Sleep Disorders in ESRD Patients Undergoing Hemodialysis
Abstract
Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected. The patients selected their specific sleep disorders using a nine-item scale while the Epworth Sleepiness Scale (ESS) determined both the presence and severity of sleep disorders. The data was finally analyzed with their baseline characteristics, dialysis characteristics, medication/stimulants use, and clinical and biochemical parameters. Over 95% of the patients had, at least, one specific sleep disorder while the ESS revealed 36.36% of patients as normal, 59.09% as having mild sleep disorders, and 4.54% as having moderate to severe sleep disorders. Sleep disorders were significantly correlated with older ages (P=0.035), dialysis dose (P=0.001), blood creatinine levels (P=0.037), upper airways obstruction (P=0.035), hepatomegaly (P=0.006), hepatic failure (P=0.001), higher blood TSH levels (P=0.039), history of hypothyroidism (P=0.005), and the use of levodopa (P=0.004), anti-hypertensive medications (P=0.006), benzodiazepines (P=0.006), Eprex (Erythropoietin) (P=0.001), Venofer (Iron Sucrose Injection) (P=0.013), and phosphate-binders agents (P=0.018). Sleep disorders are common findings among ESRD patients and seem to be a more complicated issue than a simple accumulation of the wastes products in the body. Whatever the causes of sleep disorders are, disorder-specific treatments should be considered.
Jurado-Gamez B, Martin-Malo A, Alvarez-Lara MA, et al. Sleep disorders are underdiagnosed in patients on maintenance hemodialysis. Nephron Clin Pract 2007;105(1):c35-42.
Merlino G, Piani A, Dolso P, et al. Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 2006;21(1):184-90.
Mucsi I, Molnar MZ, Rethelyi J, et al. Sleep disorders and illness intrusiveness in patients on chronic dialysis. Nephrol Dial Transplant 2004;19(7):1815-22.
Pai MF, Hsu SP, Yang SY, et al. Sleep disturbance in chronic hemodialysis patients: the impact of depression and anemia. Ren Fail 2007;29(6):673-7.
Sabbatini M, Minale B, Crispo A, et al. Insomnia in maintenance haemodialysis patients. Nephrol Dial Transplant 2002;17(5):852-6.
Wei CY, Chung TC, Wu SC, et al. The subjective sleep quality and heart rate variability in hemodialysis patients. Ren Fail 2011;33(2):109-17.
Chen WC, Lim PS, Wu EC, et al. Sleep behavior disorders in a large cohort of chinese (Taiwanese) patients maintained by long-term hemodialysis. Am J Kidney Dis 2006;48(2):277-84.
Perl J, Unruh ML, Chan CT. Sleep disorders in end-stage renal disease: 'Markers of inadequate dialysis'? Kidney Int 2006;70(10):1687-93.
Sabbatini M, Crispo A, Pisani A, et al. Sleep quality inrenal transplant patients: a never investigated problem.Nephrol Dial Transplant 2005;20(1):194-8.
Kutner NG, Zhang R, Huang Y, et al. Association of sleep difficulty with Kidney Disease Quality of Life cognitivefunction score reported by patients who recently starteddialysis. Clin J Am Soc Nephrol 2007;2(2):284-9.
Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2001; 2(4):297-307.
Johns MW. Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth sleepiness scale. Chest 1993;103(1):30-6.
Al-Jahdali HH, Khogeer HA, Al-Qadhi, et al. Insomnia in chronic renal patients on dialysis in Saudi Arabia. JCircadian Rhythms 2010;8(1):7.
Argekar P, Griffin V, Litaker D, et al. Sleep apnea in hemodialysis patients: risk factors and effect on survival. Hemodial Int 2007;11(4):435-41.
Mallamaci F, Leonardis D, Tripepi R, et al. Sleep disordered breathing in renal transplant patients. Am J Transplant 2009;9(6):1373-81.
De Santo RM, Bartiromo M, Cesare MC, et al. Sleeping disorders in patients with end-stage renal disease andchronic kidney disease. J Ren Nutr 2006;16(3):224-8.
Szentkiralyi A, Czira ME, Molnar MZ, et al. High risk of obstructive sleep apnea is a risk factor of death censored graft loss in kidney transplant recipients: an observational cohort study. Sleep Med 2011;12(3):267-73.
Sandyk R, Bernick C, Lee SM, et al. L-dopa in uremic patients with the restless legs syndrome. Int J Neurosci 1987;35(3-4):233-5.
Trenkwalder C, Stiasny K, Pollmacher T, et al. L-dopa therapy of uremic and idiopathic restless legs syndrome: a double-blind, crossover trial. Sleep 1995;18(8): 681-8.
Walker SL, Fine A, Kryger MH. L-DOPA/carbidopa fornocturnal movement disorders in uremia. Sleep 1996;19(3):214-8.
| Files | ||
| Issue | Vol 54, No 3 (2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| Sleep disorder Hemodialysis ESRD Excessive daytime sleepiness Sleep apnea Renal disease | ||
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