Article

Reviews: Diagnosis and Management of Sleep Apnea Syndrome and Restless Legs Syndrome in Dialysis Patients

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
Seminars in Dialysis (Impact Factor: 1.75). 05/2006; 19(3):210-6. DOI: 10.1111/j.1525-139X.2006.00157.x
Source: PubMed

ABSTRACT

Sleep complaints are very common in patients with end-stage renal disease (ESRD) and contribute to their impaired quality of life. Both obstructive and central sleep apnea syndromes are reported more often in patients on dialysis than in the general population. Impaired daytime functioning, sleepiness, and fatigue, as well as cognitive problems, are well known in patients with sleep apnea. Increasing evidence supports the pathophysiological role of sleep apnea in cardiovascular disorders, which are the leading cause of death in ESRD patients. Uremic factors may be involved in the pathogenesis of sleep apnea in this patient population and optimal dialysis may reduce disease severity. Furthermore, treatment with continuous positive airway pressure may improve quality of life and may help to manage hypertension in these patients. Secondary restless legs syndrome is highly prevalent in patients on maintenance dialysis. The pathophysiology of the disorder may also involve uremia-related factors, iron deficiency, and anemia, but genetic and lifestyle factors might also play a role. The treatment of restless legs syndrome involves various pharmacologic approaches and might be challenging in severe cases. In this article we review the diagnosis and treatment of sleep apnea and restless legs syndrome, with a focus on dialysis patients. We also briefly review current data regarding sleep problems after transplantation, since these studies may indirectly shed light on the possible pathophysiological role of uremia or dialysis in the etiology of sleep disorders. Considering the importance of sleep disorders, more awareness among professionals involved in the care of patients on dialysis is necessary. Appropriate management of sleep disorders could improve the quality of life and possibly even impact upon survival of renal patients.

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    • "Lithium, selective serotonin reuptake inhibitors, and tricyclic antidepressant play a deteriorative role in RLS symptoms (related to their dopamine antagonists activity) [26]. Home short daily hemodialysis, as a nonpharmacological choice of therapy, is also associated with long-term improvement of RLS severity [27]. "
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    ABSTRACT: Background: Restless leg syndrome (RLS) is one of the prevalent complaints of patients with end stage renal diseases suffering chronic hemodialysis. Although there are some known pharmacological managements for this syndrome, the adverse effect of drugs causes a limitation for using them. In this randomized clinical trial we aimed to find a nonpharmacological way to improve signs of restless leg syndrome and patients' quality of life. Material and methods: Twenty-six patients were included in the study and divided into 2 groups of control and exercise. The exercise group used aerobic exercise during their hemodialysis for 16 weeks. The quality of life and severity of restless leg syndrome were assessed at the first week of study and final week. Data were analyzed using SPSS software. Results: The difference of means of RLS signs at the first week of study and final week was -5.5 ± 4.96 in exercise group and -0.53 ± 2.3 in control group. There was not any statistical difference between control group and exercise group in quality of life at the first week of study and final week. Conclusions: We suggest using aerobic exercise for improving signs of restless leg syndrome, but no evidence was found for its efficacy on patient's quality of life.
    Full-text · Article · Nov 2013 · The Scientific World Journal
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    • "Lithium, selective serotonin reuptake inhibitors, and tricyclic antidepressant play a deteriorative role in RLS symptoms (related to their dopamine antagonists activity) [26]. Home short daily hemodialysis, as a nonpharmacological choice of therapy, is also associated with long-term improvement of RLS severity [27]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Restless leg syndrome (RLS) is one of the prevalent complaints of patients with end stage renal diseases suffering chronic hemodialysis. Although there are some known pharmacological managements for this syndrome, the adverse effect of drugs causes a limitation for using them. In this randomized clinical trial we aimed to find a nonpharmacological way to improve signs of restless leg syndrome and patients’ quality of life. Material andMethods. Twenty-six patients were included in the study and divided into 2 groups of control and exercise.The exercise group used aerobic exercise during their hemodialysis for 16 weeks. The quality of life and severity of restless leg syndrome were assessed at the first week of study and final week. Data were analyzed using SPSS software. Results. The difference of means of RLS signs at the first week of study and final week was −5.5 ± 4.96 in exercise group and −0.53±2.3 in control group.There was not any statistical difference between control group and exercise group in quality of life at the first week of study and final week. Conclusions. We suggest using aerobic exercise for improving signs of restless leg syndrome, but no evidence was found for its efficacy on patient’s quality of life. 1. Introduction Restless leg syndrome (RLS) is one of the most common complaints among end stage renal disease (ESRD) patients [1].This syndrome is characterizedby a strong urge in the legs and other extremities which force the patient to move during rest [2]. Previous studies estimated the prevalence of RLS between ESRD patients to be 20%to 57% [3–5]. Multiparity, older age, sedentary life style, obesity, and positive family history are factors associated with RLS outbreak [6, 7]. In about 40% of patients presenting with RLS, a family history of this syndrome could be seen, and a dominant pattern of inheritance is known about its he
    Full-text · Article · Oct 2013

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