Kidney Disease And Sleep

What is kidney disease?

Kidney disease may impair the body's capacity to cleanse the blood, filter excess water from the blood, and regulate blood pressure. It may also impact the synthesis of red blood cells and vitamin D metabolism required for bone health. When the kidneys are compromised, waste and fluid may accumulate in the body. This might result in ankle swelling (edema), nausea, weakness, disturbed sleep, and shortness of breath. Without therapy, kidney disease may worsen, and its function can ultimately be lost. This is significant and even life-threatening. 

If kidneys abruptly cease functioning, your doctor will diagnose you with acute kidney injury or acute renal failure. The primary reasons are: 

  • Insufficient blood flow to the kidneys 
  • Damage to the kidneys directly 
  • Kidneys were blocked up with urine. 

These situations may occur when: 

  • Blood loss from a catastrophic injury, such as in a car accident 
  • You are dehydrated or your muscle tissue deteriorates, releasing an excessive amount of protein into your bloodstream 
  • You are in shock due to a serious illness known as sepsis. 
  • Have a prostate enlargement that limits urine flow. 
  • Take some medicines or are exposed to specific poisons that cause direct kidney damage 
  • Develop pregnancy-related problems, such as eclampsia and preeclampsia. 

An acute kidney damage may also be caused by autoimmune illnesses, in which the immune system damages the body. Individuals with severe heart or liver failure may develop acute renal damage. 

In the early stage of chronic kidney disease (CKD), there may be no symptoms, but the disease is easier to treat. Diabetes (types 1 and 2) and hypertension are the most prevalent causes. High blood sugar levels might cause kidney damage over time. In addition, high blood pressure causes wear and tear on blood arteries, especially those that supply the kidneys. Other circumstances include: 

  • Immune system disorders (If you have lupus-related kidney illness, your physician will refer to it as lupus nephritis.) 
  • Long-lasting viral diseases, such as HIV and AIDS, hepatitis B, and hepatitis C, are a major public health concern. 
  • Pyelonephritis is an infection of the kidneys' urinary system, when it recovers, may cause scarring. It may cause kidney damage if it occurs several times. 
  • Inflammation of the small kidney filters (glomeruli). This may occur after a streptococcal infection. 
  • The hereditary disorder polycystic kidney disease causes the formation of fluid-filled sacs in the kidneys. 

Birth defects may obstruct the urinary tract or harm the kidneys. One of the most common defects consists of a kind of valve between the bladder and urethra. Frequently, a urologist may perform surgery to correct these issues.. Drugs and poisons, such as lead poisoning, long-term use of certain pharmaceuticals, such as NSAIDs (nonsteroidal anti-inflammatory drugs) like  ibuprofen and naproxen, and intravenous drug abuse, may cause lifelong kidney damage. Likewise, prolonged exposure to some kinds of chemicals might be harmful.

Symptoms of kidney disease

In the early stages of chronic kidney disease, you may not have any symptoms, and sometimes not even in the severe stages. Most individuals do not exhibit early signs. This is risky because this might harm you without your knowledge. If the chronic kidney disease has progressed to a later stage, patients may exhibit following: 

  • Vomiting or frequently feel like they’re  going to (Nausea)
  • Pee more regularly or less often than usual 
  • Observe froth in your urine 
  • Have edema, especially in the ankles, and eye puffiness 
  • Constantly feel weary or short of breath 
  • Have no desire to eat 
  • Not be capable of tasting very well 
  • Experiencing muscular cramps, particularly in their legs 
  • Very dry and itchy skin 
  • Sleep badly 
  • Go through weight loss for no apparent cause 

A child with chronic renal illness may feel fatigued and drowsier than usual, have a diminished appetite, and not develop as predicted.

Can lack of sleep cause kidney disease?

Researchers studied the sleeping patterns of hundreds of women and discovered a correlation between insufficient sleep and a more rapid deterioration in kidney function. The researchers observed that women who slept five hours or fewer per night had a 65% higher risk of fast decrease in kidney function than women who slept seven to eight hours each night. In the last two decades, the average quantity of sleep we receive as a nation has declined, which is troubling. It is unknown if extended sleep improves kidney function or reverses the harm caused by sleep deprivation. The research can only demonstrate that decreasing kidney function is connected with a lack of sleep, not that a lack of sleep causes renal function to diminish. For this, further investigation is required. 

