Sleep disturbances are much more prevalent in the dialysis population than in the general population, and have a major effect on the vitality and general health of these patients. In this Review, Koch and colleagues discuss circadian sleep–wake rhythm disturbances in individuals with end-stage renal disease. The possible external and internal influences on sleep–wake rhythmicity in such patients—such as the effect of dialysis, medications, melatonin and biochemical parameters—are presented, and possible approaches for strengthening the synchronization of the circadian sleep–wake rhythm are explored.
- Birgit C. P. Koch
- J. Elsbeth Nagtegaal
- Piet M. ter Wee