Abstract
BackgroundPatients with chronic kidney disease progress regularly every year to end-stage renal disease and have to undergo dialysis. Sleep disturbances have been reported to be frequent among patients receiving dialysis and contributing to the increase of their mortality and morbidity. The present research aimed to study the sleep pattern in hemodialysis patients and the risk factors associated. This cross-sectional case-control study included 40 subjects divided into 2 groups: 20 cases recruited from Ain Shams University Hospital’s dialysis unit and 20 in the control group with normal Pittsburgh Sleep Quality Index score matched for age and sex. Both groups were subjected to overnight polysomnography, and the cases group was assessed by the Pittsburgh Sleep Quality Index to determine their sleep quality.ResultsNearly all polysomnographic parameters were significantly abnormal in the cases group except for sleep onset latency (P > 0.05), showing obstructive sleep apnea and periodic limb movement (P value 0.001). Based on their Pittsburgh Sleep Quality Index score, 30% were classified as good sleepers and 70% as bad sleepers. On comparing both groups, a significant difference was found. Poor sleepers had more worse sleep efficiency (62.9%), spent longer time during their sleep in stage 1 (26.6%) with shorter REM onset latency (113.5 ± 99.5), and had a longer duration of illness with lower serum creatinine level compared to good sleepers.ConclusionsThe prevalence of obstructive sleep apnea and periodic limb movement in hemodialysis patients is high; patients with longer time on dialysis are at more risk of sleep disorders, whereas hemoglobin levels, BUN, and other demographic factors do not seem to play a role in sleep disorder. Hence, patients on hemodialysis need to be screened for sleep disorders so as to improve their mortality and morbidity.
Highlights
Patients with chronic kidney disease progress regularly every year to end-stage renal disease and have to undergo dialysis
The purpose of the current study was to explore whether the patients undergoing hemodialysis suffer from sleep disorders, aiming to raise awareness across medical disciplines especially nephrologists and providing them with sufficient knowledge to identify those affected with sleep disorders and implement the treatment in place to enhance their quality of life and improve mortality among those groups of patients by preventing the metabolic derangements caused by obstructive sleep apnea (OSA)
We found that obstructive sleep apneas were predominant in HD patients
Summary
Patients with chronic kidney disease progress regularly every year to end-stage renal disease and have to undergo dialysis. The present research aimed to study the sleep pattern in hemodialysis patients and the risk factors associated This cross-sectional case-control study included 40 subjects divided into 2 groups: 20 cases recruited from Ain Shams University Hospital’s dialysis unit and 20 in the control group with normal Pittsburgh Sleep Quality Index score matched for age and sex. End-stage renal disease (ESRD) corresponds to a glomerular filtration rate (eGFR) of < 15 mL/min/1.73 m [1] It showed variable-elevated incidence across the world where in the USA, the annual incidence rate is 355 per million [2]. Renal Registry, the prevalence in Egypt raised to 483 patients per million [5] At this stage, survival and quality of life are sustained by kidney replacement therapy, which includes hemodialysis (HD), peritoneal dialysis, and kidney transplantation [6]. Most patients are treated with dialysis due to the scarcity of donor organs and contraindications to transplantation [7, 8]
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