Sleep Disturbances Among Dialysis Patients

Abstract

Sleep disturbances are extremely common among dialysis patients. Subjective sleep complaints are reported in up to 80% of patients and are characterized by difficulty in initiating and maintaining sleep, problems with restlessness, jerking legs, snoring, choking sensations and/or daytime sleepiness (Holley et al., 1992; Walker et al., 1995; Veiga et al., 1997). Epidemiological studies have found how sleep apnea syndrome (SAS), restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) are much more prevalent than in the general population. These sleep problems appear to have significant negative effects on the quality of life as they are often cited as major sources of stress. Indeed, interviews of patients on hemodialysis and on peritoneal dialysis have found that sleep disturbances are one of the seven most distressing symptoms experienced (Eichel et al., 1986; Bass et al., 1999). Half of patients complaining of sleep disturbances feel that these problems affect their daily living and activity, and 21% consider that relief of this symptom would improve significantly their subjective quality of life (Parfrey et al., 1988; Iliescu et al., 2003). In the following sections two major sleep disturbances associated with Insomnia, Restless Legs Syndrome and Sleep Apnea Syndrome, will be reviewed in detail.