+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prevalence and Correlates of Insomnia and Obstructive Sleep Apnea in Chronic Kidney Disease


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Poor sleep quality, insomnia, and restless legs syndrome (RLS) and sleep apnea are common in patients with chronic kidney disease (CKD). Clinical correlates of these problems are poorly understood.


          This study was to find out the prevalence and correlates of insomnia and subjects with ‘high risk for obstructive sleep apnea (OSA)’ in adults with chronic kidney disease.

          Materials and Methods:

          One hundred and four adults with CKD were included. Their demographic data, details regarding kidney disease and hemodialysis (HD) were recorded. Presence of insomnia and its severity was assessed. They were screened for sleep apnea using a validated questionnaire.


          Average age was 54.17 (± 12.96) years. 89.4% had stage 5 nephropathy and 78.8% subjects were on regular HD. Males outnumbered females. Insomnia was reported by 35.5%. Among these, 50% had chronic insomnia. Insomnia subjects had higher prevalence of diabetes ( P = 0.01) and depression ( P < 0.001). Fifty-one percent subjects were at “high risk for sleep apnea”. They had higher prevalence of diabetes ( P < 0.001), coronary disease ( P = 0.02), insomnia ( P = 0.008), and experienced daytime symptoms of insomnia ( P < 0.001). However, in the logistic regression, only male gender (odds ratio, OR = 13.59) and daytime symptoms of insomnia (OR = 7.34) were found to be associated with “higher risk for sleep apnea”.


          Insomnia was prevalent in CKD. Nearly half of these patients are at high risk for sleep apnea and a third of them suffer from insomnia. Hence, these patients should be screened for sleep disorders.

          Related collections

          Most cited references27

          • Record: found
          • Abstract: found
          • Article: not found

          Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.

          Anthropometry provides the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size, proportions, and composition of the human body. It reflects both health and nutritional status and predicts performance, health, and survival. As such, it is a valuable, but currently underused, tool for guiding public health policy and clinical decisions. This report presents the conclusions and comprehensive recommendations of a WHO Expert Committee for the present and future uses and interpretation of anthropometry. In a section that sets the technical framework for the report, the significance of anthropometric indicators and indices is explained and the principles of applied biostatistics and epidemiology that underlie their various uses are discussed. Subsequent sections provide detailed guidance on the use and interpretation of anthropometric measurements in pregnant and lactating women, newborn infants, infants and children, adolescents, overweight and thin adults, and adults aged 60 years and over. With a similar format for each section, the report assesses specific applications of anthropometry in individuals and populations for purposes of screening and for targeting and evaluating interventions. Advice on data management and analysis is offered, and methods of taking particular measurements are described. Each section also includes a discussion of the extent, reliability and universal relevance of existing reference data. An extensive series of reference data recommended by the Expert Committee and not widely distributed by WHO hitherto is included in an annex.
            • Record: found
            • Abstract: found
            • Article: not found

            Prediction of creatinine clearance from serum creatinine.

            A formula has been developed to predict creatinine clearance (Ccr) from serum creatinine (Scr) in adult males: (see article)(15% less in females). Derivation included the relationship found between age and 24-hour creatinine excretion/kg in 249 patients aged 18-92. Values for Ccr were predicted by this formula and four other methods and the results compared with the means of two 24-hour Ccr's measured in 236 patients. The above formula gave a correlation coefficient between predicted and mean measured Ccr's of 0.83; on average, the difference predicted and mean measured values was no greater than that between paired clearances. Factors for age and body weight must be included for reasonable prediction.
              • Record: found
              • Abstract: found
              • Article: not found

              A systematic review of screening questionnaires for obstructive sleep apnea.

              Obstructive sleep apnea (OSA) may lead to life-threatening problems if it is left undiagnosed. Polysomnography is the "gold standard" for OSA diagnosis; however, it is expensive and not widely available. The objective of this systematic review is to identify and evaluate the available questionnaires for screening OSA. We carried out a literature search through MEDLINE, EMBASE, and CINAHL to identify eligible studies. The methodological validity of each study was assessed using the Cochrane Methods Group's guideline. Ten studies (n = 1,484 patients) met the inclusion criteria. The Berlin questionnaire was the most common questionnaire (four studies) followed by the Wisconsin sleep questionnaire (two studies). Four studies were conducted exclusively on "sleep-disorder patients", and six studies were conducted on "patients without history of sleep disorders". For the first group, pooled sensitivity was 72.0% (95% confidence interval [CI]: 66.0-78.0%; I(2) = 23.0%) and pooled specificity was 61.0% (95% CI: 55.0-67.0%; I(2) = 43.8%). For the second group, pooled sensitivity was 77.0% (95% CI: 73.0-80.0%; I(2) = 78.1%) and pooled specificity was 53.0% (95% CI: 50-57%; I(2) = 88.8%). The risk of verification bias could not be eliminated in eight studies due to insufficient reporting. Studies on snoring, tiredness, observed apnea, and high blood pressure (STOP) and STOP including body mass index, age, neck circumference, gender (Bang) questionnaires had the highest methodological quality. The existing evidence regarding the accuracy of OSA questionnaires is associated with promising but inconsistent results. This inconsistency could be due to studies with heterogeneous design (population, questionnaire type, validity). STOP and STOP-Bang questionnaires for screening of OSA in the surgical population are suggested due to their higher methodological quality and easy-to-use features.

                Author and article information

                N Am J Med Sci
                N Am J Med Sci
                North American Journal of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                November 2013
                : 5
                : 11
                : 641-646
                [1 ] Department of Nephrology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India
                [2 ][4 ] Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, Dehradun, Uttarakhand, India
                Author notes
                Address for correspondence: Dr. Ravi Gupta, Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Doiwala, 248-140, Dehradun, Uttarakhand, India. E-mail: sleepdoc.ravi@ 123456gmail.com
                Copyright: © North American Journal of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article

                chronic kidney disease,hemodialysis,insomnia,obstructive sleep apnea
                chronic kidney disease, hemodialysis, insomnia, obstructive sleep apnea


                Comment on this article