Determinants of prolonged time perception during in-center hemodialysis in Japan: a multicenter cross-sectional study

Abstract Background Time during hemodialysis is often perceived as burdensome. Evidence on time perception during in-center hemodialysis among Japanese patients is limited. To our knowledge, this is the first English-language report focusing on time perception during in-center hemodialysis in Japan. Methods We conducted a multicenter cross-sectional study (July–September 2023) of outpatients receiving maintenance hemodialysis in Japan. At 2 h after dialysis initiation, participants completed an estimation task by answering: “How many minutes have passed since dialysis started?” Prolonged time perception was defined as perceived time longer than the actual elapsed time (120 min); shortened time perception was defined as perceived time shorter than 120 min. Insomnia severity was assessed using the Athens Insomnia Scale (AIS). We used logistic regression to identify factors associated with prolonged time perception, limiting the number of covariates to avoid model overfitting. Results Among 97 participants, 71 (73%) perceived the elapsed time as longer than 120 min. The prolonged-time-perception group had higher AIS scores. In adjusted logistic regression, higher AIS score was independently associated with prolonged time perception. Conclusions A large proportion of Japanese in-center patients undergoing hemodialysis perceived treatment time as longer than the actual elapsed time. Insomnia severity was independently associated with prolonged time perception. Screening and management of insomnia may be a practical target to improve patients’ experience during dialysis.