Ambulatory nocturnal oximetry and sleep questionnaire-based findings in 38 patients with end-stage renal disease

Pfister, Marc; Jakob, Stephan M.; Marti, Hanspeter; Frey, Felix J.; Gugger, Matthias

doi:10.1093/ndt/14.6.1496

Cited by 14 publications

(10 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These previous studies, however, included case series of symptomatic patients who had ESRD and were referred for sleep studies, and the rates of SDB were not that different from a group of patients who were referred similarly for evaluation at a sleep center, suggesting the potential for referral biases in both the ESRD and SDB patient groups. Our findings demonstrated a similar severity of sleep apnea on both HD and off-HD evenings, confirming previous findings that showed similar severity of apnea in the same HD patients who underwent study on both evenings (3,10,12,31). However, our findings do not address whether HD patients should be studied on the dialysis or nondialysis evening for their sleep problems, because the timing of that study would depend on the clinical indication for the sleep study.…”

Section: Discussionsupporting

confidence: 81%

Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis

Unruh

Sanders

Redline

et al. 2006

Journal of the American Society of Nephrology

158

106

View full text Add to dashboard Cite

Sleep-disordered breathing (SDB) has been noted commonly in hemodialysis (HD) patients, but it is not known whether this is related directly to the treatment of kidney failure with HD or to the higher prevalence of obesity and older age. Forty-six HD patients were compared with 137 participants from the Sleep Heart Health Study (SHHS) who were matched for age, gender, body mass index (BMI), and race. Home unattended polysomnography was performed and scored using similar protocols. The study sample was 62.7 ؎ 10.1 yr, was predominantly male (72%) and white (63%), and had an average BMI of 28 ؎ 5.3 kg/m 2 . The HD sample had a higher systolic BP (137 versus 121 mmHg; P < 0.01) and a higher prevalence of diabetes (33 versus 9%; P < 0.01) and cardiovascular disease (33 versus 13%; P < 0.01) compared with the SHHS sample. The HD group had significantly less sleep time (320 versus 379 min; P < 0.0001) but similar sleep efficiency. HD patients had a higher frequency of arousals per hour (25.1 versus 17.1; P < 0.0001) and apnea-hypopneas per hour (27.2 versus 15.2; P < 0.0001) and greater percentage of the total sleep time below an oxygen saturation of 90% (7.2 versus 1.8; P < 0.0001). HD patients were more likely to have severe SDB (>30 respiratory events per hour) compared with the SHHS sample (odds ratio 4.07; 95% confidence interval 1.83 to 9.07). There was a strong association of HD with severe SDB and nocturnal hypoxemia independent of age, BMI, and the higher prevalence of chronic disease. The potential mechanisms for the higher likelihood of SDB in the HD population must be identified to provide specific prevention and therapy. P oor sleep and fatigue are common in older adults who undergo hemodialysis (HD), with HD patients reporting sleep problems more than twice as frequently as healthy control subjects (1,2). Despite this association, the extent and the severity of sleep disorders among the HD population and their cause both remain unclear (3-6). Although polysomnographic information in HD patients is limited, the available data do suggest that sleep-disordered breathing (SDB) may affect a significant percentage of dialysis patients (2,7). Although a number of studies have shown that a substantial proportion of HD patient have sleep apnea, these studies were limited by very small study samples (8 -12), by the use of partial channel polysomnography (PSG) (12)(13)(14), by the study of populations with limited generalizability to HD patients who are cared for in the United States (15), by very selected subpopulation of dialysis patients without sleep symptoms (16), or by study samples that largely were composed of symptomatic patients (7,8,17).Because a growing number of HD patients who are cared for in the United States are older than 65 yr (18), it is possible that reports of high rates of SDB and sleep problems in HD patients represent an aging effect, uremia effect, or some combination of the two. In particular, the prevalence of SDB and daytime sleepiness both increase with age (19), with SDB estimated to ...

