Introduction:
Patients with end stage renal disease (ESRD) have been reported to be affected with sleep disorders like insomnia, obstructive sleep apnoea (OSA), hypoventilation, central sleep apnoea, central disorders of hypersomnolence, circadian rhythm sleep–wake disorders, parasomnias and restless legs syndrome. OSA deserves special attention as CKD is a comorbidity of OSA. The objective of this study was to delineate the prevalence of OSA in ESRD patients on hemodialysis(HD) and to document the comorbidities in these patients which might have an association with OSA as well.
Methods:
The study was a descriptive cross- sectional study conducted using a pre-designed pre-tested and semi structured schedule on 75 adult patients with CKD stage 5 on MHD attending the Haemodialysis centre of a tertiary care centre in Kolkata. Stratified sampling was used. The American Academy of Sleep Medicine guidelines for OSA were used for diagnosis, wherein, OSA diagnosis is defined by ≥15 events per hour (with or without OSA symptoms) or ≥5 events per hour with OSA symptoms. Severity of OSA classified according to AHI is defined as mild if 5-14 events per hour, moderate if 15-30 events per hour and severe if ≥ 30 events per hour. Statistical software SPSS 20 was used for the analysis.
Results:
Mean age of the study participants was 62 years. The prevalence of OSA was found to be 65.3%, of whom 42.7% had moderate OSA and 22.6 % had mild disease. Statistically significant association was observed between OSA and increased BMI; presence of alcoholism, hypertension, chronic liver disease; those having lesser frequency of dialysis per week, hypomagnesemia and low ejection fraction. Binary logistic regression analysis showed statistically significant association with increased BMI (p=0.000,95% CI=1.304-2.067) and low ejection fraction (p=0.017,95% CI=0.019-0.682).
Conclusions:
This study highlights the increased prevalence of sinister sleep disorders like OSA in patients on haemodialysis. These patients are mostly obese and have cardiac failure. Screening and detection of OSA enables early treatment with CPAP, which can improve the quality of life.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.