Sleep and activity in chronic kidney disease: A longitudinal study

Rajiv Agarwal, Robert P. Light

Research output: Contribution to journalArticle

38 Scopus citations


Background and objectives Commonly sleep is disrupted and physical activity is restricted among patientswith CKD and those on long-term dialysis. However, few studies have assessed patients longitudinally.Design, setting, participants, & measurements We compared the prevalence of sleep disturbances measuredboth subjectively using a questionnaire and objectively using actimetry among patients with CKD (n = 145), those on hemodialysis (n = 116), and people without kidney disease (n = 19). Activity level duringthe day was measured using actimetry, and patients were then followed for up to 2 years.Results Compared with people without kidney disease, patients with CKD not on dialysis had disruption ofsleep that was independent of several risk factors. However, disrupted sleep was correlated with neitherestimated GFR in cross-sectional nor longitudinal assessment. Those on hemodialysis had sleep disruptionthat was of much greater severity than that found among those with CKD not on dialysis. Furthermore,missing or shortening the prescribed duration of dialysis was associated with greater severity of sleep disturbancein cross-sectional but not in longitudinal assessment. Day-time activity declined both in durationand intensity from controls to CKD to hemodialysis.Conclusions The loss of kidney function is related to both reduced duration and intensity of day time physicalactivity. Although patients with CKD have disrupted sleep, this is independent of estimated GFR.However, compared with those with CKD, dialysis patients have more severely disrupted sleep; this is relatedto missing dialysis. Thus, shortening patients' dialysis may reduce their sleep.

Original languageEnglish (US)
Pages (from-to)1258-1265
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Issue number6
StatePublished - Jun 1 2011

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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