PURPOSE: Prior studies have shown an increased prevalence in sleep related disorders (SRD) in patients on hemodialysis (HD); the aim of our study was to investigate the prevalence of SRD in our HD population.
METHODS: Eighty one patients responded to a self-administered questionnaire to assess the prevalence of SRD from 10/2005 to 2/2006. Inclusion: maintenance HD for >3 months. Exclusion: psychiatric and cognitive dysfunction. Epworth sleepiness scale (ESS) was used to evaluate subjective average sleep propensity during real-life situations, taken as an indicator of daytime sleepiness. Demographics, comorbidities, laboratory data and medications were obtained.
RESULTS: We compared patients with ESS scores <8 (group 1) with scores >8 (group 2). There was no significant difference in terms of gender, race, prevalence of diabetes (62.5% vs.44.4 %, p=ns), hypertension (84.6% vs. 80.9 %, p=ns), restless leg syndrome (67.2 % vs 50%, p=ns), secondary hyperparathyroidism (60% vs. 60%, p=ns), obesity (36.8% vs. 36.3 %, p=ns) and morning headaches (41% vs 15.3%, p=ns) between the two groups. There was a significant difference in the prevalence of anemia (86.5% vs 61.9%, p=0.02), witnessed apnea( 5.4% vs 22.7%, p=0.039),subjective daytime sleepiness ( 21.4%vs 45.5%, p=0.03),sleep paralysis (8.9% vs27%,p=0.04) and nighttime sweating (14.2% vs 36.3%, p=0.035). Dialysis dose delivered was measured by using standard kt/V and the mean ESS was noted to be significantly lower in patients with Kt/V >1.5(mean ESS in patients with kt/V >1.5 was 5.2 vs 8.2 in patients with kt/V <1.5, p=0.005). When ESS >8, snoring and difficulty sleeping were taken together as criteria to evaluate chances of having Obstructive Sleep Apnea only about 15 % met the criteria.
CONCLUSION: In contrast to prior reports, when taking into account EDS, self reported SRD seems to be less prevalent in our population. Intriguingly, dialysis adequacy may play an important role in these findings.
CLINICAL IMPLICATIONS: Further studies with larger populations and sleep studies are necessary to assess the clinical significance of this trend.
DISCLOSURE: Layola Lunghar, None.