Short and Long Term Effectiveness of Existing Insomnia Therapies for Patients Undergoing HD

In-center Hemodialysis

Short and Long-Term Effectiveness of Existing Insomnia Therapies for Patients Undergoing Hemodialysis

Dialysis and Quality of Life

Today, more than 400,000 patients in the United States treat their kidney failure, or end-stage renal disease (ESRD), with hemodialysis. These patients face many challenges, resulting in a significantly lower quality of life. Most attend four-hour dialysis sessions three times a week, follow a strict, low-salt diet, take an average of 17 pills every day, have other medical conditions, and frequently transition between receiving care in the dialysis facility and the hospital.

Dialysis and Sleep Problems

Many patients on dialysis experience significant sleep problems, including difficulty falling asleep, waking at night, and early morning awakening. Two factors contribute sleep problems in patients on dialysis - day/night sleep reversal, a problem caused by toxins that build in patients with kidney failure, and the unpredictable consequences of hemodialysis schedules that make maintaining regular sleep/wake routines challenging. Insomnia contributes to poor health outcomes for dialysis patients and is strongly associated with daytime sleepiness, fatigue, pain, and depression. Dialysis patients and their caregivers rank sleep, fatigue, and anxiety/stress among the top 10 most important outcomes for clinical trials.

SLEEP-HD: Evaluating treatments for insomnia

The SLEEP-HD study is the first randomized, controlled clinical trial among adult hemodialysis patients that will evaluate two ways to treat insomnia, with the aim that its results would help clinicians make more informed decisions about treatment.

It will compare the effectiveness of two different treatment methods-- Cognitive Behavioral Therapy for Insomnia (CBT-I) and drug therapy--in patients in Seattle and Albuquerque.