An association between sleep disturbances and heart disease has been explored before. A correlation between insufficient sleep and impaired kidney function might be the consequence of medical diseases that impact renal function, such as diabetes and hypertension. Diabetes and high blood pressure are both more common among those who sleep less. Diabetes and high blood pressure are two of the major variables that impair kidney function. 

The circadian clock 1 , the body's inbuilt cycles, may also play a role. Due to varying demands on the body throughout the day and night, the timing of the kidney's activity changes. Perhaps a lack of sleep alters the physiology of the kidney over the course of a day, and these alterations might be harmful to the kidney. As the population ages and more individuals develop diabetes and hypertension, the incidence of kidney disease will rise, and insufficient sleep may play a role. There is fear that sleep deprivation may diminish renal function. It is probable that the results would also apply to males, but this must be investigated. 

The research team gathered information from over 4,200 women who participated in the Nurses' Health Study. At least twice during the course of 11 years, the womens’ kidney function was evaluated. A healthy amount of sleep is seven hours. Those who sleep excessively less than that are at risk for various ailments. In terms of renal illness, it will be significant to see how this situation develops.

Chronic kidney disease and sleep problems

In comparison to the general population, around 80% of people with chronic renal disease suffer from sleep disturbances. 

Obstructive chronic apnea

In the population with CKD, obstructive sleep apnea (OSA) is a significant clinical issue. OSA is characterised by occasional partial or total blockage of the upper airway during sleep, resulting in sleep disorders, intermittent hypoxemia, and daytime drowsiness. OSA is quite prevalent in patients with end-stage renal failure, affecting an estimated fifty percent of patients. 2 It indicates that intensive dialysis treatments, such as night dialysis, reduce the incidence of apneic episodes. Also feasible is the possibility that OSA treatment might enhance kidney results.

Excessive sleeping

Excessive sleepiness (ES) is the inability to remain awake or attentive throughout the major waking events of the day, leading to unintentional slips into drowsiness or sleep. EDS is the third most common complaint among these patients and is strongly connected with an increased risk of sleep apnea. When severe daytime drowsiness is accompanied by sleep apnea and other comorbidities, it is vital to thoroughly evaluate patients' symptoms and incorporate a nighttime polysomnography as a standard test. There was a significant correlation between poor sleep quality and age, blood calcium levels, and diabetes mellitus as the underlying cause of renal failure. In the current investigation, diabetes mellitus was the second leading cause of end-stage renal disease (ESRD) and accounted for 40% of the sample. 3 

Insomnia

Insomnia and self-reported poor sleep quality are quite prevalent among CKD patients. Insufficient sleep is linked to exhaustion, drowsiness, reduced daytime performance, diminished health-related quality of life, and increased morbidity and death. Numerous illness- and treatment-related factors (metabolic changes, inflammation, altered sleep regulatory mechanisms, CKD symptoms and complications, comorbid conditions, medications, and renal replacement therapies) may interfere with sleep and contribute to the high prevalence of insomnia in this patient population. 4  Consequently, both the diagnosis and treatment of this illness are highly difficult. Despite the fact that sleep-related issues are very common for people with CKD, they are often underrecognized and undertreated. Extremely few intervention studies offer evidence to support therapy choices for this patient group. 

What can you do to sleep better

People with CKD often have difficulty getting asleep and staying asleep. Your physical and emotional health might affect your ability to sleep. These are some typical reasons of sleep disturbances in persons with renal disease: 

No more than eight hours should be allocated for sleep. At least seven hours of sleep is advised for adults in good health. The majority of individuals do not need more than eight hours of sleep to feel refreshed. Consistently go to bed and wake up, even on weekends. Consistency supports the sleep-wake cycle of the body. If you cannot fall asleep after 20 minutes of going to bed, you should leave your bedroom and engage in a calming activity. Relax by reading or listening to music. Return to bed when you are exhausted. Repeat as necessary, but keep your regular bedtime and wake-up time. 

