Sleep disorders are underdiagnosed in patients on maintenance hemodialysis.

Abstract

BACKGROUND:

Sleep apnea-hypopnea syndrome (SAHS) is a cardiovascular risk factor. The aim of this study was to evaluate sleep disorders using polysomnography on a non-selected population of patients on maintenance hemodialysis.

METHODS:

Overnight polysomnography was performed on 32 hemodialysis patients (24 men/8 women, 54 +/- 16 years), and on 19 healthy subjects of similar age, sex and body mass index who were used as controls.

RESULTS:

In hemodialysis patients, the most frequent sleep disorder was SAHS in 44% (14/32), followed by insomnia in 41% (13/32). Compared to healthy controls, patients on hemodialysis showed less slow-wave sleep and rapid eye movement sleep (23 vs. 36%, p = 0.001), less sleep efficiency (71 vs. 87%, p = 0.0079) and a higher periodic limb movement index (39.7 vs. 9.1; p = 0.003). An increase in apnea-hypopnea index (18.9 vs. 4.3; p = 0.007) and dips in the SaO(2) (> or =4%) per hour of sleep (22.6 vs. 6.4; p = 0.021) were also significantly greater in hemodialysis patients than controls. 72% of the cases of SAHS were diagnosed solely by means of polysomnography.

CONCLUSIONS:

The patients on hemodialysis showed poor sleep quality with a significant increase in the apnea-hypopnea index and in the number of dips in SaO(2). SAHS was underdiagnosed in a large percentage of the hemodialysis patients.

• Authors: B Jurado-Gamez, A Martin-Malo, M A Alvarez-Lara, L Muñoz, A Cosano, P Aljama
• Journal: Nephron. Clinical practice (Nephron Clin Pract) Vol. 105 Issue 1 Pg. c35-42 ( 2007) ISSN: 1660-2110 [Electronic] Switzerland
• PMID: 17114901 (Publication Type: Journal Article)
• Copyright: Copyright 2007 S. Karger AG, Basel.

Topics

• Causality
• Comorbidity
• Cross-Sectional Studies
• Diagnosis, Differential
• Diagnostic Errors
• Female
• Humans
• Kidney Failure, Chronic (epidemiology, therapy)
• Male
• Middle Aged
• Polysomnography
• Renal Dialysis (adverse effects, statistics & numerical data)
• Sleep Apnea Syndromes (diagnosis, epidemiology)
• Sleep Wake Disorders (diagnosis, epidemiology, etiology)
• Snoring (diagnosis, epidemiology)