Effects of sleep apnea and kidney dysfunction on objective sleep quality in nondialyzed patients with chronic kidney disease: an ESADA study

Maria Rosaria Bonsignore, Haralampos Gouveris, Athanasia Pataka, Ulla Anttalainen, Gabriel Roisman, Izolde Bouloukaki, Jan Hedner, Jean-Louis Pépin, Maria R. Bonsignore, Walter T. Mcnicholas, Pawel Sliwinski, Sophia Schiza, Brian D. Kent, Ding Zou, John A. Kvamme, Sebastien Bailly, Paschalis Steiropoulos, Ruzena Tkacova, Pierre Escourrou, Johan VerbraeckenThomas Penzel, Gianfranco Parati, Sophia Schiza, Oreste Marrone, Ludger Grote, Gabriel Roisman, Fabio Cibella, Mafalda Von Zeller, Pawel Sliwinski, Ozen K. Basoglu, Ondrej Ludka, Sezai Tasbakan, Renaud Tamisier, Renata Riha, Richard Staats, Martin Pretl, Stefan Mihaicuta, Georgia Trakada, Zoran Dogas, Robert Plywaczewski, Tarja Saaresranta, Johan Verbraecken, Ingo Fietze, Jan Hedner, Ludger Grote, Carolina Lombardi, Holger Hein, Marta Drummond, Ozen K. Basoglu, Pavol Joppa, Silke Ryan

Risultato della ricerca: Articlepeer review

Abstract

STUDY OBJECTIVES: Patients with chronic kidney disease (CKD) often report poor sleep quality, but they commonly exhibit OSA. The aim of this study was to evaluate the influence of OSA severity and of estimated glomerular filtration rate impairment on objective sleep quality in nondialyzed patients with CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73m². METHODS: Polysomnographic sleep characteristics were compared between patients with (n = 430) and without CKD (n = 6,639) in the European Sleep Apnea Database cohort. Comparisons were repeated in 375 patients with CKD and 375 control patients without CKD matched for sleep center, age, sex, and AHI, and in 310 matched CKD and non-CKD patients without psychiatric disturbances. RESULTS: Among all patients with and without CKD, total sleep time was similar but sleep stage N1 (median 8.7% [IQR 4.8-18.0] vs 6.7% [3.6-12.7], respectively) and sleep stage R (12.6% [6.8-17.7] vs 14.2% [8.8-19.8], respectively) significantly differed (P < .0001). No difference in sleep characteristics was observed between matched patients either with or without psychiatric disturbances. After subdividing the matched patients according to AHI tertile (<25, ≥25 to <49, and ≥49 events/h) and estimated glomerular filtration rate (≥60, 45 to <60, <45 mL/min/1.73m²), we found a significant effect of AHI on sleep stages N2, N3, and R (P < .001), but there was no effect of CKD. CONCLUSIONS: In nondialyzed patients with CKD, objective sleep quality is influenced similarly by AHI as in patients without CKD but is not affected by CKD severity. Previously reported poor sleep quality in CKD may partly result from the high prevalence of OSA in CKD.
Lingua originaleEnglish
pagine (da-a)1475-1481
Numero di pagine7
RivistaJournal of Clinical Sleep Medicine
Volume16
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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