ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1112

Sleep Patterns and Mortality Risk in a Prospective Hemodialysis Cohort

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • You, Amy Seung, University of California Irvine, Irvine, California, United States
  • Kalantar, Sara S., University of California Irvine, Irvine, California, United States
  • Ferrey, Antoney Joseph, University of California Irvine, Irvine, California, United States
  • Molnar, Miklos Zsolt, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Fischman, Ronald A., Southland Renal Associates, Long Beach, California, United States
  • Fischman, Michael Alan, Southland Renal Associates, Long Beach, California, United States
  • Semerjian, Avedik, Southland Renal Associates, Long Beach, California, United States
  • Guerrero, Yalitzi, University of California Irvine, Irvine, California, United States
  • Nakata, Tracy, University of California Irvine, Irvine, California, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Nguyen, Danh V., University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine, Irvine, California, United States
Background

While sleep disorders are common in hemodialysis (HD) patients, the association of sleep patterns and mortality remains uncertain. We sought to examine the association of sleep patterns with survival in a prospective HD cohort.

Methods

Among 452 HD patients from the prospective Malnutrition, Diet, and Racial Disparities in Chronic Kidney Disease study, we examined the association between sleep patterns and mortality. Patients underwent protocolized self-reported sleep questionnaires over 3/2014-6/2019. We examined associations of baseline sleep patterns with all-cause mortality using Cox regression adjusted for expanded case-mix covariates.

Results

In the overall cohort, the median (IQR) sleep duration was 6.0 (4.5, 8.0) hours vs. 7.0 (5.0, 8.0) hours on dialysis vs. non-dialysis days, respectively. In analyses examining the association of sleep duration with survival on dialysis days, patients with shorter sleep duration (defined as ≤median) had higher mortality (ref: longer sleep duration >median): adjusted HR (aHR) (95%CI) 1.59 (1.09, 2.31) (Fig 1A). Similar findings were observed for patients with shorter sleep duration (defined as ≤median sleep duration) on non-dialysis days (ref: longer sleep duration >median): aHR (95%CI) 1.51 (1.04, 2.19). When surveying patients with regards to having difficulty sleeping at night, those who reported a high frequency (often to almost always) had higher death risk (ref: never/rarely to sometimes): aHR (95%CI) 1.74 (1.17, 2.58). Upon surveying patients with respect to use of sleeping pills, those who reported moderate (sometimes) to frequent use (often/almost always) had higher mortality (ref: never/rare use): aHRs 2.07 (1.08, 3.97) and 2.00 (1.22, 3.28), respectively (Fig 1B).

Conclusion

In HD patients, shorter sleep duration, frequent sleeping difficulty, and moderate to frequent use of sleeping pills were associated with higher mortality risk. Future studies are needed to determine if interventions that improve sleeping patterns increase survival in this population.

Funding

  • NIDDK Support