Oreste Marrone1, Fabio Cibella1, Gabriel Roisman2, Pawel Sliwinski3, Pavol Joppa4, Ozen K Basoglu5, Izolde Bouloukaki6, Sophia Schiza6, Athanasia Pataka7, Richard Staats8, Johan Verbraecken9, Jan Hedner10, Ludger Grote10, Maria R Bonsignore1,11. 1. Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council, Palermo, Italy. 2. Sleep Disorders Centre, Antoine-Béclère Hospital, Clamart, France. 3. Second Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland. 4. Department of Respiratory Medicine and Tuberculosis, P.J. Safarik University, Kosice, Slovakia. 5. Department of Chest Diseases, Ege University, Izmir, Turkey. 6. Sleep Disorders Center, Department of Respiratory Medicine, University of Crete, Heraklion, Greece. 7. Respiratory Failure Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Greece. 8. Department of Respiratory Medicine, Hospital de Santa Maria, CHULN, Lisbon, Portugal. 9. Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Antwerp, Belgium. 10. Department of Sleep Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 11. Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Italy.
Abstract
STUDY OBJECTIVES: Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73m². METHODS: Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matched CKD and non-CKD patients without psychiatric disturbances. RESULTS: Among all patients with and without CKD, total sleep time was similar but sleep stage N1 (median 8.7% [IQR 4.8-18.0] vs 6.7% [3.6-12.7], respectively) and sleep stage R (12.6% [6.8-17.7] vs 14.2% [8.8-19.8], respectively) significantly differed (P < .0001). No difference in sleep characteristics was observed between matched patients either with or without psychiatric disturbances. After subdividing the matched patients according to AHI tertile (<25, ≥25 to <49, and ≥49 events/h) and estimated glomerular filtration rate (≥60, 45 to <60, <45 mL/min/1.73m²), we found a significant effect of AHI on sleep stages N2, N3, and R (P < .001), but there was no effect of CKD. CONCLUSIONS: In nondialyzed patients with CKD, objective sleep quality is influenced similarly by AHI as in patients without CKD but is not affected by CKD severity. Previously reported poor sleep quality in CKD may partly result from the high prevalence of OSA in CKD.
STUDY OBJECTIVES:Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73m². METHODS: Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matched CKD and non-CKD patients without psychiatric disturbances. RESULTS: Among all patients with and without CKD, total sleep time was similar but sleep stage N1 (median 8.7% [IQR 4.8-18.0] vs 6.7% [3.6-12.7], respectively) and sleep stage R (12.6% [6.8-17.7] vs 14.2% [8.8-19.8], respectively) significantly differed (P < .0001). No difference in sleep characteristics was observed between matched patients either with or without psychiatric disturbances. After subdividing the matched patients according to AHI tertile (<25, ≥25 to <49, and ≥49 events/h) and estimated glomerular filtration rate (≥60, 45 to <60, <45 mL/min/1.73m²), we found a significant effect of AHI on sleep stages N2, N3, and R (P < .001), but there was no effect of CKD. CONCLUSIONS: In nondialyzed patients with CKD, objective sleep quality is influenced similarly by AHI as in patients without CKD but is not affected by CKD severity. Previously reported poor sleep quality in CKD may partly result from the high prevalence of OSA in CKD.
Authors: Pierre Escourrou; Ludger Grote; Thomas Penzel; Walter T Mcnicholas; Johan Verbraecken; Rosa Tkacova; Renata L Riha; Jan Hedner Journal: J Sleep Res Date: 2015-08-14 Impact factor: 3.981
Authors: Adam Ogna; Valentina Forni Ogna; José Haba Rubio; Nadia Tobback; Dana Andries; Martin Preisig; Mehdi Tafti; Peter Vollenweider; Gerard Waeber; Pedro Marques-Vidal; Raphaël Heinzer Journal: Sleep Date: 2016-04-01 Impact factor: 5.849
Authors: B Kumar; A Tilea; B W Gillespie; X Zhang; M Kiser; G Eisele; F Finkelstein; P Kotanko; N Levin; S Rajagopalan; R Saran Journal: Clin Nephrol Date: 2010-02 Impact factor: 0.975