| Title | Effects of nocturnal hemodialysis on melatonin rhythm and sleep-wake behavior: an uncontrolled trial. | | Author(s) | Koch BC, Hagen EC, Nagtegaal JE, Boringa JB, Kerkhof GA, Ter Wee PM | | Institution | Department of Clinical Pharmacy, Meander Medical Center, Amersfoort, The Netherlands. bcp.koch@meandermc.nl | | Source | Am J Kidney Dis 2009 Apr; 53(4):658-64. | | MeSH | Adult
Aged
Aged, 80 and over
Circadian Rhythm
Female
Health Surveys
Humans
Kidney Failure, Chronic
Male
Melatonin
Middle Aged
Polysomnography
Renal Dialysis
Salvia
Sleep
Treatment Outcome
Wakefulness
| | Abstract | End-stage renal disease and its treatment are associated with sleep disturbances such as deterioration of the circadian sleep-wake pattern. Melatonin rhythm, which has an important role in this pattern, is disturbed. The nocturnal melatonin surge is absent in this population. Whether nocturnal in-center hemodialysis changes melatonin and sleep-wake rhythms is unknown.A nonrandomized uncontrolled trial. Patients served as their own controls.Thirteen daytime hemodialysis patients (median age, 58 years; 5 women) from our hospital receiving conventional daytime hemodialysis 3 times weekly for 3 to 4 hours each session.Six months of treatment with nocturnal in-center dialysis 4 nights/wk with 8-hour sessions.At baseline, while still on conventional hemodialysis therapy, polysomnography was performed, sleep questionnaires were filled out, and melatonin concentration in saliva was obtained. After 6 months of in-center nocturnal hemodialysis, all measurements were repeated.After 6 months of in-center nocturnal hemodialysis, polysomnography showed significant improvements in sleep efficiency (P = 0.05) and stage 3/4 sleep (P = 0.03) in comparison to t = 0. Trends in improvement of rapid-eye-movement sleep, awake time, and oxygen saturation were seen after 6 months of in-center nocturnal hemodialysis therapy. Sleep questionnaires showed a trend in improved sleep quality and daytime function. Patients were less exhausted during the daytime. The nocturnal melatonin surge was partially restored.Small sample size and a nonrandomized uncontrolled study design.Patients after 6 months of in-center nocturnal hemodialysis had significant improvements in subjective and objective sleep parameters and partially restored nocturnal melatonin rhythm. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 18950916 |
|
