Article

Chronic insomnia in kidney transplant recipients.

Institute of Behavioral Sciences, First Department of Internal Medicine, Semmelweis University, Budapest, Hungary.
American Journal of Kidney Diseases (impact factor: 5.43). 04/2006; 47(4):655-65. DOI:10.1053/j.ajkd.2005.12.035 pp.655-65
Source: PubMed

ABSTRACT Recent studies confirmed that sleep disorders have a significant impact on various aspects of health in patients at different stages of chronic kidney disease. At the same time, there is an almost complete lack of information on the prevalence and correlates of insomnia in kidney transplant recipients.
In a cross-sectional study, the Athens Insomnia Scale was used to assess the prevalence of insomnia in a large sample of kidney transplant recipients compared with wait-listed dialysis patients and also a matched group obtained from a nationally representative sample of the Hungarian population.
The prevalence of insomnia was 15% in wait-listed patients, whereas it was only 8% in transplant recipients (P < 0.001), which, in turn, was not different from the prevalence of this sleep problem in the sample of the general population (8%). Prevalences of insomnia in the transplant group were 5%, 7%, and 14% for the groups with glomerular filtration rates (GFRs) greater than 60 mL/min (> 1.00 mL/s), 30 to 60 mL/min (0.50 to 1.00 mL/s), and less than 30 mL/min (< 0.5 mL/s), respectively (P < 0.01). However, estimated GFR was no longer associated significantly with insomnia in the transplant population after statistical adjustment for several covariates. In a multivariate model, insomnia was significantly and independently associated with treatment modality (transplantation versus wait listing), as well as the presence of depression, restless legs syndrome, and high risk for obstructive sleep apnea syndrome, and with self-reported comorbidity.
The prevalence of insomnia was substantially less in the transplant group than in wait-listed dialysis patients and similar to that observed in the general population. Because this condition potentially is treatable, attention should be directed to the appropriate diagnosis and management of insomnia in the kidney transplant recipient population.

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    Article: Prevalence of sleep disturbances in children and adolescents with chronic kidney disease.
    Ira D Davis, Larry A Greenbaum, Debbie Gipson, Lie Ling Wu, Rajiv Sinha, Mina Matsuda-Abedini, Judith L Emancipator, Jerome C Lane, Kavita Hodgkins, Corina Nailescu, Gina Marie Barletta, Steven Arora, John D Mahan, Carol L Rosen
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    ABSTRACT: Although sleep disorders are common in adults with chronic kidney disease, little is known about the prevalence of sleep problems in children and adolescents with chronic kidney disease and their relationship to health-related quality of life measurements. We performed a clinic-based survey of sleep habits and common symptoms of sleep disturbances in 159 school-aged patients with chronic kidney disease. Three patient groups of chronic kidney disease were assessed: group 1, those not on dialysis and not transplanted; group 2, those on dialysis; and group 3, those with a functioning renal allograft. Four symptom domains for sleep disorders were assessed: excessive daytime sleepiness; sleep disordered breathing; restless legs syndrome symptoms; and insufficient sleep. Patients and the parent-proxy also completed the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales questionnaire. Ninety-three (93) patients (58.5%) had symptoms of a sleep disturbance. The presence of a sleep disturbance correlated with a decrease in health-related quality of life scores that was independent of the chronic kidney disease study group or estimated glomerular filtration rate. We conclude that sleep disturbances are common throughout the spectrum of chronic kidney disease in children and adolescents and are associated with diminished health-related quality of life scores.
    Pediatric Nephrology 10/2011; 27(3):451-9. · 2.52 Impact Factor
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Keywords

apnea syndrome
 
appropriate diagnosis
 
Athens Insomnia Scale
 
chronic kidney disease
 
different stages
 
general population
 
glomerular filtration rates
 
Hungarian population
 
kidney transplant recipient population
 
kidney transplant recipients
 
large sample
 
multivariate model
 
nationally representative sample
 
restless legs syndrome
 
significant impact
 
statistical adjustment
 
transplant population
 
treatment modality
 
wait-listed dialysis patients
 
wait-listed patients