A lot of the body’s maintenance chores, as well as healing processes, occur while we’re sleeping. Unfortunately, people with chronic kidney disease (CKD) often have trouble falling asleep and staying asleep. Both physical discomfort and psychological stress can contribute to this. Here, DaVita Kidney Care shares some common causes for disrupted sleep patterns in people with moderate to advanced CKD, along with tips for getting better rest.*

Causes of sleep challenges with CKD

There are a variety of reasons why someone with CKD might experience difficulties with getting sufficient sleep and/or good quality sleep. Some common causes of sleep problems are:

• Restless leg syndrome (RLS). RLS is when you have uncomfortable sensations of itching, pain, or irritation in your legs when you’re just sitting or lying down. Moving your legs may reduce these symptoms. Contributing factors to RLS can include:
  • Alcohol, caffeine, and/or nicotine
  • Medications (e.g. anti-nausea, antipsychotic, antidepressant, antihistamine)
  • Diabetes
  • Iron deficiency
• Obstructive sleep apnea (OSA). Sleep apnea is when your breathing stops for more than 10 seconds while you’re sleeping. This may happen multiple times during a deep sleep. OSA is associated with kidney function decline. Fluid retention, which is common in advanced CKD (particularly in the end stage) can also contribute to OSA.
• Inadequate dialysis. If your dialysis treatments aren’t clearing wastes from your blood sufficiently, the resulting waste buildup can make you feel ill and interfere with your sleep.
• Stress. Emotional stress from fear, anger, depression, or grief, can literally keep you up at night. Worries about the future, the loss of health, lifestyle, or dreams, and other deeply-felt concerns can easily prevent you from getting quality rest. 
• Caffeine consumption. Being a stimulant, caffeine can keep you awake past your bedtime, particularly if you have it after around 3 pm, as its effects can last for several hours. Caffeine is present in coffee (even decaf), many teas, sodas (especially colas), energy drinks, and chocolate.
• Machine noises. People on peritoneal dialysis may find that the intermittent cycler noises wake them up, though many grow accustomed to the sound over time.

How to fall asleep and stay asleep

If you’re having difficulty falling or staying asleep, you can try: 

• Exercising during the day 
• Training your body for sleep by setting and maintaining a regular bedtime and wake up time 
• Limiting your daytime naps to no more than an hour 
• Reducing your alcohol, caffeine, and nicotine/tobacco consumption, especially after 3 pm
• Devising a relaxing pre-bedtime routine to tell to your body and brain that you’re winding down
• Arranging your bedroom in a comfortable manner that’s conducive to sleep, including adjusting the temperature, using darkening shades on the windows, and ridding the room of noisy devices
• Getting a mattress that supports you, and using more comfortable bedding

Speak with your doctor if you have trouble sleeping for a week or more. Medications can sometimes be adjusted, and helping you get better rest can be incorporated into your overall CKD treatment plan. 

*DaVita Kidney Care. (n.d.) Sleep Issues and Chronic Kidney Disease. https://www.davita.com/education/ckd-life/lifestyle-changes/sleep-issues-and-chronic-kidney-disease#:~ 

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