertension has direct benefit on kidney function.

Tips on improving sleep

  • If you have restless legs syndrome, talk to your doctor. You might have to see a sleep medicine specialist or neurologist to help you select the appropriate medication for RLS. Today there are numerous FDA approved medications for RLS including a 24 hour patch. In addition, the doctor needs to make sure that there are no other reasons for the RLS such as anemia or you are on medications that make it worse.
  • If you suspect sleep apnea, consult with your doctor. You might need a sleep study to diagnose it.

Reference:

–          Sleep Medicine. December 2011

–          Clinical Journal of the  American Society of Nephrology. 2011 May