MO868: The Impact of Cognitive Impairment in Sleep Disorders in Haemodialysis and Peritoneal Dialysis Patients

Abstract

Abstract BACKGROUND AND AIMS Patients undergoing dialysis have a higher cognitive impairment (CI) risk than the general population. We evaluated the association of cognitive function (CI) in haemodialysis (HD)and peritoneal dialysis patients (PD) and the relationship with restless leg syndrome (RLS) and hypersomnolence. METHOD This is a cross-section study evaluating 167 patients who met the inclusion criteria in the study. Of these, 39% were on Haemodialysis, 22% on Peritoneal Dialysis, 19% on Transplant and 20% with CKD stage IV-V. Cognitive impairment (CI) in the study population was assessed based on the MoCA test. Patients with a MoCA global score of 24/30 were considered cognitively impaired. The rating is classified: light, moderate, heavy and very heavy.The International Restless Legs Syndrome study group (IRLSSG) was used for evaluation of restless leg and the Epworth Sleepiness Scale is used as a The Epworth Sleepiness Scale is widely used in the field of sleep medicine as a subjective measure of a patient's sleepiness. RESULTS The frequency of CI based on the test classification was 20% mild, 61% moderate, 15% severe and 3% very severe. In the studied population, it was observed that there is a significant relationship between cognitive impairment and forms of renal replacement therapy (P < 0.001) and the etiology of the underlying disease, P = 0.0011). The multivariate linear regression test shows an independent relationship of CI with age, where each increase of 1 year in age leads to a decrease of 0.094 points of the MoCA test. Patients in the study were evaluated as having enough sleep (60.8% patients), mildly sleepy (10.1% patients) and sleepy (29.1% patients). In 59% of patients that responded positively for restless leg syndrome, the degree of severity was significantly correlated with dialysis treatment (P < 0.001) and not with time in dialysis. The comparison between the three tests performed in the studied population showed a positive correlation of sleepiness and restless leg syndrome (r = 0.32) and a negative correlation between CG and CK(r = –0.38). CONCLUSION In this study, we saw the impact of RRT on CI, RLS and Sleepiness, affecting the quality of life negatively. Cognitive function disorders negatively impact the independence of realizing essential life functions, thus reducing compliance with medical care. Sleep fragmentation in sleepiness can also affect CI through dysfunction in neural networks, particularly in the frontal lobes, probably reducing the efficiency of restorative processes in the prefrontal cortex leading to cellular and biochemical stress. RLS is associated with sleepiness, and both negatively affect the quality of life and emotional states like anxiety and depression.