Sleep plays a vital role in overall health, yet for patients with chronic kidney disease (CKD) or end-stage kidney disease (ESKD), achieving restful sleep
can be a constant battle. Conditions like Restless Legs Syndrome (RLS), sleep apnea, and nocturia further disrupt rest, leading to cycles of fatigue,
diminished appetite, and muscle loss.
As clinicians in dialysis settings, it’s important to recognize the profound connection between sleep disturbances, malnutrition, and overall health.
By addressing these interconnected challenges, we can empower patients to improve their well-being and quality of life.
Amongst many things, sleep deprivation increases the risk of cardiovascular issues, worsens glucose regulation, and it also weakens the immune system, making infections more likely.
For CKD and ESRD patients, poor sleep can also exacerbate malnutrition, a challenge that many already face.
The connection between sleep and nutrition is intertwined. Chronic sleep deprivation disrupts hormone levels, increasing cravings for unhealthy foods while reducing the body’s ability to process and utilize nutrients effectively. For dialysis patients at risk of protein-energy wasting (PEW), this can lead to significant declines in muscle mass and albumin levels, which are key indicators of nutritional status and overall health.
Clinicians play a vital role in helping patients make connections between sleep, nutrition, and health. During patient appointments, consider discussing these actionable strategies:
Encourage patients to establish consistent sleep and wake times to regulate their internal clocks.
Discuss the timing and quality of their meals, emphasizing the importance of adequate protein intake to maintain muscle and albumin levels.
For evening meals, a focus on protein can enhance sleep quality, while reducing high-sodium and high-sugar foods can support both sleep
and kidney function.
Advocate for a screen-free wind-down period: Blue light exposure from phones, TVs, or tablets can suppress melatonin production and delay sleep onset. Suggest patients turn off screens at least 30 minutes before bed and replace this time with calming activities like reading or gentle stretches.
Highlight the connection between malnutrition and sleep disturbances, explaining how poor nutrition contributes to fatigue and restless nights.
Provide resources, like dietary logs or apps, to help patients track their intake and identify areas for improvement.
Patients should also be encouraged to limit caffeine in the afternoon, reduce evening fluid intake to manage nocturia, and avoid alcohol, which disrupts deeper sleep stages.
For dialysis patients struggling to meet their nutritional needs due to poor appetite or other factors, advanced nutritional interventions like Intradialytic Parenteral Nutrition (IDPN) or Intraperitoneal Nutrition (IPN) can offer significant benefits. These therapies provide essential nutrients directly during dialysis sessions, helping to stabilize albumin levels, potentially supporting better sleep patterns.
Supporting patients in achieving both better sleep and adequate nutrition requires a holistic approach. Encourage open conversations about sleep
and its effects on health during appointments, emphasizing how restorative sleep can improve energy, mood, and physical outcomes.
For more resources on addressing sleep, nutrition, and fluid management, log in to our clinician portal: pcacorp.com.
We thank our guest blogger Adriana Ball, Marketing Director, for sharing her knowledge and writing this blog post!
