The effect of extended hours dialysis on sleep quality in a randomised trial

Liao, Jin-Lan, van den Broek-Best, Oliver, Smyth, Brendan, Hong, Daqing, Vo, Kha, Zuo, Li, Gray, Nicholas A., Chan, Christopher T., de Zoysa, Janak, Perkovic, Vlado, Jiang, Lei and Jardine, Meg (2018) The effect of extended hours dialysis on sleep quality in a randomised trial. Nephrology, . doi:10.1111/nep.13236


Author Liao, Jin-Lan
van den Broek-Best, Oliver
Smyth, Brendan
Hong, Daqing
Vo, Kha
Zuo, Li
Gray, Nicholas A.
Chan, Christopher T.
de Zoysa, Janak
Perkovic, Vlado
Jiang, Lei
Jardine, Meg
Title The effect of extended hours dialysis on sleep quality in a randomised trial
Journal name Nephrology   Check publisher's open access policy
ISSN 1440-1797
1320-5358
Publication date 2018-02-09
Sub-type Article (original research)
DOI 10.1111/nep.13236
Open Access Status Not yet assessed
Total pages 24
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Abstract Poor sleep quality is common in haemodialysis patients and associated with worse outcomes. In this pre-specified analysis, we examined the impact of extended hours haemodialysis on sleep quality.

The ACTIVE Dialysis trial randomized 200 participants to extended (≥24 hours/week) or standard (target 12-15 hours) hours haemodialysis over 12 months. Sleep quality was measured in the Kidney Disease Quality of Life Short Form 1.3 (KDQOL-SF) by overall sleep quality score (0-10, 10 = "very good") and the sleep subscale (0-100, 100 = 'best possible sleep') every three months via blinded telephone interviewer. The average intervention effect was calculated by mixed linear regression adjusted by time point and baseline score. Factors predicting sleep quality were assessed by multivariate regression analysis.

Overall sleep quality score and sleep subscale at baseline were similar in both groups (5.9 [95%CI 5.4-6.4] vs 6.3 [5.9-6.8]; 65.0 [60.9-69.1] vs 63.2 [59.1-67.3]; extended and standard hours respectively). Extended hours haemodialysis led to a non-significant improvement in overall sleep quality score (average intervention effect 0.44 (-0.01-0.89), p=0.053) and sleep subscale (average intervention effect 3.58 (-0.02-7.18), p= 0.051). Poor sleep quality was associated with being female and with current smoking. Sleep quality was positively associated with EuroQol-5D (EQ5D) and the SF-36 Physical Component and Mental Component Summary Scores but not with hospitalisations.

Sleep quality was not significantly improved by extended hours dialysis in this study. Sleep quality is positively correlated with quality of life in haemodialysis patients and is poorer in women and current smokers.
Formatted abstract
Background: Poor sleep quality is common in haemodialysis patients and associated with worse outcomes. In this pre-specified analysis, we examined the impact of extended hours haemodialysis on sleep quality.

Methods: The ACTIVE Dialysis trial randomized 200 participants to extended (≥24 hours/week) or standard (target 12-15 hours) hours haemodialysis over 12 months. Sleep quality was measured in the Kidney Disease Quality of Life Short Form 1.3 (KDQOL-SF) by overall sleep quality score (0-10, 10 = “very good”) and the sleep subscale (0-100, 100 = ‘best possible sleep’) every three months via blinded telephone interviewer. The average intervention effect was calculated by mixed linear regression adjusted by time point and baseline score. Factors predicting sleep quality were assessed by multivariate regression analysis.

Results: Overall sleep quality score and sleep subscale at baseline were similar in both groups (5.9 [95%CI 5.4-6.4] vs 6.3 [5.9-6.8]; 65.0 [60.9-69.1] vs 63.2 [59.1-67.3]; extended and standard hours respectively). Extended hours haemodialysis led to a non-significant improvement in overall sleep quality score (average intervention effect 0.44 (-0.01-0.89), p=0.053) and sleep subscale (average intervention effect 3.58 (-0.02-7.18), p= 0.051). Poor sleep quality was associated with being female and with current smoking. Sleep quality was positively associated with EuroQol-5D (EQ5D) and the SF-36 Physical Component and Mental Component Summary Scores but not with hospitalisations.

Conclusions: Sleep quality was not significantly improved by extended hours dialysis in this study. Sleep quality is positively correlated with quality of life in haemodialysis patients and is poorer in women and current smokers.
Keyword Health status
Quality of life
Randomized controlled trial
Renal dialysis
Sleep
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: eSpace Followup
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Created: Wed, 14 Feb 2018, 11:04:03 EST