Incidence of sleep pattern disturbance in a peritoneal dialysis sample

Our experience and the research literature suggest that sleep pattern disturbance (SPD) is a problem among dialysis patients. The purpose of this study was to describe the scope of sleep problems among willing patients on peritoneal dialysis at a mid-size university teaching hospital. To examine SPD, this descriptive study used a sleep diary that patients completed each morning for a week. Patients were asked to describe sleep latency, perceived difficulty falling asleep, number of arousals, use of sedatives, whether they awoke feeling rested, sleep efficiency, and factors preventing or inducing sleep. The sample consisted of 22 respondents whose average age was 60.5 years. With respect to the variables included in the sleep diary, respondents reported: 82% sleep latency of 40 minutes or less; of 154 nights studied, difficulty falling asleep on 41 (27%) of the nights; 82% experience of 15 or fewer sleep arousals per week (that is, approximately 2 arousals per night); 64% no use of sedatives during the week; 55% experience of feeling rested on awakening 5 or more mornings per week; and 55% experience of sleep efficiency above 80%. Of the factors reported to interfere with sleep, treatment-related factors such as alarms and other machine-related problems were, by far, the most predominant, reported by 82% of respondents. These findings compare very favorably with reports in the literature noting the incidence of SPD among dialysis patients to be as high as 73%. Information regarding factors that are barriers or facilitators to sleep have formed the basis of some practice changes within our program to address this distressing problem.