Prevalence of sleep disorders among ESRD patients

Abstract

Sleep disorders are common among the patients undergoing dialysis in end stage renal disease (ESRD). Although variable, their prevalence has been reported to be higher when compared to the general population. The most frequently reported complaints are insomnia, restless leg syndrome (RLS), sleep-disordered breathing and excessive daytime sleepiness (EDS). The aim of this study was to assess the prevalence of sleep disorders in end stage renal disease patients on regular hemodialysis (group I with 30 patients) and CKD patients (group II with 30 patients) in comparison to 30 normal population (control group). In addition to laboratory investigations which included creatinine clearance using Cockroft and Gault formula, hemoglobin level (Hb), blood urea, serum creatinine, serum albumin, serum calcium and phosphorus and lipid profile, all subjects underwent one night of laboratory-based polysomnography (PSG) consisting of a standard montage of electroencephalography (EEG) (C3/A1 and O2/C3 or O1/C4), monopolar left and right electrooculography (EOG) referenced to the opposite mastoid, surface mentalis electromyography (EMG), respiratory airflow (measured by thermistor) and effort (piezoelectric sensors), electrocardiography (ECG), anterior tibialis EMG and pulse oximetry. For hemodialysis subjects, this study was performed on a night immediately following hemodialysis treatment. The results showed that patients on hemodialysis have sleep disorders, and that sleep disorders are common in group I and II than control group. The percentage of sleep disorders in hemodialysis patients were as follows: insomnia (69%), followed by obstructive sleep apnea syndrome OSAS (24%), RLS and periodic limb movement PLM (18%), nightmares (13%), EDS (12%), sleepwalking (2%), possible rapid eye movement behavior disorders RED (2%), possible narcolepsy (1.4%). While the percentage of sleep disorders in CKD patients were as follows: insomnia (54%), followed by RLS (19%), PLM (12%), OSAS (16%), nightmares (15%), EDS (15%), sleepwalking (4%), possible RBD (3%), possible narcolepsy (1%). There was inverse correlation between sleep disorders and Hb, albumin and creatinine clearance; also there was positive correlation between sleep disorder and phosphorus. We concluded that the sleep disorders are common in CKD patients either on conservative management or on regular hemodialysis. Treatment of anemia, hyperphosphatemia and hypoalbuminemia may improve sleep disorders among those patients.

Quantifying Physical Activity Levels and Sleep in Hemodialysis Patients Using a Commercially Available Activity Tracker

“…The main findings of our study are that (a) the proportion of HD patients who exceeded the WHO recommendation of 10,000 steps/day was greater than observed in other HD populations [3,15] ; (b) patients walked significantly less on Sundays compared to other days of the week; and (c) that patients in our population experience poor sleep quality, corroborating findings in other HD populations [16] . The feedback provided to the participants about their physical activity levels did not appear to make a difference in the number of steps walked ( table 1 ).…”

“…The majority of patients slept less than the NIH recommendation of 420 min (7 h) and experienced poor sleep efficiency (minutes asleep/total time in bed ×100 <85%) [12,13] . It is well known that HD patients frequently experience sleep disorders [16] . A main cause of abnormal sleep in this population is restless leg syndrome [18] .…”

Dream Anxiety in Hemodialysis and Peritoneal Dialysis Patients

“…Regardless of taking regular dialysis treatment, patients with end-stage renal disease have been shown to have frequent sleep disturbances and sleep disorder levels are associated with parameters such as hemoglobin, albumin, and creatinine clearance [1] . The available literature stresses the cause of sleep disorders in patients with end-stage renal disease is more complicated than just the accumulation of metabolic waste in the body as well as providing various data on its likely association with inflammation and on the role of low melatonin levels, which all needs to be further clarified.…”

“…I n many chronic diseases, including chronic kidney disease, sleep disorders are frequently detected and sleep quality is impaired [1] . Sleep quality has been shown to be poor in patients undergoing hemodialysis or peritoneal dialysis [2] .…”

Potential benefits of melatonin in organ transplantation: a review

“…It is well known that a worst renal function is associated with sleep disorders (Ezzat & Mohab 2015). This may be a result of an imbalance between defensive agents (melatonin is decreased) and an increasing cell death rate due to the rise in oxidative markers such as TNF-α (Pinto et al 2016).…”