show abstract

Section: Discussionsupporting

confidence: 81%

Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis

Unruh

Sanders

Redline

et al. 2006

Journal of the American Society of Nephrology

158

106

View full text Add to dashboard Cite

show abstract

“…assessed 119 ESKD patients and compared those with SDB (defined by oxygen desaturation index [ODI] more than 5) to those without (ODI <5); they found no differences in gender between the two groups. A similar finding was reported by Pfister et al . using ODI of 15 as a cutoff point.…”

Section: Risk Factors For Sleep‐disordered Breathing In Hemodialysis supporting

confidence: 90%

“…In the general population, risk factors for SDB include male gender, obesity, hypertension, and neck circumference (>40 cm) . Although similar risk factors are identified in the HD population, some of these factors are not as pronounced nor as useful to screen for SDB in patients with ESKD.…”

Section: Risk Factors For Sleep‐disordered Breathing In Hemodialysis mentioning

confidence: 98%

“…For example, insomnia is more female predominant due to changes in hormones (menstrual cycle or menopause), and SDB is more often found in males due to larger pharyngeal length . In the HD population, gender difference does not correlate to poor sleep quality nor to the presence of SDB . Tada et al .…”

Section: Risk Factors For Sleep‐disordered Breathing In Hemodialysis mentioning

confidence: 99%

See 1 more Smart Citation

Sleep disturbance and sleep‐disordered breathing in hemodialysis patients

Chu

Choi

McDonald

2017

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…As snoring has been known to be frequent in the sleep apnea syndrome, excessive loud snoring was helpful for the assessment of sleep disordered breathing [41, 42]. …”

Section: Discussionmentioning

confidence: 99%

Insomnia in Diabetic Hemodialysis Patients

Han

Yoon

et al. 2002

Nephron

View full text Add to dashboard Cite

Background: Insomnia is one of the most common problems in dialysis patients, and likely to contribute impairment in quality of life, which has a positive correlation with patients’ survival. In diabetic patients, morbidity and mortality are substantially higher than in the nondiabetic counterparts, and also the incidence of sleep disturbances. However, there is no means to predict sleep disturbance in the dialysis patients especially in diabetics. To define the prevalence and risk factors for insomnia in diabetic patients on hemodialysis, we undertook a cross-sectional multicenter study. Methods: Eighty-two diabetic patients (50 men/32 women, aged 58.7 ± 9.23 years) on maintenance hemodialysis for more than 6 months from 12 different hospitals were enrolled. The demographic data, subjective symptoms, depression scale, and insomnia were assessed by questionnaires, and lean body mass, BMI, Kt/V, subjective global assessment, nursing assessment score (NAS), and biochemical parameters were examined. Results: The number of patients with and without insomnia were 56 and 26, respectively, which amounted to 68.2% for insomnia. NAS (28.1 ± 3.81 vs. 30.8 ± 2.88, p = 0.002), serum albumin concentration (3.82 ± 0.44 vs. 4.09 ± 0.36 g/dl, p = 0.008), and depression scale (25.2 ± 12.1 vs. 18.9 ± 10.3, p = 0.025) were significantly different between them. Patients with insomnia were older (60.5 ± 9.0 vs. 56. 1 ± 9.60 years, p = 0.053) and felt pain (38.5 vs. 15.3%, p = 0.06) more frequently than those without insomnia. The scale of depression was correlated with NAS (r = –0.455, p < 0.001) and the serum albumin concentration was correlated with NAS (r = 0.337, p = 0.002). NAS, age, and serum albumin concentration were the major risk factors for insomnia in logistic regression analysis. Conclusion: The prevalence of insomnia in diabetic hemodialysis patients was 68.2%. Age, nutritional status, and depression were the major risk factors for sleep disturbance in diabetic patients.

show abstract

Ambulatory nocturnal oximetry and sleep questionnaire-based findings in 38 patients with end-stage renal disease

Cited by 14 publications

References 10 publications

Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis

Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis

Sleep disturbance and sleep‐disordered breathing in hemodialysis patients

Insomnia in Diabetic Hemodialysis Patients

Contact Info

Product

Resources

About