투석 받는 말기 신질환 환자의 수면장애

Abstract

Background: Patients with end-stage renal diseases (ESRD) have an increased risk of sleep problems such as daytime sleepiness, insomnia, restless legs syndrome (RLS), and obstructive sleep apnea syndrome (OSAS). However, presently there is limited data available, particularly in Asia. Methods: To investigate the prevalence of sleep complaints in ESRD patients, 100 patients at the maintenance hemodialysis (HD) and 100 patients at the continuous ambulatory peritoneal dialysis (CAPD) were surveyed using a specific questionnaire. Results: Patients had a mean age of 50.58±14.03 years, with a mean body mass index (BMI) of 21.8±3.5 kg/m2. The mean duration of dialysis was 44.56±49.74 months. Fifty-six percent of the dialysis patients were poor sleepers. Daytime sleepiness occurred in 24% to 34% of the patients, and insomnia occurred in 35% of the patients, while restless legs syndrome was reported in 44% of the patients. The higher BMI group had a lower risk for insomnia when compared to the lower BMI group (OR=0.11, 95% CI=0.03-0.46). The OR of depression for insomnia was 2.8 (95% CI=1.02-7.69). There was no difference in the prevalence of sleep disturbances between the HD and CAPD patients groups. Conclusions: Complaints of sleep disturbance and daytime somnolence are very common in dialysis patients and likely contribute to the impaired quality of life experienced by many of these patients. Identifying and treating the sleep complaints in dialysis patients could contribute significantly to their quality of life and avoid potential side effects of nonspecific sedatives.