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NDT Advance Access originally published online on September 11, 2008
Nephrology Dialysis Transplantation 2009 24(1):8-14; doi:10.1093/ndt/gfn510
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Obstructive sleep apnoea: clinical signs, diagnosis and treatment

Uwe Kuhlmann1, Felix Georg Bormann1 and Heinrich Friedrich Becker2

1 Philipps-Universität Marburg, Klinik für Innere Medizin, SP Nephrologie, Baldingerstrasse, 35033 Marburg 2 AK Barmbek, Pneumologie und Internistische Intensivmedizin, Rübenkamp 220, 22291 Hamburg, Germany

Uwe Kuhlmann, Center of Internal Medicine, Department of Nephrology Philipps University Marburg, 35033, Marburg, Germany. Tel: +49-06421-28-63786; Fax: +49-06421-28-66365; E-mail: kuhlmann@med.uni-marburg.de

Keywords: chronic kidney disease; sleep; sleep apnoea; sleep disorders

The first 150 words of the full text of this article appear below.



   Normal and disturbed sleep
 
Humans spend one-third of their lifetime sleeping. It has only been ~50 years since it was recognized that sleep is not simply a passive state characterized by the absence of wakefulness, but rather a condition that has a typical structure with electrophysiologically, clearly distinguishable phases that follow one another according to a characteristic pattern in healthy subjects. Using electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG), sleep is classified as rapid eye movement (REM) sleep or one of four different non-REM sleep stages. Altogether, one spends ~20–25% of the total sleep time in deep sleep and REM sleep, respectively, and ~50% in light sleep. After the age of 50, the percentage of deep and REM sleep decreases, whereas light sleep and periods of wakefulness during the night increases.

During the night, 4–6 sleep cycles are completed lasting 70–90 min and consisting of an initial period of light sleep, followed by deep . . . [Full Text of this Article]



   Breathing during sleep and sleep-disordered breathing
 


   Sleep apnoea
 


   Symptoms suggestive of sleep apnoea
 


   Obstructive sleep apnoea and cardiovascular diseases
 


   Sleep apnoea and chronic kidney disease
 


   Diagnostic procedures
 


   Interventions with obstructive sleep-related breathing disorder (SRBD)
 


   General measures
 


   Therapy with positive ventilation pressure
 


   BiPAP, PPAP and automatic nCPAP
 


   Risks and side effects
 


   Effects
 

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