Circadian Rhythm, Sleep and Morbidity in Hemodialysis Patients.
Circadian Rhythm Sleep Disorders; Hemodialysis; Sleep; Mortality; Restless Legs Syndrome.
The occurrence of sleep disturbances is more common among people with chronic kidney disease relative to the general population. The causes are diverse, including kidney disease itself, factors associated with hemodialysis, comorbidities such as obesity and depression, environmental influences, and the accumulation of uremic toxins. Changes in the sleep-wake cycle in hemodialysis patients affect quality of life and may alter internal circadian rhythms. This study aims to identify whether sleep characteristics and circadian rhythm are risk factors for morbidity and mortality in hemodialysis patients. It investigates associations between cognitive decline, myocardial infarction, stroke, hospitalization and death with chronotype, dialysis shift, sleep quality, daytime sleepiness, risk of obstructive sleep apnea, restless legs syndrome, and iron or erythropoietin replacement. A prospective cohort study was conducted with 165 patients.