Cargando…

Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial

BACKGROUND: Sleep disturbance is common among chronic haemodialysis patients, which leads to poor quality of life, in addition to increased instances of morbidity and mortality. Hypervolemia has been linked to sleep problems observed in chronic haemodialysis patients, which suggests that optimising...

Descripción completa

Detalles Bibliográficos
Autores principales: Sethakarun, Sethanant, Bijaphala, Sutachard, Kitiyakara, Chagriya, Boongird, Sarinya, Phanachet, Pariya, Reutrakul, Sirimon, Pirojsakul, Kwanchai, Nongnuch, Arkom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717999/
https://www.ncbi.nlm.nih.gov/pubmed/31474223
http://dx.doi.org/10.1186/s12882-019-1405-z
_version_ 1783447660114477056
author Sethakarun, Sethanant
Bijaphala, Sutachard
Kitiyakara, Chagriya
Boongird, Sarinya
Phanachet, Pariya
Reutrakul, Sirimon
Pirojsakul, Kwanchai
Nongnuch, Arkom
author_facet Sethakarun, Sethanant
Bijaphala, Sutachard
Kitiyakara, Chagriya
Boongird, Sarinya
Phanachet, Pariya
Reutrakul, Sirimon
Pirojsakul, Kwanchai
Nongnuch, Arkom
author_sort Sethakarun, Sethanant
collection PubMed
description BACKGROUND: Sleep disturbance is common among chronic haemodialysis patients, which leads to poor quality of life, in addition to increased instances of morbidity and mortality. Hypervolemia has been linked to sleep problems observed in chronic haemodialysis patients, which suggests that optimising one’s fluid status could improve the sleep quality of this patient group. In our study, we subjectively examined and objectively measured sleep parameters, using actigraphy recordings, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Epworth Sleepiness Scale (ESS), in order to compare bioelectrical impedance analysis (BIA)-guided and standard clinical-guided dry weight adjustment. METHODS: We randomly selected 19 chronic haemodialysis patients with subclinical hypervolemia, defined as a clinically euvolemic status, despite the ratio of extracellular water to total body water being more than 0.4 in BIA. Furthermore, these patients, who were poor sleepers (PSQI > 5), were assigned to either a BIA-guided dry weight group (BIA group) or a standard clinical-guided one (clinical group). The primary outcome was changes in sleep actigraphy parameters between the groups at 1, 3, and 6 months. Changes observed in the PSQI and ESS score between the two groups over the same period of time were the secondary endpoints. RESULTS: The mean age of the participants was 63.53 ± 11.12 years, and 42% of them were male. All sleep parameters measured by means of actigraphy were not significantly different between the two groups. Interestingly, at 3 and 6 months, the subjective sleep quality significantly improved in the BIA group, as reflected by a greater decline in the PSQI score, in comparison with the clinical group (3 months: mean difference − 1.82 [− 3.13 to − 0.51], P = 0.006; 6 months: mean difference − 3.16 [− 4.49 to − 1.83], P <  0.001). However, sleepiness assessed by the ESS was not significantly different between the groups throughout the study. CONCLUSIONS: Optimisation of the fluid status by employing BIA did not improves sleep actigraphy parameter, however, it significantly ameliorates the subjective sleep quality of chronic haemodialysis patients. This observation should be further explored in larger samples and longer clinical trials. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (NCT02825589) on July 7, 2016. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-019-1405-z) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6717999
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-67179992019-09-06 Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial Sethakarun, Sethanant Bijaphala, Sutachard Kitiyakara, Chagriya Boongird, Sarinya Phanachet, Pariya Reutrakul, Sirimon Pirojsakul, Kwanchai Nongnuch, Arkom BMC Nephrol Research Article BACKGROUND: Sleep disturbance is common among chronic haemodialysis patients, which leads to poor quality of life, in addition to increased instances of morbidity and mortality. Hypervolemia has been linked to sleep problems observed in chronic haemodialysis patients, which suggests that optimising one’s fluid status could improve the sleep quality of this patient group. In our study, we subjectively examined and objectively measured sleep parameters, using actigraphy recordings, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Epworth Sleepiness Scale (ESS), in order to compare bioelectrical impedance analysis (BIA)-guided and standard clinical-guided dry weight adjustment. METHODS: We randomly selected 19 chronic haemodialysis patients with subclinical hypervolemia, defined as a clinically euvolemic status, despite the ratio of extracellular water to total body water being more than 0.4 in BIA. Furthermore, these patients, who were poor sleepers (PSQI > 5), were assigned to either a BIA-guided dry weight group (BIA group) or a standard clinical-guided one (clinical group). The primary outcome was changes in sleep actigraphy parameters between the groups at 1, 3, and 6 months. Changes observed in the PSQI and ESS score between the two groups over the same period of time were the secondary endpoints. RESULTS: The mean age of the participants was 63.53 ± 11.12 years, and 42% of them were male. All sleep parameters measured by means of actigraphy were not significantly different between the two groups. Interestingly, at 3 and 6 months, the subjective sleep quality significantly improved in the BIA group, as reflected by a greater decline in the PSQI score, in comparison with the clinical group (3 months: mean difference − 1.82 [− 3.13 to − 0.51], P = 0.006; 6 months: mean difference − 3.16 [− 4.49 to − 1.83], P <  0.001). However, sleepiness assessed by the ESS was not significantly different between the groups throughout the study. CONCLUSIONS: Optimisation of the fluid status by employing BIA did not improves sleep actigraphy parameter, however, it significantly ameliorates the subjective sleep quality of chronic haemodialysis patients. This observation should be further explored in larger samples and longer clinical trials. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (NCT02825589) on July 7, 2016. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-019-1405-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-02 /pmc/articles/PMC6717999/ /pubmed/31474223 http://dx.doi.org/10.1186/s12882-019-1405-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Sethakarun, Sethanant
Bijaphala, Sutachard
Kitiyakara, Chagriya
Boongird, Sarinya
Phanachet, Pariya
Reutrakul, Sirimon
Pirojsakul, Kwanchai
Nongnuch, Arkom
Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title_full Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title_fullStr Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title_full_unstemmed Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title_short Effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (BEDTIME study): a randomised controlled trial
title_sort effect of bioelectrical impedance analysis-guided dry weight adjustment, in comparison to standard clinical-guided, on the sleep quality of chronic haemodialysis patients (bedtime study): a randomised controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717999/
https://www.ncbi.nlm.nih.gov/pubmed/31474223
http://dx.doi.org/10.1186/s12882-019-1405-z
work_keys_str_mv AT sethakarunsethanant effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT bijaphalasutachard effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT kitiyakarachagriya effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT boongirdsarinya effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT phanachetpariya effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT reutrakulsirimon effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT pirojsakulkwanchai effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial
AT nongnucharkom effectofbioelectricalimpedanceanalysisguideddryweightadjustmentincomparisontostandardclinicalguidedonthesleepqualityofchronichaemodialysispatientsbedtimestudyarandomisedcontrolledtrial