Sleep and quality of life in renal disease

Abstract

Chronic kidney disease (CKD) leading to renal insufficiency and failure is a growing health care problem. It is well established that patients with end-stage renal disease (ESRD) have a diminished quality of life (QOL), as well as increased sleep complaints. Much less is known about individuals with early-stage CKD who do not require dialysis. Sleep disturbance appears to be part of the uremic syndrome, and manifests as excessive daytime sleepiness, changes in sleep architecture, sleep-disordered breathing/sleep apnea, and periodic limb movements (PLMs)/restless legs syndrome. Numerous studies in patients with ESRD have associated sleep disturbances with poor QOL, but very limited data exist on pre-dialysis CKD patients. There is increasing evidence that correction of uremia by intensification of dialysis or renal transplantation can improve sleep disturbances, as well as perceived QOL. These and other treatments for sleep disorders used in the general population require further research to demonstrate efficacy and the impact on QOL in patients with all stages of CKD. © 2008 Humana Press, Totowa, NJ.