Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis
Open Access
- 1 December 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Society of Nephrology
- Vol. 17 (12), 3503-3509
- https://doi.org/10.1681/asn.2006060659
Abstract
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/m2. 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.Keywords
This publication has 38 references indexed in Scilit:
- Enhanced chemo-responsiveness in patients with sleep apnoea and end-stage renal diseaseEuropean Respiratory Journal, 2006
- Polysomnographic measures of nocturnal sleep in patients on chronic, intermittent daytime haemodialysis vs those with chronic kidney diseaseNephrology Dialysis Transplantation, 2005
- PSYCHOSOCIAL FACTORS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: Sleepiness, Sleeplessness, and Pain in End‐Stage Renal Disease: Distressing Symptoms for PatientsSeminars in Dialysis, 2005
- Impact of nocturnal hemodialysis on the variability of heart rate and duration of hypoxemia during sleepKidney International, 2004
- Daytime sleepiness in patients with CRF: Impact of nocturnal hemodialysisAmerican Journal of Kidney Diseases, 2003
- Sleep Apnea Incidence in Maintenance HemodialysisPatients: Influence of Dialysate BufferNephron, 1995
- Sleep disordered breathing in ESRD: Acute beneficial effects of treatment with nasal continuous positive airway pressureKidney International, 1993
- Sleep apnea syndrome in chronic renal diseaseAmerican Journal Of Medicine, 1989
- Sleep Apnea in Hemodialysis Patients: The Lack of Testosterone Effect on Its PathogenesisNephron, 1985