Quality of sleep in patients with chronic kidney disease.

BACKGROUND Sleep disorders are common in patients with renal failure on dialysis; however, the prevalence of "poor sleep" in patients with chronic kidney disease (CKD) not yet on dialysis is not known. This study aimed to measure the prevalence of "poor sleep" in CKD patients and to examine the association between quality of sleep and the degree of renal impairment in this population. METHODS Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in 120 prevalent CKD patients. RESULTS Sixty-three subjects (53%) had "poor sleep" defined as a global PSQI score >5. There was no statistically significant relationship between the global PSQI score and the blood urea nitrogen level (BUN), serum creatinine level or calculated creatinine clearance, but the sleep efficiency component score correlated with BUN (r = 0.19, P = 0.04) and serum creatinine (r = 0.20, P = 0.03). A history of depression was the only independent predictor of "poor sleep" (global PSQI >5). CONCLUSIONS "Poor sleep" is common in CKD patients. Quality of sleep decreases in the early stages of CKD and does not appear to be associated with the subsequent degree of renal failure. Large prospective longitudinal studies of quality of sleep in CKD patients are needed to confirm the high prevalence of impaired quality of sleep in this population and examine the association between renal function and quality of sleep while controlling for potential confounding variables.

[1]  J. Gabor,et al.  Daytime sleepiness in patients with CRF: impact of nocturnal hemodialysis. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[2]  D. Rye,et al.  Daytime sleepiness in stable hemodialysis patients. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[3]  M. Sabbatini,et al.  Insomnia in maintenance haemodialysis patients. , 2002, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[4]  Ethan M Balk,et al.  K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[5]  M. Sevick,et al.  Correlates of Sleep Behavior among Hemodialysis Patients , 2002, American Journal of Nephrology.

[6]  P. Hanly,et al.  Improvement of sleep apnea in patients with chronic renal failure who undergo nocturnal hemodialysis. , 2001, The New England journal of medicine.

[7]  M. Saul,et al.  A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. , 2000, The American journal of medicine.

[8]  M. Pressman,et al.  Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders. , 2000, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  D. Auckley,et al.  Reversal of sleep apnea hypopnea syndrome in end-stage renal disease after kidney transplantation. , 1999, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[10]  M. Kryger,et al.  Sleep complaints are common in a dialysis unit. , 1995, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[11]  R. Rault,et al.  A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. , 1992, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[12]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[13]  P. Kimmel,et al.  Sleep apnea syndrome in chronic renal disease. , 1989, The American journal of medicine.

[14]  Wilma M Hopman,et al.  Quality of sleep and health-related quality of life in haemodialysis patients. , 2003, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[15]  Kdoqi Disclaimer K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[16]  Cockcroft Dw,et al.  Prediction of Creatinine Clearance from Serum Creatinine , 1976 .