Sleep Problems and Dialysis Patients: Causes and Practical Relief Tips

Why Sleep Problems Are Common in Dialysis Patients

Sleep problems and dialysis are nowadays common as kidney failures disrupt the neural processes, cardiovascular functions and hormonal actions that control sleep. Recent reports suggest that insomnia is a critical condition, as 60.9% of patients in India are affected by it while on maintenance dialysis ^[1].

Here are some of the prominent factors that lead to sleep disorders in dialysis patients​:

• Body-clock disruption: Your sleep cycle may be affected by early-morning and late-evening slots. Moreover, excessive travel times and longer dialysis sessions also negatively impact your sleep schedule.
• Breathing Issues During Dialysis: Shifts in fluid balance and other factors can lead to sleep apnoea, a common concern for most dialysis patients. Your body may experience daytime tiredness, disrupting your regular lifestyle.
• Stress Load: Sleep quality gets hindered due to anxiety and low mood, which worsens your working potential.
• Leg Discomfort: Restless-leg syndrome and uraemic itch are common factors that contribute to kidney disease. In such conditions, the sleep cycle is heavily affected.

Now, with a clear overview of the sleeping issues you can have during dialysis, let’s explore some of the prominent causes for such a condition.

Most Common Causes of Sleep Problems in Dialysis

Sleep problems and dialysis are correlated, and sleep-related symptoms in most cases are underdiagnosed and undertreated because of a lack of routine assessment and limitations in patient interactions. Moreover, sleep disorders are a common phenomenon for patients with end-stage renal dialysis (ESRD), with 49% of people facing difficulty while sleeping during dialysis ^[2].

Let’s see what are the most common causes of sleep problems during dialysis patient care:

1. Restless Leg Syndrome

Restless leg syndrome (RLS) is a condition that occurs when the legs rest, and at times during sitting and lying in bed. The sensation in almost all cases varies from patient to patient and is often characterised by an itchy, painful feeling.

Some patients report that maintaining leg movements reduces uncomfortable feelings.

2. Sleep Apnea

It is a critical condition and leads to interruption in breathing for up to 10 seconds while you are on deep slumber. Such non-breathing intervals are known as apneas. Snoring is exponentially increased among such patients and is an involuntary action of the body to grasp air.

3. Uraemic itching

Uremic pruritus is caused by chronic kidney failure. It is common among patients receiving hemodialysis. It is characterised by continuous itching linked to kidney failure, which often worsens at night and can repeatedly disrupt sleep. Moreover, other

4. Toxin Fluctuations & Inadequate Clearance

Excessive waste buildup is a critical issue that can lead to severe conditions and disrupt sleep cycles. If you are undergoing peritoneal dialysis, your doctor must check your dialysate to ensure it is effectively removing toxins from your body.

Also read: Kidney Failure Treatments: A Complete Patient Guide

How Dialysis Treatment Can Disrupt Normal Sleep

Dialysis, in some cases disrupt regular sleep schedules by changing how the body regulates hormones, temperature, and nervous system activity around treatment days.

• Melatonin rhythm disruption: Dialysis alters melatonin secretion, a hormone essential for sleep timing, leading to delayed sleep onset and lighter sleep.
• Inflammatory response after dialysis: Dialysis can trigger short-term inflammatory changes in the body, which may cause restlessness, body aches, or a feeling of unease that interferes with nighttime sleep.
• Core body temperature changes: Rapid blood cleansing during haemodialysis can affect body temperature regulation, making it harder for the body to reach the cooler state needed for deep sleep.
• Sensory overstimulation during dialysis sessions: Excessive noise, lights, alarms, and other conditions can overstimulate the nervous system, reducing the ability to relax later at night.
• Irregular weekly treatment patterns: Alternating dialysis and non-dialysis days create inconsistent physical recovery cycles, which prevent the body from settling into a stable sleep routine.

Also read: SLED Dialysis: A Hybrid Approach to Kidney Failure Treatment

Practical Tips to Overcome Sleep Problems in Dialysis Patients

Sleep problems and dialysis are closely linked, but structured medical and lifestyle interventions can significantly improve sleep quality. However, a study suggested that only 46% patients with sleeping difficulties undergoing dialysis adhered to medications, indicating lower acceptance of medical care ^[3].

Despite this negative correlation, here are some practical strategies you can use to maintain a healthy sleep cycle if you are on dialysis.

• Screen for sleep-specific conditions: Conditions such as sleep apnoea and restless legs syndrome are common in dialysis patients and require targeted medical treatment rather than general sleep advice.
• Optimise fluid removal targets: Improper dry-weight settings can cause night-time breathlessness or cramps, so regular reassessment helps reduce sleep disruption.
• Review evening medication timing: Some blood pressure or phosphate medicines can interfere with sleep; adjusting timing under medical guidance can improve night rest.
• Manage daytime naps carefully: Long or late naps after dialysis sessions can delay nighttime sleep; short, early naps work better for sleep recovery.
• Use relaxation techniques before bed: Gentle breathing exercises or guided relaxation can reduce dialysis-related stress and improve sleep onset.

When to Consult Dialysis Centres Near You

If sleep problems and dialysis continue despite major changes, it is critical to take medical review at a specialised dialysis facility. At Eskag Sanjeevani Dialysis, our centres focus on isolating dialysis-related causes of poor sleep, such as fluid imbalance, treatment timing, or underlying medical conditions.

Early consultation helps ensure that dialysis schedules, patient care plans, and supportive treatments are adjusted to improve both sleep quality and overall health.