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NDT Advance Access originally published online on May 25, 2004
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Nephrol Dial Transplant (2004) 19: 1815-1822
Nephrol Dial Transplant Vol. 19 No. 7 © ERA-EDTA 2004; all rights reserved

Original Article

Sleep disorders and illness intrusiveness in patients on chronic dialysis

Istvan Mucsi1,2,3, Miklos Zs. Molnar, MD1,4, Janos Rethelyi1, Eszter Vamos1, Gabor Csepanyi1, Gyorgyi Tompa5, Szabolcs Barotfi1,6, Adrienn Marton2 and Marta Novak1,7

1 Psychonephrology Study Group, Institute of Behavioral Sciences and 2 1st Department of Internal Medicine, Semmelweis University Budapest, 4 2nd Department of Internal Medicine, St Margaret Hospital, 5 Nephrocentrum Foundation and 6 Quintiles Hungary Ltd, Budapest, Hungary, 3 Department of Medicine, Faculty of Medicine and 7 Sleep Research Laboratory, Department of Psychiatry, University Health Network, University of Toronto, Canada

Correspondence and offprint requests to: Dr Istvan Mucsi, 21 Mayfair Avenue, Apt. 414, Toronto, ON M5N 2N5 Canada. Email: mucsist{at}net.sote.hu

Background. The prevalence of sleep problems (insomnia, restless legs syndrome, periodic limb movements in sleep and sleep apnoea) has been shown to be high in patients with end-stage renal disease (ESRD) and might contribute to impaired quality of life in this population.

Methods. In a cross-sectional study using self-administered questionnaires, we examined the prevalence of sleep disorders and assessed their effect on different aspects of health-related quality of life in a sample of Hungarian patients on maintenance dialysis.

Results. Our data confirm that sleep problems are frequent in patients with ESRD; 65% of the patients reported symptoms of at least one specific sleep disorder; insomnia was the most common sleep complaint with 49%, the prevalence of sleep apnoea was 32% and the prevalence of restless legs syndrome was 15%. Co-morbidity, assessed by the End-Stage Renal Disease Severity Index, was shown to be an independent predictor of sleep disorders. Patients with sleep disorders reported higher illness intrusiveness and worse self-perceived health than those without sleep problems. The presence of sleep disorders was an independent predictor of illness intrusiveness, an important determinant of health-related quality of life.

Conclusion. Sleep disorders are important determinants of illness intrusiveness and health-related quality of life in patients with ESRD. Sleep problems may be treated successfully; therefore, more attention should be paid to assessing these problems in this patient population.

Keywords: illness intrusiveness; insomnia; restless legs syndrome; self-perceived health; sleep apnoea; sleep disorders


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