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.