Approximately half of patients with advanced CKD have trouble falling asleep

April 01, 2022

2 min read


Disclosures: Tan reports no relevant financial disclosures.

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Among patients with chronic kidney disease, nearly half experience insomnia and poor sleep, but kidney transplantation treatment may help, according to data published in Kidney Medicine.

Further, investigators found insomnia prevalence was higher among patients receiving kidney replacement therapy.

Infographic about sleep disorders
Data were derived from Tan LH, et al. Kidney Med. 2022;doi:10.1016/j.xkme.2022.100458.

“Although many studies have reported the prevalence of insomnia and poor sleep among patients with CKD, relatively less attention has been paid to quantitative syntheses related to studies on insomnia or poor sleep prevalence on a global scale,” Lek-Hong Tan, MD, MPH, from the department of medicine at China Medical University Hospital and College of Medicine in Taiwan, and colleagues wrote. They added, “To fill this knowledge gap, this systematic review and meta-analysis synthesized existing findings on the prevalence estimates for insomnia, poor sleep quality, patient-reported symptoms of insomnia and sleep disturbance in patients across the different CKD stages. We explored variations in prevalence estimates by investigating the effects that different CKD stages, diagnostic criteria, demographics and methodological characteristics have on such estimates.”

In a systematic review and meta-analysis, researchers searched for studies on PubMed, Embase and PsycNET for the time between Jan. 1, 1990, and Sept. 28, 2018, for studies that evaluated sleep disorders in patients with CKD, on hemodialysis, on peritoneal dialysis and who received kidney transplantations. Of the 3,708 studies found, researchers selected 93 for the analysis.

Using random-effects metaanalysis, researchers estimated and stratified pooled prevalence of poor sleep quality and insomnia according to age, CKD state, WHO region, risk of bias, Pittsburg Sleep Quality Index score and the different criteria for insomnia that were used at diagnosis.

Analyses revealed the pooled prevalence of poor sleep quality for those with CKD without kidney replacement therapy, hemodialysis, PD and kidney transplantation was 59%, 68%, 67% and 46%, respectively. Similarly, the prevalence of insomnia was 48%, 46%, 61% and 26%, respectively. Among patients receiving hemodialysis or PD, kidney transplantation “significantly reduced the prevalence of insomnia.”

Researchers identified a higher prevalence of insomnia among aged 51 to 60 years and older than among patients younger than 50 years. Additionally, of all the WHO regions, insomnia was least prevalent in Europe.

“In summary, insomnia and poor sleep quality are pervasive in patients with CKD, and kidney transplantation treatment may solve those problems. The actual prognostic benefits resulting from the improvement of sleep hygiene in patients with CKD warrant further investigation,” Tan and colleagues wrote. “More research, such as intervention trials, is also required to assess the effectiveness and potentially harmful consequences of the current treatments for sleep disturbances associated with CKD.”

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