The clinical diagnosis of sleep apnea is difficult among ESRD patients since the characteristic clinical features of sleep apnea may be absent and since sleep-related symptoms, such as fatigue and sleepiness, may be attributed to kidney failure. However, the evaluation of patients with possible sleep apnea is the same among ESRD patients as in the general population.

Inclusion Criteria:

• Age ≥18 years and able to give written informed consent to the study
• On chronic hemodialysis for ≥ 90 days at time of enrollment
• Ability to read
• Consent to have video recording taken during study visit

Exclusion Criteria:

• Subjects with cognitive impairment to consent
• Sickle cell anemia
• Prescription of nasal oxygen
• Simultaneous participation in another clinical trial that may affect breathing frequency/patterns, blood oxygenation, sleep/wake cycle or other parameters related to the outcomes of interest to this study
• Use of a breathing device, e.g. CPAP
• Central venous catheter used as vascular access for hemodialysis
• Artificial fingernails (may disturb the measurement of the WatchPAT)
• Use of one of the following medications: alpha blockers, short acting nitrates (less than 3 hours before the study).
• Permanent pacemaker
• Sustained non-sinus cardiac arrhythmias.

Chronic hemodialysis patients