J Korean Neurol Assoc > Volume 21(5); 2003 > Article

Journal of the Korean Neurological Association 2003;21(5): 492-497.

투석 받는 말기 신질환 환자의 수면장애

조용원 , 이 형 이주화 한승엽 이미영

계명대학교 의과대학 신경과학교실 뇌연구소, 내과학교실, 예방의학교실

"Sleep Disorders In Maintenance Dialysis Patients with End-Stage Renal Disease"

Yong-Won Cho

"Department of Neurology and Brain Research Institute, Department of Internal Medicine, Department of Preventive Medicine, Keimyung University, School of Medicine"

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. M e t h o d s: 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.Key Words: Sleep disorders, End-stage renal disease, Hemodialysis, Continuous ambulatory, Peritoneal dialysis"