{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:16:55Z","timestamp":1784067415211,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,6,27]],"date-time":"2016-06-27T00:00:00Z","timestamp":1466985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction:<\/jats:bold>Previous studies of patients with end\u2010stage renal disease have examined the role of fluid shifts on apnea\u2010hypopnea episodes, but the association between volume overload and patient\u2010reported sleep quality or duration has not been well\u2010established.<jats:bold>Methods:<\/jats:bold>We studied the association between predialysis bioimpedance spectroscopy\u2010derived volume estimates and self\u2010reported sleep quality and duration in 638 patients in the United States Renal Data System ACTIVE\/ADIPOSE study receiving hemodialysis from 2009 to 2011. We used questionnaires to assess self\u2010reported sleep duration and quality. We used relative hydration status (fluid overload\/extracellular water; FO\/ECW) as the primary predictor and examined associations with hours of sleep duration using linear regression. We used multivariable ordinal logistic regression to determine the association between categories of relative hydration status (normal hydration [FO\/ECW\u2009&lt;\u20096.8%], mild overhydration [FO\/ECW 6.8%\u201315%], and hyperhydration [FO\/ECW\u2009&gt;\u200915%]) and four levels of difficulty with falling asleep, waking, and returning to sleep.<jats:bold>Findings:<\/jats:bold>Higher relative hydration status was associated with fewer hours of sleep (\u22120.31 hours per 10%, 95% confidence interval (CI) \u22120.49 to \u22120.13). Compared to the normal hydration group, there was a statistically significant association between higher relative hydration status category and more frequent nighttime waking (OR: mild overhydration 1.92 [95% CI 1.23\u20132.99], hyperhydration 1.87 [95% CI 1.16\u20132.99]), a trend toward more difficulty returning to sleep (OR: mild overhydration 1.46 [95% CI 0.94\u20132.27], hyperhydration 1.52 [95% CI 0.95\u20132.43]), and no association between relative hydration category and difficulty falling asleep.<jats:bold>Discussion:<\/jats:bold>Hydration status was associated with self\u2010reported sleep duration in patients on dialysis. Future studies should prospectively examine the effects of optimizing fluid status on sleep duration and quality.<\/jats:p>","DOI":"10.1111\/hdi.12446","type":"journal-article","created":{"date-parts":[[2016,6,27]],"date-time":"2016-06-27T08:36:41Z","timestamp":1467016601000},"page":"133-141","source":"Crossref","is-referenced-by-count":11,"title":["Predialysis volume overload and patient\u2010reported sleep duration and quality in patients receiving hemodialysis"],"prefix":"10.1111","volume":"21","author":[{"given":"Adrian P.","family":"Abreo","sequence":"first","affiliation":[{"name":"Division of Nephrology Louisiana State University Health Sciences Center Shreveport, Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorien S.","family":"Dalrymple","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of California Davis Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"Division of Nephrology Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Kaysen","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of California Davis Davis California USA"},{"name":"Department of Biochemistry and Molecular Medicine University of California Davis Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Herzog","sequence":"additional","affiliation":[{"name":"Division of Cardiology Hennepin County Medical Center and University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten L.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Division of Nephrology University of California, San Francisco San Francisco California USA"},{"name":"Department of Epidemiology &amp; 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