Do not go to bed hungry or too full. Specifically, avoid eating heavy or substantial meals within two hours before night. Discomfort might keep you awake. Nicotine, coffee, and alcohol all warrant care. It takes hours for the stimulating effects of nicotine and caffeine to wear off, which might interfere with sleep. And although alcohol may induce sleepiness initially, it may disturb sleep later in the night. 

Maintain a cold, dark, and quiet environment. Evening exposure to light might make it more difficult to fall asleep. Avoid extended exposure to screens generating light before sleep. Consider using room-darkening blinds, earplugs, a fan, or other gadgets to produce a suitable setting. Before night, engaging in relaxing activities, such as taking a bath or practising relaxation methods, may encourage better sleep. 

Long naps throughout the day might disrupt nocturnal sleep. Avoid sleeping in the late afternoon and limit naps to no more than one hour. However, if you work evenings, you may require a late-afternoon nap before work to make up for lost sleep. Occasionally, CKD patients have more fatigue than normal. They often fall asleep sooner than their usual nighttime or daytime nap. If you believe that sleep might be beneficial, restrict your nap duration. Longer than one-hour naps might disturb the sleep-wake cycle. 

Regular physical exercise may improve sleep quality. However, avoid engaging in physical activity too close to sleep. Daily exposure to nature might also be beneficial. 

Inadequate dialysis clearance leads to a buildup of waste in the blood, which may cause illness and discomfort. This might make it tough to sleep. If you are undergoing peritoneal dialysis (PD), your doctor will periodically test your dialysate to ensure that it is removing sufficient waste and toxins from your body. Patients who rely on Continuous Cycler-Assisted PD or Nocturnal Intermittent PD may discover that the noise of the cycler disturbs their sleep. Numerous patients adapt to the noises. However, if you are losing sleep as a result of this therapy, speak with your doctor about alternatives. 

Worry, stress, and melancholy emotions may keep a person up at night. Try to address your issues or anxieties before going to bed. Write down your thoughts and lay them away for tomorrow. Stress management could assist. Start with the fundamentals, such as organisation, identifying priorities, and work delegation. Meditation may also reduce anxiety.

Summary

Kidney disease may impair the body's capacity to cleanse the blood and filter excess water from the blood. It may also impact the synthesis of red blood cells and the vitamin D metabolism required for bone health. If the kidneys abruptly cease functioning, your doctor will diagnose you with acute kidney injury or acute renal failure. In the early stages of chronic kidney disease, there may be no symptoms. Diabetes (types 1 and 2) and hypertension are the most prevalent causes. Exposure to some kinds of chemicals might be harmful to the kidneys.

References

  1. Calero K, Anderson W. Can Poor Sleep Cause Kidney Disease? Another Step Closer to the Answer. Journal of Clinical Sleep Medicine. 2019;15(03):371-372.
  2. Adeseun G, Rosas S. The Impact of Obstructive Sleep Apnea on Chronic Kidney Disease. Current Hypertension Reports. 2010;12(5):378-383.
  3. Lindner A, Novak M, Bohra M, Mucsi I. Insomnia in Patients With Chronic Kidney Disease. Seminars in Nephrology. 2015;35(4):359-372.
  4. Fonsêca N, Santos I, Fernandes V, Fernandes V, Lopes V, Luis V. Excessive daytime sleepiness in patients with chronic kidney disease undergone hemodialysis. Fisioterapia em Movimento. 2014;27(4):653-660

Sara Maria Majernikova

Bachelor of Science - BSc, Biomedical Sciences: Drug Mechanisms, UCL (University College London)
Experienced as a Research Intern at Department of Health Psychology and Methodology Research, Faculty of Medicine, Laboratory Intern at Department of Medical Biology, Faculty Medicine Biomedical Sciences Research Intern and Pharmacology Research Intern.

my.klarity.health presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles. 
Email:
Klarity / Managed Self Ltd
Alum House
5 Alum Chine Road
Westbourne Bournemouth BH4 8DT
VAT Number: 362 5758 74
Company Number: 10696687

Phone Number:

 +44 20 3239 9818