Sleep problems are very common in dialysis patients. We are going to discuss three that are very common in dialysis patients:
Sleep Apnea
Restless Legs Syndrome
Insomnia
Sleep Apnea
Sleep apnea is due to a collapse of the breathing tube (which gives you snoring) or due to the absence of breathing while sleeping. This will lead to the lung not doing its job of oxygenating the blood while you are sleeping. Because of this, your brain does not get enough oxygenation and the quality of the sleep is poor. As a result, you will get up not feel refreshed and you may notice fatigue setting in later in the day. This can lead to excessive sleepiness in the afternoon and dozing off. If you have sleep apnea, it is important to have it diagnosed and treated as it can lead to stroke and heart disease. You may have sleep apnea if:
1) You snore
2) You have been told you stop breathing during sleep
3) You are often grumpy and irritable
4) You often wake up gasping for breath
5) You are overweight
6) You struggle to stay alert during the day
7) You wake up with a dry mouth
8) You have fallen asleep while driving
9) You often feel like you are in a daze
10) You have experienced vivid dreamlike scenes upon falling asleep or awakening
11) You have episodes of feeling paralyzed during sleep
12) Part of my body jerk while you are asleep
13) You have been told you kick and jerk during sleep
Sleep apnea can be diagnosed with a sleep study and treated with something called “CPAP”. If you have these symptoms,ask you doctor to refer you for a sleep evaluation
Restless Legs Syndrome
This is common in patients with kidney disease. It can be seen with pregnancy,iron defiency,caffeine and certain anti-depressant drugs as well. The symptoms usually occur when you legs are still or during sleep. It is characterized by an aching or crawling sensation in the legs which is relieved by getting up and walking around on them. Patients will also describe it as an inability to keep the legs still at night. Restless Legs Syndrome can be treated with different medications.
Insomnia
People with insomnia have trouble falling asleep or staying asleep. People with insomnia may feel sleepy during the day,depressed,moody, or have trouble concentrating.
Common causes are:
1) Stress
2) Caffeine
3) Alcohol
4) Depression
5) Changes in work schedule
6) Pain or other symptoms from health conditions
Sometimes changing sleep habits is enough to make insomnia better.. When other treatments are needed, behavioral treatments are usually better than taking medications. Behavioral therapies may take 1 to 2 months to help insomnia and need to be kept up even after the insomnia gets better.
If you have trouble sleeping,try these things:
- Do not use caffeine,alcohol and stimulant medications (including some cold and allergy medicines)
- Try to go to sleep around the same time each night and wake up around the same time each morning
- Follow a bedtime routine that helps you relax before bed (reading,listening to music,or taking a bath)
- Do not exercise or eat big meals shortly before bedtime
- Make your bedroom comfortable,quiet,dark, and do not tum on the television or computer
Your doctor may want you to fill out a sleep diary. The diary will help you keep track of when you go to bed,how long you lie in bed before falling asleep,how often you wake during the night,when you get up in the morning,and how well you sleep. Sleeping pills may only help for a short time, have side effects, and can be unsafe in some people.Sleeping pills should not be used for longer than a few days. Using them regularly can make insomnia worse.
Websites that have good information on Insomnia:
www.nhlbi.nih.gov/health/dci/Diseases/inso
www.crbestbuydrugs.org/drugreportDRsleepingpills.shtml