Sleep disorders and illness intrusiveness in patients on chronic dialysis

Mucsi, István; Molnar, Miklos Z.; Réthelyi, János; Vámos, Eszter; Csepanyi, Gabor; Tompa, G; Barotfi, Szabolcs; Márton, Adrienn; Novák, Márta

doi:10.1093/ndt/gfh130

Cited by 103 publications

(101 citation statements)

References 18 publications

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“…In our study, we also found that these habits did not contribute to the insomnia severity score. A few studies have suggested that number and severity of comorbidity in hemodialysis patients can be attributed with the increase in the prevalence of sleep disorders [2,4,30]. In our study, we found that ischemic hearth disease was an independent determinant of the insomnia severity score.…”

Section: Discussionsupporting

confidence: 57%

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Insomnia severity in chronic kidney disease patients with various therapies

Knežević

Djordjević²,

Bivolarevic

et al. 2011

Open Medicine

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AbstractThe prevalence of insomnia is greater in end-stage renal disease. The aim of our study was to determine the frequency of insomnia and subclinical insomnia in patients with various dialysis therapy and kidney transplant recipients, in order to assess the severity of insomnia and examine whether there is a difference in severity among groups. In cross-sectional study, we evaluated 120 patients with terminal renal failure. Based on therapy, patients were divided into four groups: hemodiafiltration, standard bicarbonate dialysis, peritoneal dialysis and kidney transplant recipients. The severity of insomnia was evaluated through the use of the Insomnia Severity Index (ISI). Most patients who reported any kind of insomnia problems with ISI were on conventional dialysis (80%), followed by hemodiafiltration (76.7%) and peritoneal dialysis (63.3%). Transplant recipients had least difficulties with insomnia (46.7%). Insomnia Severity Index showed that insomnia in end-stage renal patients is not very severe. Most of the patients had “no clinically significant insomnia”. Our findings indicate that patients on hemodiafiltration and transplant recipients have a significantly lower score on Insomnia Severity Index. Patients with end-stage renal disease have high frequency insomnia problems. However, our study shows that insomnia in these patients is not severe. Insomnia is the most frequent and severest in patients on standard bicarbonate dialysis.

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Section: Discussionsupporting

confidence: 57%

“…Studies have been reported to range from 45% to 90% [4][5][6][7][8][9][10][11]. Insomnia occurs at an early stage chronic kidney disease (CKD), too [12,13].…”

Section: Introductionmentioning

confidence: 99%

Insomnia severity in chronic kidney disease patients with various therapies

Knežević

Djordjević²,

Bivolarevic

et al. 2011

Open Medicine

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“…45 The original instrument was used in an epidemiologic survey 46 and the Hungarian version was used in our earlier studies involving different populations with CKD. [47][48][49] Comorbidity was assessed by the modified Charlson Comorbidity Index 50 completed by the main responsible transplant physician of the participant. Information about medication use was obtained from the questionnaires and the medical charts.…”

Section: Assessment Of Insomnia Restless Legs Syndrome and Comorbidmentioning

confidence: 99%

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Rónai

Szentkirályi

Lázár

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Both depression and sleep complaints are very prevalent among kidney transplant (kTx) recipients. However, details of the complex relationship between sleep and depression in this population are not well documented. Thus, we investigated the association between depressive symptoms and sleep macrostructure parameters among prevalent kTx recipients. Methods: Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m 2 , estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m 2 ). Symptoms of depression were assessed by the Center for Epidemiologic Studies -Depression Scale (CES-D). After 1-night polysomnography each recording was visually scored and sleep macrostructure was analyzed. Results: The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20, P < .05), rapid eye movement (REM) latency (r = 0.21, P < .05) and REM percentage (r = −0.24, P < .05), but not with the amount of slow wave sleep (r = −0.12, P > .05). In multivariable linear regression models the CES-D score was independently associated with the amount of stage 2 sleep (β: 0.205; confidence interval: 0.001-0.409; P = .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468; P = .05) after adjustment for potential confounders. I NTRO DUCTI O NDepression is one of the most prevalent mental health conditions in patients with chronic kidney disease (CKD) [1][2][3][4] ; furthermore, it is an important determinant of impaired quality of life. 5,6 Among kidney transplant (kTx) recipients, depression is associated with reduced adherence and also with increased morbidity, graft loss, and mortality. [7][8][9][10][11][12][13] Poor sleep and various sleep problems are also frequent complaints among kTx recipients.14,15 Earlier we reported that chronic insomnia was independently associated with the presence of depression in kTx recipients. 16 In the general population there is a strong and bidirectional relationship between depression and sleep.17 This is also reflected in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition definition of major depression (MD), 18 as sleep complaints are core symptoms of MD. Several objective sleep parameters are different in patients with MD than in healthy control patients. Patients with MD have decreased amounts of slow wave sleep (SWS) and shortened rapid eye movement (REM) latency with increased amounts of REM sleep. The exact mechanisms and factors that may link depression to poor clinical outcomes among kTx recipients are not yet well defined. In a recent review focusing on kTx and depression, 23 sleep is not mentioned. This may be due to the complete lack of polysomnography (PSG) studies that assess the association between sleep and depression in this population. The frequent co-occurrence of subjective sleep complaints and depression among kTx recipients 16 suggests that the relationship between the two conditions may be similar to the association described in the g...

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“…poor sleep quality is related to worse quality of life and increased morbidity and mortality in these patients (14)(15)(16). A wide variability of the incidence of certain sleep disorders in patients on dialysis, ranging from 30 -80%, indicates inadequately defined criteria for their diagnosis and previous lack of valid instruments for identifying specific disorders (15).…”

Section: Discussionmentioning

confidence: 99%

Quality of sleep in hemodialysis patients: The role of demographic and clinical characteristics

Aljušević¹,

Vatic²,

Trbojević-Stanković³

2017

Med podmladak

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Introduction: Sleep disorders are common among patients treated with chronic dialysis. Still, these conditions are seldom diagnosed and often undertreated, because they are attributed to the renal disease itself and/or considered a reaction to dialysis treatment. Aim: The aim of this study was to assess the prevalence of poor sleep quality and its relations with demographic and clinical characteristics of patients undergoing chronic hemodialysis (HD). Material and Methods: A cross-sectional observational study was performed on 82 patients (49 men, mean age 64.77 ± 10.00 years, range 30-85) on HD maintenance in a University Hospital Center in Belgrade. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Other relevant data were collected by general questionnaire and from patients' medical histories. Data were analyzed with Chi-square, Fisher and T test, using the SPSS (version 21.0). Results: The mean PSQI was 6.74 ± 3.99. Poor quality of sleep (PSQI>5) was present in 47 (57.3%) patients. Patients treated with hemodiafiltration statistically more often had significantly better quality of sleep (p=0.047), whereas patients receiving dialysis treatment in the afternoon shift more frequently had poor quality of sleep (p=0.017). Age, sex, employment status, comorbidities, dialysis vintage and adequacy were not related to the quality of sleep significantly. Conclusion: The type of dialysis treatment and dialysis shift are closely interrelated with the quality of sleep in patients on chronic HD treatment.

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Sleep disorders and illness intrusiveness in patients on chronic dialysis

Abstract: Sleep disorders are important determinants of illness intrusiveness and health-related quality of life in patients with ESRD. Sleep problems may be treated successfully; therefore, more attention should be paid to assessing these problems in this patient population.

Cited by 103 publications

References 18 publications

Insomnia severity in chronic kidney disease patients with various therapies

Insomnia severity in chronic kidney disease patients with various therapies

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Quality of sleep in hemodialysis patients: The role of demographic and clinical characteristics

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