4-7-8 Breathing for Fatigue and Sleep Management in Hemodialysis

Conditions

• 4-7-8 Breathing Technique
• Chronic Kidney Diseases
• Insomnia

Eligibility Criteria

Sex

ALL

Age

18 Years - 85 Years

Healthy Volunteers

Not accepted

Interventions

• Breathing technique — BEHAVIORAL
  A non-pharmacological behavioral intervention utilizing the 4-7-8 breathing technique. Prior to the first session, a research nurse provides brief face-to-face training and an instructional video sent to participants' smartphones for home practice. During daily practice sessions in a comfortable position, the cycle is performed: inhale for 4 seconds, hold for 7, exhale for 8 through pursed lips. This 10-cycle sequence lasts approximately 10-15 minutes per session. Applied twice daily (once during the day and once before bedtime) for four weeks, with fatigue, sleep quality, and daytime sleepiness assessed via validated questionnaires (Chalder Fatigue Scale, Jenkins Sleep Scale, Epworth Sleepiness Scale) at baseline, week 2, and week 4. The intervention aims to reduce fatigue and sleep disturbances by activating the parasympathetic system, promoting relaxation, decreasing anxiety, and modulating autonomic balance.

Study Details

For many hemodialysis patients, fatigue and sleep disturbances are common and debilitating side effects that severely impact daily life and quality of life. In this study, patients will be taught a simple breathing exercise called the 4-7-8 technique to help manage these symptoms. A total of 80 adult patients undergoing regular hemodialysis at Izmir Atatürk Training and Research Hospital will be randomly assigned to two groups: an intervention group and a control group. Participants in the intervention group will receive a face-to-face training session from a research nurse and a short instructional video sent to their smartphones to encourage daily home practice, especially before bedtime. The program will be continued over the study period. Participants in the control group will continue with their current routine hemodialysis care without any structured breathing exercises. Fatigue levels, sleep quality, and daytime sleepiness will be measured in both groups before and after the program using validated questionnaires. The results of this study may provide nurses and patients with a safe, cost-effective, non-drug option to improve symptom management and overall well-being in hemodialysis patients.

Key Dates

First listed

Jul 14, 2026

Start date

Aug 1, 2026

Status verified

Jul 2026

Primary completion

Sep 30, 2026

Completion

Jan 30, 2027

Study Design

Enrollment

80 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SUPPORTIVE_CARE

Arms

• Experimental: Experimental
  Arm Description:During daily practice sessions, patients will be instructed to sit or lie down in a comfortable position and begin the breathing exercise. The patient will perform the following cycle: * 4 seconds: Take a slow, deep breath through the nose. * 7 seconds: Hold the breath. * 8 seconds: Exhale slowly and completely through the mouth, with lips slightly pursed (making a slight hissing sound). Number of Repetitions: This cycle will be repeated 10 times consecutively per session, with a total duration of approximately 10-15 minutes. Participants will be asked to perform this routine twice daily (once during the day and once before bedtime) throughout the four-week intervention period. On hemodialysis session days, the exercise will be performed under the supervision of the research nurse to ensure adherence.
• No Intervention: Control
  Control Arm Description: Participants in the control group, on the other hand, will

Primary Outcome Measure

Fatigue Level [ Time Frame: Baseline, Week 2, Week 4 ]

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