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Fulltext A randomized controlled trial for effectiveness of zolpidem versus acupressure on sleep in hemodialysis patients having chronic kidney disease-associated pruritus

Rehman IU, Wu DB, Ahmed R, Khan NA, Rahman AU, Munib S, et al.

Medicine (Baltimore), 2018 08;97(31):e10764.
PMID: 30075491 DOI: 10.1097/MD.0000000000010764

BACKGROUND: Pruritus adds to the complications of chronic kidney disease (CKD) patient and a well-recognized complication among the CKD patients. Majority of the patients on hemodialysis experience a generalized pruritus and patients reported being moderately to extremely disturbed by at least one of the sleep-related condition. This study aim to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-associated pruritus.
METHODS: A multicentered, open-label, parallel group, prospective randomized controlled trial among patients suffering from CKD-associated pruritus with sleep disturbance, after randomization into control, and intervention group to be held at North West General Hospital and Research Center Peshawar, Pakistan and Institute of Kidney Diseases Peshawar, Pakistan.
RESULTS: The primary outcome is to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-associated pruritus. After baseline assessment by Urdu version of 5D itch scale and Urdu version of Pittsburgh Sleep Quality Index (PSQI) and Urdu EQ-5D 3L, the intervention group will be given zolpidem 10 mg oral tablets and control group with acupressure on both foots on KI-1 acupoints for total of 6 minutes. Assessment will be done at weeks 4 and 8 from baseline by using Urdu version of 5D itch scale and Urdu version of PSQI and Urdu EQ-5D 3L, whereas safety profiling of zolpidem 10 mg tablet at week 6 from baseline and acupressure acceptability at week 6 from baseline. Analysis of covariance will be used to examine the differences in treatment effects between the intervention and control groups.
CONCLUSION: Improvement of sleep quality and quality of life among patients with CKD-associated pruritus requires great importance. This study aims to improve the quality of sleep and quality of life among patients with hemodialysis suffering from CKD-associated pruritus.

Matched MeSH terms: Sleep Wake Disorders/therapy*
Fulltext Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients

Maniam R, Subramanian P, Singh SK, Lim SK, Chinna K, Rosli R

Singapore Med J, 2014 Sep;55(9):476-82.
PMID: 25273932

INTRODUCTION: Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.

METHODS: In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients' perception of the exercise programme was also determined using self-reported questionnaires.

RESULTS: Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).

CONCLUSION: Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.

Matched MeSH terms: Sleep Wake Disorders/therapy*
Sleep education in medical school curriculum: a glimpse across countries

Mindell JA, Bartle A, Wahab NA, Ahn Y, Ramamurthy MB, Huong HT, et al.

Sleep Med, 2011 Oct;12(9):928-31.
PMID: 21924951 DOI: 10.1016/j.sleep.2011.07.001

The objective of this study was to assess the prevalence of education about sleep and sleep disorders in medical school education and to identify barriers to providing such education.

Matched MeSH terms: Sleep Wake Disorders/therapy*
Case Series

Vetrayan J, Othman S, Victor Paulraj SJ

J Atten Disord, 2017 01;21(2):168-179.
PMID: 23529885 DOI: 10.1177/1087054713479665

OBJECTIVE: To assess the effectiveness and feasibility of behavioral sleep intervention for medicated children with ADHD.
METHOD: Six medicated children (five boys, one girl; aged 6-12 years) with ADHD participated in a 4-week sleep intervention program. The main behavioral strategies used were Faded Bedtime With Response Cost (FBRC) and positive reinforcement. Within a case-series design, objective measure (Sleep Disturbance Scale for Children [SDSC]) and subjective measure (sleep diaries) were used to record changes in children's sleep.
RESULTS: For all six children, significant decrease was found in the severity of children's sleep problems (based on SDSC data). Bedtime resistance and mean sleep onset latency were reduced following the 4-week intervention program according to sleep diaries data. Gains were generally maintained at the follow-up. Parents perceived the intervention as being helpful.
CONCLUSION: Based on the initial data, this intervention shows promise as an effective and feasible treatment.

Matched MeSH terms: Sleep Wake Disorders/therapy